Vaccination Behavior Research Articles

Interventions involving nudge theory for COVID-19 vaccination: A systematic review and meta-analysis.

New approaches to mitigate vaccine hesitancy and improve vaccine uptake are urgently needed. Nudging has shown effective results in several health areas. However, the effectiveness of interventions involving nudge theory in increasing COVID-19 vaccination remains unclear. We searched PubMed, Web of Science, and Scopus for randomized controlled trials published before December 31, 2022, to determine whether interventions involving nudge theory improved COVID-19 vaccination behavior and intent. Risk ratio (RR) and a 95% confidence interval (CI) were used as pooled measures to assess vaccination behavior. Intention to vaccinate was reported in a narrative synthesis. Sixteen randomized controlled trials involving 176,125 participants were included. Interventions involving nudge theory weakly boosted the COVID-19 vaccine uptake rate (RR = 1.21, 95% CI [1.07, 1.36], p < .01). Subgroup analysis showed a weak positive effect of social norms (RR = 2.04, 95% CI [1.61, 2.57]), defaults (RR = 1.32, 95% CI [1.03, 1.69]), and salient reminders (RR = 1.19, 95% CI [1.04, 1.36]). Nudge interventions integrating multiple components were more efficacious in increasing vaccination rates compared to nudge alone. The effect of nudging interventions weakened over time (p < .001). Most studies (10 of 11) involving vaccination intention outcomes showed positive or partially positive results. Interventions involving nudge theory can promote COVID-19 vaccination behavior and intentions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Vaccine hesitancy: a structured review from a behavioral perspective (2015–2022)

ABSTRACT Vaccine hesitancy, a complex behavioral phenomenon, poses a significant global health threat and has gained renewed attention amidst the COVID-19 pandemic. This paper scrutinized peer-reviewed literature on vaccine hesitancy published from 2015 to 2022, with a specific focus on behavioral perspectives, utilizing a Theories-Constructs-Variables-Contexts-Methods (TCVCM) framework. The study highlighted prominent theoretical approaches, abstract concepts, research variables, global contexts and academic techniques employed across a selected sample of 138 studies. The result is a consolidated overview of research and schematization of the factors influencing vaccine hesitancy and vaccination behaviors. These include individual-level, contextual, vaccine-specific, organizational, and public-policy-related dynamics. The findings corroborated the complexity of vaccine hesitancy and emphasized the difficulties of pursuing vaccine advocacy. The analysis also identified several directions for future research, and the need to conduct more contextual studies in low- and middle-income nations to bring out the cross-cultural nuances of vaccine hesitancy.

Measuring Vaccine Literacy in Switzerland: How is the situation after COVID-19?

Abstract Background Vaccinations are one of the most effective medical health interventions and one of the most important preventive measures. However, the population is often unsure about vaccination, and the roles and responsibilities of the key actors seem often unclear. To adequately protect the population against vaccine-preventable diseases, the Swiss Confederation, the Cantons and other stakeholders have developed the National Vaccination Strategy and an associated action plan. For its implementation, studies on the population’s knowledge, attitudes, skills, and vaccination behavior are crucial. Thus, the Swiss Federal Office of Public Health launched a study to assess vaccine literacy and its relation to vaccination readiness and behavior in the adult population in Switzerland. Methods A representative sample of 2,500 people living in Switzerland will be surveyed in summer 2024. The online questionnaire will include validated instruments, e.g. the HLS19-VAC Instrument to measure vaccine literacy or the 7C Vaccination Readiness Scale, as well as questions on correlates of vaccine literacy, vaccination readiness and behavior. Results The results of the survey will be presented, with a focus on vaccine literacy, vaccination readiness and behavior and their correlates. Specifically, differences among the three main language regions and between specific population groups will be shown. Further, a comparison with data from previous studies will be presented. Conclusions Despite having an advanced healthcare system, to date Switzerland has only partially reached its objectives in terms of vaccination, both for individual protection and collective immunity. New data on vaccine literacy, vaccination readiness and behavior as well as on the influencing factors are needed, especially after the pandemic, to guide effective future actions and measures to improve the vaccine coverage and public health in Switzerland. Key messages • Due to the COVID-19 pandemic the topic of vaccination in general has received increasing attention and may has changed people’s knowledge and attitudes towards vaccination. • Newest data on vaccine literacy, vaccination readiness and behavior are necessary to inform future, targeted actions and increase vaccine uptake.

Online Media Use and COVID-19 Vaccination in Real-World Personal Networks: Quantitative Study.

Most studies assessing the impact of online media and social media use on COVID-19 vaccine hesitancy predominantly rely on survey data, which often fail to capture the clustering of health opinions and behaviors within real-world networks. In contrast, research using social network analysis aims to uncover the diverse communities and discourse themes related to vaccine support and hesitancy within social media platforms. Despite these advancements, there is a gap in the literature on how a person's social circle affects vaccine acceptance, wherein an important part of social influence stems from offline interactions. We aimed to examine how online media consumption influences vaccination decisions within real-world social networks by analyzing unique quantitative network data collected from Romania, an Eastern European state and member of the European Union. We conducted 83 face-to-face interviews with participants from a living lab in Lerești, a small rural community in Romania, using a personal network analysis framework. This approach involved gathering data on both the respondents and individuals within their social circles (referred to as alters). After excluding cases with missing data, our analysis proceeded with 73% (61/83) of the complete personal networks. To examine the hierarchical structure of alters nested within ego networks, we used a mixed multilevel logistic regression model with random intercepts. The model aimed to predict vaccination status among alters, with the focal independent variable being the respondents' preferred source of health and prevention information. This variable was categorized into 3 types: traditional media, online media (including social media), and a combination of both, with traditional media as the reference category. In this study, we analyzed 61 personal networks, encompassing between 15 and 25 alters each, totaling 1280 alters with valid data across all variables of interest. Our primary findings indicate that alters within personal networks, whose respondents rely solely on online media for health information, exhibit lower vaccination rates (odds ratio [OR] 0.37, 95% CI 0.15-0.92; P=.03). Conversely, the transition from exclusive traditional media use to a combination of both traditional and online media does not significantly impact vaccination rate odds (OR 0.75, 95% CI 0.32-1.78; P=.52). In addition, our analysis revealed that alters in personal networks of respondents who received the vaccine are more likely to have received the vaccine themselves (OR 3.75, 95% CI 1.79-7.85; P<.001). Real-world networks combine diverse human interactions and attributes along with consequences on health opinions and behaviors. As individuals' vaccination status is influenced by how their social alters use online media and vaccination behavior, further insights are needed to create tailored communication campaigns and interventions regarding vaccination in areas with low levels of digital health literacy and vaccination rates, as Romania exposes.

Evaluating a WeChat-Based Intervention to Enhance Influenza Vaccination Knowledge, Attitude, and Behavior Among Chinese University Students Residing in the United Kingdom: Controlled, Quasi-Experimental, Mixed Methods Study.

University students, who often live in close quarters and engage in frequent social interaction, face a heightened risk of influenza morbidity. Still, vaccination rates among this group, particularly Chinese students, remain consistently low due to limited awareness and insufficient access to vaccinations. This study examines the effectiveness of a cocreated WeChat-based intervention that targets mainland Chinese university students in the United Kingdom, aiming to improve their knowledge, attitude, and behavior (KAB) toward seasonal influenza vaccination. A quasi-experimental mixed methods design was used, incorporating an intervention and comparison group, with baseline and follow-up self-reported surveys. The study was conducted from December 19, 2022, to January 16, 2023. The primary outcome is the KAB score, which was measured before and after the intervention phases. System-recorded data and user feedback were included in the analysis as secondary outcomes. A series of hypothesis testing methods were applied to test the primary outcomes, and path analysis was used to explore the relationships. Our study included 596 students, of which 303 (50.8%) were in the intervention group and 293 (49.2%) were in the control group. The intervention group showed significant improvements in knowledge, attitude, and intended behavior scores over time, whereas the control group had only a slight increase in intended behavior scores. When comparing changes between the 2 groups, the intervention group displayed significant differences in knowledge and attitude scores compared to the control group, while intended behavior scores did not significantly differ. After the intervention, the actual vaccination rate was slightly higher in the intervention group (63/303, 20.8%) compared to the control group (54/293, 18.4%). Path analysis found that the intervention had a significant direct impact on knowledge but not on attitudes; knowledge strongly influenced attitudes, and both knowledge and attitudes significantly influenced intended behavior; and there was a strong correlation between intended and actual behavior. In the intervention group, participants expressed a high level of satisfaction and positive review of the content and its use. This study demonstrates how a WeChat intervention effectively improves KAB related to seasonal influenza vaccination among Chinese students, highlighting the potential of social media interventions to drive vaccination behavior change. It contributes to the broader research on digital health intervention effectiveness and lays the groundwork for tailoring similar interventions to different health contexts and populations.

Evaluation of the Relationship between Sociodemographic Factors, COVID-19 Fear Levels and Vaccination Status in Patients Applying to Family Medicine Outpatient Clinics in a University Hospital

ABSTRACT Objective: This study has aimed to examine the relationship between sociodemographic factors and COVID-19 fear levels in patients aged 18-65 years and their COVID-19 vaccination status. Methods: The study sample consists of 866 patients aged between 18-65 who applied to the Family Medicine Polyclinics of a university hospital between 01.03.2022 and 01.06.2022. Personal Information Form and Fear of COVID-19 Scale were used to collect data. As the score obtained from the scale increases, the level of fear of COVID-19 increases. The analyzes of the study were done in SPSS 21.0 package program. Kruskal Wallis test and Mann Whitney U test were used for comparisons. Results: 52.3% of the participants in the study were women and the mean age was 36.59±12.32 years. Compared to men, women's fear of coronavirus was statistically significantly higher. The coronavirus fear levels of those who received at least one dose of vaccine compared to those who did not get vaccinated at all, and those who received more doses of vaccines compared to those who received only one dose were found to be statistically significantly higher. Conclusion: As the level of fear of COVID-19 increased, it was determined that the vaccination behavior of individuals was positively affected. COVID-19 is a vaccine preventable disease. With vaccination in all healthcare institutions, it will be possible to prevent morbidity and mortality, as well as economic and social losses that may be caused by the COVID-19 pandemic.

COVID-19 vaccine hesitancy in Ethiopia: a latent class analysis

BackgroundDespite evidence demonstrating the effectiveness of the COVID-19 vaccine, vaccine hesitancy has emerged as a major challenge for vaccine uptake. The objective of this study was to classify latent typologies of vaccine hesitant adults in Ethiopia and identify predictors of the latent classes.MethodsWe employed a cross-sectional household survey among 1,112 individuals aged 18 and above who were partially vaccinated (one dose) or not vaccinated at the time of the survey. Data was collected in August 2022. We collected information on participant socio-demographics, COVID-19 knowledge, prevention practices, disease history, and vaccine hesitancy. Latent class analysis was used to classify individuals into categories of vaccine hesitancy. We conducted multinomial logistic regression to test the associations between latent typologies and different demographic and COVID-19 related characteristics of study participants.ResultsUsing latent class analysis we found a four-class solution for vaccine hesitancy typologies. The identified classes were strong vaccine acceptors (30%); vaccine acceptors with some concerns (7%); vaccine sceptics (13%); and vaccine rejectors (50%). In adjusted models with vaccine sceptics as the referent group, those with high COVID-19 vaccine knowledge were significantly more likely to belong to the strong vaccine acceptors class compared to those with low vaccine knowledge (adj. RRR: 17.36, 95% CI: 10.94–27.55). Better COVID-19 prevention practices were also significantly associated with belonging to the vaccine acceptors with some concerns class than the vaccine sceptics class (adj. RRR: 2.13, 95% CI: 1.09–4.16). Those who had one dose of the COVID-19 vaccine were significantly more likely to belong in the vaccine acceptors class than the vaccine sceptics class compared to those who had no dose (adj. RRR: 6.82, 95% CI: 3.06–15.21).ConclusionsHalf of the study participants were in the vaccine rejectors class. Individuals in the vaccine sceptics and rejector classes evidenced lower vaccine knowledge and worse COVD-19 prevention practices and were less likely to have been partially vaccinated. Future program interventions should focus on improving knowledge around the vaccine, decrease rumors and misconceptions, and target individuals who may be more amenable to changing their vaccination attitudes or behaviors like vaccine sceptics or acceptors with some concerns.

The Effects of Behaviorally Informed Messages on COVID-19 Vaccination Intentions and Behavior: Evidence from Randomized Survey Experiments in South Africa

With COVID-19 vaccination rates remaining below optimal levels, scalable interventions to shift vaccination intentions are needed. We embedded two randomized experiments in South Africa’s COVID-19 Vaccine Survey (CVACS) to investigate the potential to change vaccine intentions and behavior. In Experiment 1, 3510 unvaccinated South African adults were randomly assigned to a no-message control group, a social norm message, or a message highlighting that vaccines were free, available and easy to obtain. The free and easy message significantly increased vaccine intentions but did not increase other outcome measures. The social proof message was associated with an increase in self-reported vaccination status at follow-up (not significant at traditional statistical thresholds). In Experiment 2, 3608 unvaccinated South African adults were randomly assigned to a no-message control group, a message highlighting gaining greater freedoms, or a message highlighting being part of the solution to the pandemic. Neither value proposition message increased vaccination intentions. Light-touch and scalable messages informed by behavioral science and social marketing principles may increase vaccination intentions and uptake, However, more attention should be paid to understanding the behavioral barriers experienced by different population segments, and to tailoring and targeting messaging to those barriers and segments.

Improved Methods for Vaccine Effectiveness Studies.

Evaluating the impact of public health investments in vaccination programs is crucial for ensuring their efficiency and effectiveness. Vaccine effectiveness (VE) studies, such as those using the test-negative design (TND), are commonly used to confirm the impact of vaccines and to guide future improvements. The TND, favored for its simplicity and cost efficiency, mitigates biases common in other epidemiological study designs. However, its validity can be compromised by inconsistent symptom definitions and retrospective data application. Here we summarize recent findings that highlight the need to address correlated vaccination behaviors when estimating VE, that suggest using negative control variables to reduce confounding, and that recommend accounting for prior infection history in VE studies to improve accuracy and reliability. These insights are important for refining VE estimation methods.

ANALYSIS OF DETERMINANTS OF COVID-19 VACCINATION BEHAVIOR IN THE ACEH BESAR COMMUNITY

The COVID-19 vaccination program is one of the Government's policies to prevent the spread of COVID-19 disease. Some people in Aceh Besar receive and participate in vaccinations voluntarily. However, there are some people who take vaccinations because they are forced to and there are also those who refuse vaccination. This community behavior has greatly influenced the achievement of COVID-19 vaccination in Aceh Besar. In mid-February 2022, the achievement of the first dose of COVID-19 vaccination in Aceh Besar reached 90.5% and the achievement of the second dose was still low at only 47%. Objective : analyze the relationship between Perceived Behavioral Control and behavior, analyze the relationship between Actual Behavioral Control and behavior and analyze the relationship between Actual Behavioral Control and Perceived Behavioral Control. Method : This research is a quantitative research with a cross sectional research design. Sampling using cluster sampling. The respondents were determined to be 384 people. Data analysis with Spearman Correlation using the SPSS application. Results : There is a significant relationship between Perceived Behavioral Control and behavior, between Actual Behavioral Control and behavior, and between Actual Behavioral Control and Perceived Behavioral Control (p-value 0.000). There is a fairly strong relationship between Perceived Behavioral Control and behavior (r = 0.433). There is a fairly strong relationship between Actual Behavioral Control and behavior (r = 0.502). There is a strong relationship between Actual Behavioral Control and Perceived Behavioral Control (r = 0.725). Conclusion : Actual Behavioral Control influences COVID-19 vaccination behavior in the people of Aceh Besar more than Perceived Behavioral Control.

Racial disparities in Phase 1 COVID-19 vaccine shipments to Neighborhood sites in Pennsylvania by the Federal Retail Pharmacy Program

Early racial disparities in COVID-19 vaccination rates have been attributed primarily to personal vaccine attitudes and behavior. Little attention has been paid to the possibility that inequitable vaccine distribution may have contributed to racial disparities in vaccine uptake when supplies were most scarce. We test the hypothesis that scarce vaccines were distributed inequitably using the shipping addresses of 385,930 COVID-19 vaccine doses distributed in the first 17 weeks of Pennsylvania’s Phase 1 rollout (December 14, 2020 through April 12, 2021). All shipments we analyze were allocated via the Federal Retail Pharmacy Program, a public-private partnership coordinated by the Centers for Disease Control and Prevention.Overall, White people had an average of 81.4% more retail pharmacy program doses shipped to their neighborhoods than did Black people. Regression models reveal that weekly vaccine allocations determined by pharmacy chains—rather than initial shipment and administration site decisions requiring state and federal approval—drove these effects. All findings remained consistent after controlling for neighborhood differences in income, population density, insurance coverage, number of pharmacies, and other social determinants of health.Our findings suggest that the private distribution of scarce public resources should be assessed for racial impact, regulated as public resources, and monitored continuously.

Attitudes towards Maternal Immunisation of Polish Mothers: A Cross-Sectional, Non-Representative Study.

Vaccination protects pregnant women against dangerous infectious diseases and contributes to disease prevention for the child until their vaccination schedule begins. Vaccination behaviour is related to attitudes concerning vaccine prevention. This cross-sectional, non-representative study was conducted among Polish mothers using a diagnostic survey. We used the Vaccination Attitudes Examination (VAX) Scale. The author's questionnaire included questions concerning experiences with adult and maternal vaccinations, as well as sociodemographic data. Among the 375 respondents, more than half (n = 208, 55.47%) received at least one vaccine during pregnancy. The majority of respondents had a university education (n = 356, 94.93%). There was no statistically significant difference in terms of receiving vaccines during pregnancy between respondents with and without a healthcare education (p = 0.230). A logistic regression model indicated that women who were vaccinated outside pregnancy for COVID-19 (OR 4.61, 2.60-8.22) and influenza (OR 7.14, 3.58-14.25) were statistically significantly more likely to be vaccinated during pregnancy. There were statistically significant differences between women who were vaccinated during pregnancy and those who did not receive maternal immunisation in three subscales of the VAX Scale: Mistrust of Vaccine Benefit, Concerns about Commercial Profiteering, and Preference for Natural Immunity (p < 0.001). The most frequently indicated reason for a woman's decision to be vaccinated was concern for the health and safety of the unborn child (n = 196, 94.23%). In contrast, women who were not vaccinated reported fear for the health and safety of the unborn child (n = 88, 52.69%). A key point may be to contribute to the vaccinology education of healthcare professionals, who play an important role in pregnant women's decision to be vaccinated. However, our results may be disrupted because the majority of the women in our study had a university education.

Trust and needles: how perceptions of inequality shape vaccination in South Korea

This study investigates the influence of perceived inequality on vaccination behaviors within the social context of South Korea. It explores how perceptions of inequality affect trust in science and society, subsequently impacting vaccination behaviors. The first analysis utilizes path analysis to identify both direct and indirect effects of perceived inequality on COVID-19 vaccine-related attitudes, mediated by trust in science and society. This provides foundational insights into these relationships at the individual level. The second analysis expands the scope to district-level data, analyzing influenza vaccination records from 2015 to 2021 to validate and enhance the initial findings. These results suggest that the public uses perceptions of inequality and regional economic disparity as heuristics in vaccination decisions. This study contributes to academic discourse by elucidating factors influencing vaccination behavior. It highlights the critical role of subjective sense of inequality in shaping public health policy, especially in response to emerging infectious diseases and future pandemics.

Moral values and vaccination behavior in Russia during the COVID-19 pandemic

ObjectiveEffective persuasive communication necessitates message matching; the conveyed message should resonate with the recipient's characteristics, including individual moral values. While studies examining the relationship between moral values and vaccination behavior have been conducted in a limited number of countries, this study seeks to provide evidence on this relationship beyond Western democracies. MethodsA cross-sectional online survey was conducted from November 4 to December 17, 2021, in Russia. Participants reported their COVID-19 vaccination behavior and completed the Moral Foundations Questionnaire, designed to measure the endorsement of moral values (n = 415). Regression analysis was employed to assess the association between each moral foundation and COVID-19 vaccination behavior. ResultsOur findings indicate that the moral foundations of Care, Loyalty, Fairness, and Sanctity significantly influence vaccination behavior. Individuals who strongly endorse Fairness (AME = −0.019; 95 % CI = −0.033, −0.005) and Sanctity (AME = −0.016; 95 % CI = −0.031, −0.002) were less likely to be vaccinated. Conversely, individuals endorsing Care (AME = −0.018; 95 % CI = −0.031, −0.005) and Loyalty (AME = −0.015; 95 % CI = −0.028, −0.001) were less likely to report refusal of vaccination. These results remain robust after adjusting for sociodemographic variables related to vaccination barriers. ConclusionOur findings carry public health implications; an understanding of the moral psychology underlying vaccination behavior can facilitate more targeted and effective health communication. Employing skillfully crafted moral appeals may mitigate negative attitudes toward vaccination and enhance vaccination rates.

Dissatisfaction with working conditions associated with lower vaccine confidence, commitment and behaviors among nurses: A large scale cross-sectional survey in France

BackgroundBefore, during, and after the COVID-19 pandemic, doctor shortages led many countries to expand nurses' role in their mass vaccination programs. Nonetheless, nurses often express marked vaccine hesitancy. Simultaneously, their working conditions have been deteriorating. ObjectivesTo study 1) the association between nurses' perceptions of their working conditions and their vaccination-related behaviors (vaccination recommendations to their patients), and 2) the mediating role in this associations of their trust in health authorities, vaccine confidence, and vaccine proactive efficacy. DesignA cross-sectional survey. SettingsSalaried, community (self-employed) and mixed nurses in France. Participants18,888 nurses registered with the French national order of nurses (ONI, registration is mandatory) (N = 439,323). MethodsIn February 2023, this cross-sectional study used an online questionnaire to survey the nurses mandatorily registered with the French national order of nurses. Seven items adapted from models of psychosocial risk factors at work assessed their satisfaction with their working conditions. The international short version of the Pro-VC-Be (health professionals, vaccine confidence and behaviors) a validated instrument measuring psychosocial determinants of health-care professionals' vaccine behaviors) evaluated their vaccine-related attitudes and behaviors. Multiple group mediation analysis with structural equation modeling measured the associations between satisfaction at work, trust in health authorities, vaccine confidence, proactive efficacy (commitment and self-efficacy) in vaccination, and vaccination recommendations (against seasonal influenza for those with a chronic disease and against COVID-19 among adults). ResultsAmong the 18,888 participants, satisfaction at work had generally deteriorated, and only 47 % considered vaccines safe. Among salaried nurses (61 %), satisfaction at work was statistically significantly associated (p < 10−3) with trust in health authorities (β = 0.26 [0.24; 0.28]), vaccine confidence (total effect: β = 0.35 [0.31; 0.38]), proactive efficacy (total effect: β = 0.18 [0.16; 0.21]), and, to a smaller extent, with seasonal influenza and Covid-19 vaccine recommendations (total effect: β = 0.13 [0.09; 0.16]). Trust in health authorities played a statistically significant role (p < 10−3) mediating the associations of satisfaction at work with vaccine confidence and proactive efficacy. These three dimensions in turn mediated the relation between satisfaction at work and frequency of vaccination recommendations. These relations were similar among community nurses. ConclusionsSatisfaction at work appears to enhance nurses' vaccination attitudes and behaviors, which are likely to reinforce their capacity to promote their patients' vaccination. Significant improvement in their working conditions is needed to enable them to accomplish this role serenely.

Beyond perceived risk: COVID-19 vaccination more strongly linked to individual risk perception in wheat areas than rice areas

Vaccines save lives, but vaccine hesitancy remains a global health challenge. That makes it critical to explore the factors that influence whether people get vaccinated. Perceived risk is a pivotal factor in traditional theories of health behavior, such as the Risk Perception Attitude framework and the Health Belief Model. However, studies have found that these models are less predictive of COVID-19 vaccination in some cultures. Studies that test culture by comparing nations are useful, but nations have different healthcare systems and policies that are hard to equate and control for. We addressed this question by testing regional cultural differences in China. Drawing on the rice theory, we compared residents in China's historical rice-farming areas (which are more interdependent) with those in wheat-farming areas (which are more independent). Our survey data from 1872 participants in 29 provinces found that models of perceived risk explained COVID-19 vaccination mainly in historically wheat-farming areas. Conversely, in historically rice-farming areas, perceived risk did not explain vaccination behavior. These findings suggest that cultural factors that are rooted in historical farming practices influence vaccination behaviors. By comparing regions within the same country, we can rule out confounds of national policy and healthcare systems. These insights could help policymakers understand how to tailor vaccination campaigns to people from different cultures.

Acceptance of COVID-19 vaccine booster doses among the Adult Population in Ghana: a cross-sectional study using the Health Belief Model.

The Health Belief Model (HBM) is a widely utilised framework for understanding vaccination behaviour against COVID-19. This study assessed the acceptance of COVID-19 vaccine booster doses in Ghana and identified predictors using HBM domains, including perceived susceptibility, severity, benefits, barriers, self-efficacy, and cues to action. Additionally, it examined the sources of information about COVID-19 vaccines. We employed a cross-sectional quantitative design, using convenient and snowball sampling methods to recruit participants. Between March 20 and May 10, 2023, 822 Ghanaians completed a predesigned self-administered online survey via commonly used social media platforms (WhatsApp, Facebook, X (Twitter), and LinkedIn). The study used a binary logistic regression to predict COVID-19 booster dose acceptance. The respondents had a mean age of 29.3 ± 6.2, with 55.5 being males, 53.0% being single/never married, 93.7% having tertiary education, 83.0% being Christians, 59.1% were healthcare workers, 57.8% residing in urban areas, 95.5% having no chronic disease, 90.6% reporting negative COVID-19 history, and 78.3% reporting no reported relative/friend infected with COVID-19. The study showed that 81.1% [95% confidence interval (CI) = 78.4 - 83.8%] of respondents received the COVID-19 vaccine, and 58.3% [95% CI = 54.2 - 62.5%] of respondents were willing to accept the COVID-19 booster dose. The main reasons for non-acceptance of COVID-19 vaccine booster doses were personal reasons (41.7%) and experienced side effects or fear of side effects (32.4%). Regression analysis revealed that perceived benefits and perceived barriers (specifically worrying about serious risk factors) were the significant predictors of accepting COVID-19 booster doses in Ghana. Many respondents were willing to receive the COVID-19 booster dose. Personal reasons, fear of side effects, and experienced side effects were the main reasons for refusing COVID-19 booster doses. Perceived benefits and perceived barriers predicted COVID-19 booster dose acceptance in Ghana. Policymakers should consider these factors in designing public health interventions to increase the patronage of COVID-19 booster doses.

Vaccine hesitancy among parents of children in their first two years of life.

Vaccine hesitancy is considered a primary cause of outbreaks of vaccine-preventable infectious diseases. The Austrian vaccination plan includes 24 vaccinations in the first 2 years of life, 12 for free and 12 subject to a fee. Since preterm babies are more susceptible to severe infections, immunization is a vital protection strategy. This study examines the routine immunization schedule recommended for children in Austria, the number of timely vaccinations, and the number of delayed and rejected vaccinations. Possible reasons for vaccination delays and rejection and potential influencing factors (preterm birth, COVID-19 pandemic, information sources) are also analyzed. We included children aged 2 to 5 years who presented to Vienna's largest pediatric center with an Austrian mother-child pass and spent the first 2 years of their lives in Austria. Data was collected using questionnaires about the vaccination status, parents' reasons for any rejections or delays in the recommended vaccination regimen, the impact of the COVID-19 pandemic on individuals' vaccination behavior, and child-specific influencing factors such as preterm birth and socioeconomic factors. 90% of the 150 study subjects follow the recommendations on routine vaccinations, while 40-62% accept vaccinations subject to a fee. Preterm infants received less fee-based (53%) as well as gratuitous (88%) vaccinations. While free vaccinations tend to be delayed, more fee based vaccinations are rejected. With free vaccinations, delays and refusals occur due to illness or missed appointments. In the case of fee- required vaccinations, however, fears of side effects are also one of the main reasons. Due to the COVID-19 pandemic, about a quarter of parents have become more skeptical about vaccines. However, the vaccination rate of premature babies is usually just below that of full-term babies. Physicians remain the most trustworthy source of information about vaccinations. Free vaccinations are more accepted by parents than fee based vaccinations. Preterm babies, which are a high risk group for vaccination preventable diseases, show a lower or delayed vaccination rate, which must be prevented through intensive doctor education. In addition, vaccination hesitancy changed during the COVID-19 pandemic, which needs to be addressed during the medical consultation.

The impact of coronavirus disease 2019 (COVID-19) pandemic experiences on attitudes towards vaccinations: on the social, cultural and political determinants of preferred vaccination organization models in Poland

BackgroundThe article describes attitudes towards vaccinations in Poland in relation to issues such as voluntary versus compulsory vaccinations, the method of financing vaccinations, the method of organizing and carrying out vaccinations, the cognitive and educational aspect of vaccines (how to obtain knowledge about vaccines) and the preferred model of work and research on new vaccines. Taking into account these issues, the authors have created four ideal models of preferred vaccination policies: (a) the market model; (b) the state model; (c) the vaccine hesitancy model; and (d) the civic–social model. This perspective makes it possible to better understand and learn about the various motives behind the attitudes of anti-vaccination movements, as well as to notice cracks and divisions among vaccination supporters and their attitudes towards the financing and organization of vaccinations.MethodsThe study was carried out using the CATI method on a representative random-quota sample of Polish society of 1000 people aged 18 and over. The study took age, sex, education and the size of the place of residence into account.Additionally, in the Socio-demographic factors influencing attitudes towards vaccination practices in Poland section, we used the chi-squared test and regression analysis of factors influencing vaccination practices in Poland. PASW Statistics 18 (a version of SPSS) software was used for statistical analysis. Significant correlations were demonstrated at a significance level of 0.05% Pearson.ResultsThis article has shown that attitudes towards vaccinations are embedded in broader divisions and orientations related to the vision of the social order: the role of the state, the organization of healthcare and payments for vaccinations and medical services, as well as preferred ways of knowledge production in society and work on new vaccines. The political sympathies and the age of the respondents were the most important variables influencing vaccination behaviour. The education of the respondents was less important.ConclusionsA few years after the peak of the pandemic, the scope of anti-vaccination attitudes in Polish society ranges from 20% of the population (dogmatic anti-vaxxers) to 30% (vaccine hesitancy occurring depending on attitudes towards vaccinations).

Understanding the rationales and information environments for early, late, and nonadopters of the COVID-19 vaccine

Anti-vaccine sentiment during the COVID-19 pandemic grew at an alarming rate, leaving much to understand about the relationship between people’s vaccination status and the information they were exposed to. This study investigated the relationship between vaccine behavior, decision rationales, and information exposure on social media over time. Using a cohort study that consisted of a nationally representative survey of American adults, three subpopulations (early adopters, late adopters, and nonadopters) were analyzed through a combination of statistical analysis, network analysis, and semi-supervised topic modeling. The main reasons Americans reported choosing to get vaccinated were safety and health. However, work requirements and travel were more important for late adopters than early adopters (95% CI on OR of [0.121, 0.453]). While late adopters’ and nonadopters’ primary reason for not getting vaccinated was it being too early, late adopters also mentioned safety issues more often and nonadopters mentioned government distrust (95% CI on OR of [0.125, 0.763]). Among those who shared Twitter/X accounts, early adopters and nonadopters followed a larger fraction of highly partisan political accounts compared to late adopters, and late adopters were exposed to more neutral and pro-vaccine messaging than nonadopters. Together, these findings suggest that the decision-making process and the information environments of these subpopulations have notable differences, and any online vaccination campaigns need to consider these differences when attempting to provide accurate vaccine information to all three subpopulations.