Vaccine Hesitancy Research Articles

Does Policy Uncertainty Boost Vaccine Hesitancy? Political Controversy, the FDA and COVID-19 Vaccine Hesitancy in Fall 2020.

Vaccine hesitancy is associated with political and institutional distrust, but there is little research on how people's trust responds to political events. We revisit the fall of 2020 when evaluation of new COVID-19 vaccines collided with an impending national election. Drawing on a political Bayesian perspective, we assess abrupt changes in attention to political events and test hypotheses on subpopulation response: (1) partisan, (2) educational, and (3) ethnic and racial. Analysis of daily changes in news reporting and social media use in 2020, combined with detailed analysis of two-large scale surveys fielded at the time, focusing on questions of COVID-19 vaccine hesitancy and safety concerns about COVID-19 vaccines. Vaccine hesitancy in the US spiked from late August to early October 2020. We identify several plausible triggers for this spike, all pertaining to the FDA and electoral politics. Heightened vaccine hesitancy occurred among Democrats, Asian and Black citizens, as well as college-educated respondents. Turbulence mainly affected those who were initially most trusting in government and vaccines. Asian-American vaccine confidence recovered; that of Black Americans did not. Electoral politics may destabilize citizen assumptions about vaccine authorization and boost uncertainty, thereby undermining public willingness to take approved vaccines.

Does Experience of Vaccination Improve Vaccine Confidence and Trust? Policy Feedback Effects of Mass COVID-19 Vaccination in the United States.

Policy feedback research has demonstrated that a highly tangible policy that shapes public attitudes through direct and day-to-day experiences often reshapes public opinion, with the effect of generating supportive or skeptical constituencies that determine the sustainability of future programs. This paper examines the impact of mass vaccination efforts on attitudes towards vaccines in a context of high vaccine hesitancy in the U.S. We analyzed 73,092 survey responses from 9,229 participants in the longitudinal data from the Understanding America Study project, covering December 2020 to July 2023. Using two-way fixed-effects ordinary least squares regression and ordinal logistic regression, we estimated the changes in attitudes towards vaccines, including trust in vaccine manufacturing and approval processes, following COVID-19 vaccinations. COVID-19 vaccination was associated with improved perceptions of vaccine effectiveness and social benefits and reduced mistrust in vaccine-related processes. However, it did not significantly alleviate concerns regarding vaccine side effects and illness. The strongest effects were observed among respondents initially hesitant but who eventually vaccinated. The experience of COVID-19 vaccination generally improved attitudes and confidence in COVID-19 vaccines among the U.S. public, particularly among vaccine-hesitant people. These effects could have positive impacts on future immunization programs by mitigating vaccine hesitancy.

Perspectives on the Vaccine Debates

Perspectives on the Vaccine Debates

Moral foundations messaging to improve vaccine attitudes: An online randomized experiment from Argentina.

The uptake of routine childhood vaccinations has declined globally since the start of the COVID-19 pandemic, due in part to increased vaccine hesitancy among parents. The Moral Foundations Theory proposes six foundations which can be targeted to increase vaccine uptake. In this study, we tested whether a post by UNICEF with a purity violation message could affect vaccine attitudes among parents in Argentina, where routine immunization coverage has been declining since 2014. Using an online randomized controlled survey experiment, we included 1,511 parents with a child under 12 years in Argentina. Outcomes were measured on the Vaccine Trust Indicator (VTI). We found that the purity violation message significantly affected vaccine attitudes: 80% of the intervention group scored high on the Vaccine Trust Indicator, compared to 73% in the control group (coefficient: 0.33, 95% Confidence Interval 0.20-0.47). Vaccine messaging framed as a purity violation is a promising way to improve vaccine attitudes among parents.

New pedagogical tools for vaccine education: preparing future healthcare workers for the next pandemic.

Vaccine hesitancy (VH) is an issue for healthcare students, influenced by safety concerns and misinformation. The need for better communication training and understanding sociocultural factors in VH was highlighted in a European University Alliance seminar. Practical exercises like simulation role-playing, interprofessional collaboration, and digital literacy may improve vaccine education.

Factors associated with HPV vaccine acceptance and hesitancy in Africa: a systematic review protocol

IntroductionHuman papillomavirus (HPV) infection is the most prevalent sexually transmitted infection worldwide. HPV vaccination is an important tool to prevent and control HPV infection and its complications. Despite carrying the...

Interventions employed to address vaccine hesitancy among Black populations outside of African and Caribbean countries: a scoping review.

Black people are disproportionately affected by structural and social determinants of health, resulting in greater risks of exposure to and deaths from COVID-19. Structural and social determinants of health feed vaccine hesitancy and worsen health disparities. This scoping review explored interventions that have been employed to address vaccine hesitancy among Black population outside of African and Caribbean countries. This review provides several strategies for addressing this deep-rooted public health problem. The scoping review followed the five-step framework outlined by Arksey and O'Malley. It complies with reporting guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Research studies that examined interventions utilized to promote vaccine confidence within Black populations living outside of African and Caribbean countries were reviewed. A total of 20 articles met the inclusion criteria for this study: 17 were quantitative studies and three were mixed-method studies. This scoping review highlighted six themes: educational advancement, messaging, multi-component approaches, outreach efforts, enhancing healthcare access, and healthcare provider leadership. The review identified effective interventions for addressing vaccine hesitancy among Black populations outside Africa and the Caribbean, emphasizing education, multidimensional approaches, and healthcare provider recommendations. It calls for more qualitative research and interventions in countries like Canada and the UK to enhance vaccine confidence and reduce mistrust.

Caregivers’ hesitancy and outright refusal toward children’s COVID-19 vaccination in the Democratic Republic of Congo: A community-based cross-sectional study

ABSTRACT Data from the global South show higher COVID-19-related mortality in children compared to the North. Parents’ willingness to vaccinate their children once COVID-19 vaccines are available is poorly documented. We assessed parents’ willingness to vaccinate their children in the DRC. A year after the vaccination program started, we conducted a population and online-based cross-sectional study, using the WHO modified Behavior and Social Drivers questionnaire among parents and caregivers in the eastern DRC. We performed Modified Poisson regressions to determine factors associated with vaccine hesitancy and outright refusal, focusing on the intention to vaccinate one’s children as our primary outcome. Of the 1709 respondents aged 38 years, 82.56% were unwilling to vaccinate their children, of which 26.80% were hesitant and 55.76% were outright refusals. Drivers of hesitancy were religious refusal of vaccine, non-healthcare status, and caregiver beliefs about vaccine unsafety. Independent predictors of refusal were religious refusal of vaccine, neither healthcare nor student status and belief about vaccine effectiveness, unsafety, and distrust. In addition, both hesitancy and refusal to vaccinate one’s children were driven by not being ready to get vaccinated if recommended or mandated. In contrast, parents’ and caregivers’ trust in the government and readiness to vaccinate themselves reduced hesitancy and outright refusal to vaccinate one’s children, respectively. Briefly, COVID-19 vaccine hesitancy and outright refusal in eastern DRC are influenced by individual (subjective convictions) and system-level factors (government confidence, mandate trust). It is important to address these issues to improve vaccine coverage during disease outbreaks and mitigate public health risks.

Susceptibility to online misinformation: A systematic meta-analysis of demographic and psychological factors

Nearly five billion people use and receive news through social media and there is widespread concern about the negative consequences of misinformation on social media (e.g., election interference, vaccine hesitancy). Despite a burgeoning body of research on misinformation, it remains largely unclear who is susceptible to misinformation and why. To address this, we conducted a systematic individual participant data meta-analysis covering 256,337 unique choices made by 11,561 US-based participants across 31 experiments. Our meta-analysis reveals the impact of key demographic and psychological factors on online misinformation veracity judgments. We also disentangle the ability to discern between true and false news (discrimination ability) from response bias, that is, the tendency to label news as either true (true-news bias) or false (false-news bias). Across all studies, participants were well above-chance accurate for both true (68.51%) and false (67.24%) news headlines. We find that older age, higher analytical thinking skills, and identifying as a Democrat are associated with higher discrimination ability. Additionally, older age and higher analytical thinking skills are associated with a false-news bias (caution). In contrast, ideological congruency (alignment of participants' ideology with news), motivated reflection (higher analytical thinking skills being associated with a greater congruency effect), and self-reported familiarity with news are associated with a true-news bias (naïvety). We also find that experiments on MTurk show higher discrimination ability than those on Lucid. Displaying sources alongside news headlines is associated with improved discrimination ability, with Republicans benefiting more from source display. Our results provide critical insights that can help inform the design of targeted interventions.

Understanding the COVID-19 vaccine uptake, acceptance, and hesitancy in Ethiopia and Tanzania: a scoping review

BackgroundThe development and implementation of COVID-19 vaccines have been a breakthrough in controlling the pandemic. However, the vaccination coverage in most low-income countries remains very low due to critical vaccine shortage and profound hesitancy. In this scoping review, we aimed to assess COVID-19 vaccine uptake, acceptance, and hesitancy in Ethiopia and Tanzania.MethodsThe search was made in PubMed, Scopus, Embase, and Web of Science. Only original research articles focusing on vaccine acceptance and hesitancy were included. The studies selected for a full read were analysed using a thematic analysis approach.FindingsA total of 76 articles were included in the study, with 74 of them coming from Ethiopia. The study found an increasing trend in vaccine uptake over time. However, there was also an increase in hesitancy and a decline in willingness to receive the vaccine. The willingness to receive the COVID-19 vaccine in Ethiopia ranged from 18.5 to 88%. The main reasons for "vaccine hesitancy" included fear of side effects, concerns about long-term safety, doubts about vaccine effectiveness, lack of information, vaccine fast-tracking, and religious beliefs. The study also found that younger individuals, females, and pregnant women were less willing to receive the vaccine. The adverse events reported among vaccinated individuals were mostly mild. Most of the studies operationalised vaccine acceptance-hesitancy as dichotomous variables. However, the historical, political, and socio-cultural context in which vaccine acceptance and hesitancy occur was not given any attention. While there is a good amount of data from Ethiopia describing patterns of vaccine acceptance and hesitancy among different populations over time, there is limited information from Tanzania due to the late arrival of the vaccine and limited published articles.ConclusionWe have observed a paradox involving two seemingly conflicting trends: an increase in vaccination rates/coverage and "anti-vax." Most studies have simplified vaccine acceptance-hesitancy as an “either-or” incident, without considering its dynamic nature and occurrence within a broader political, social, and cultural context. Therefore, it is crucial to explore approaches that can enhance our understanding of the vaccine acceptance-hesitancy phenomenon, in order to improve vaccine trust and uptake.

Prophylactic and therapeutic vaccine development: advancements and challenges.

Biomedical research is fundamental in developing preventive and therapeutic vaccines, serving as a cornerstone of global public health. This review explores the key concepts, methodologies, tools, and challenges in the vaccine development landscape, focusing on transitioning from basic biomedical sciences to clinical applications. Foundational disciplines such as virology, immunology, and molecular biology lay the groundwork for vaccine creation, while recent innovations like messenger RNA (mRNA) technology and reverse vaccinology have transformed the field. Additionally, it highlights the role of pharmaceutical advancements in translating lab discoveries into clinical solutions. Techniques like CRISPR-Cas9, genome sequencing, monoclonal antibodies, and computational modeling have significantly enhanced vaccine precision and efficacy, expediting the development of vaccines against infectious diseases. The review also discusses challenges that continue to hinder progress, including stringent regulatory pathways, vaccine hesitancy, and the rapid emergence of new pathogens. These obstacles underscore the need for interdisciplinary collaboration and the adoption of innovative strategies. Integrating personalized medicine, nanotechnology, and artificial intelligence is expected to revolutionize vaccine science further. By embracing these advancements, biomedical research has the potential to overcome existing challenges and usher in a new era of therapeutic and prophylactic vaccines, ultimately improving global health outcomes. This review emphasizes the critical role of vaccines in combating current and future health threats, advocating for continued investment in biomedical science and technology.

Securing long-term immunity: The possible necessity of supplementary measles vaccination.

The global initiative to eliminate measles, spearheaded by the World Health Organization, has yet to achieve its intended goals. In Turkey, despite robust vaccination strategies, recent increases in measles cases have been attributed to vaccine hesitancy and irregular migration. This study evaluates measles serology within a pediatric population to determine the impact of vaccination regimens on immunity. A retrospective study at Ankara Bilkent City Hospital analyzed serum measles IgG levels in children aged 1-18 years from January 2020 to August 2023. Exclusions were applied for individuals with positive IgM results, incomplete vaccinations, and immunocompromised conditions. Patients were categorized based on their M-M-R®II vaccine status into those having received either one or two doses. Seropositivity was assessed using the ELISA method. Of the 686 children, 30.2% received a single dose, and 69.8% received two doses of the MMR vaccine. Overall, 70.7% exhibited positive IgG levels. No significant differences were found in IgG levels between those who received one dose and those who received two doses. However, a decline in IgG levels was observed with age, particularly notable in adolescents aged 14-18 years. The study reveals seropositivity rates lower than expected, highlighting challenges in achieving WHO targets. This suggests a potential need for booster doses during adolescence to maintain protective antibody levels. The findings emphasize the importance of continued surveillance and research to adapt vaccination strategies effectively and prevent measles outbreaks, particularly considering the decline in antibody levels and diverse vaccination histories across populations.

Confronting Vaccine Hesitancy in India: A Vital Call for Unified Action

Confronting Vaccine Hesitancy in India: A Vital Call for Unified Action

Exploring the factors influencing the adult population's reluctance to accept the COVID-19 vaccine in Tehran.

While evidence of efficacy, safety, and technical feasibility is crucial when introducing a vaccine, it is equally important to consider the psychological, social, and political factors influencing vaccine acceptance. This study aims to identify the factors contributing to COVID-19 vaccine hesitancy among adults in Tehran, Iran. The study employed a descriptive and analytical cross-sectional design carried out from 2021 to 2022. It involved 260 eligible individuals residing in the catchment areas of Tehran and Shahid Beheshti Universities of Medical Sciences who declined to receive the COVID-19 vaccine, selected through systematic sampling. Data collection was accomplished through a researcher-developed questionnaire and analyzed using SPSS 26 software. The analysis utilized descriptive statistics and non-parametric tests including Mann-Whitney U, Kruskal-Wallis, and Multiple Linear Regression, to examine the relationships between variables. The average scores (SD) across dimensions were as follows: the individual's health status and perceived risk, 15.53 (1.70); contextual and social effects, 17.68 (2.53); awareness, 14.81 (2.34); and beliefs and concerns. 14.91 (2.64), indicating a concerning situation regarding contextual and social impacts and a moderate status as to other areas. The primary reasons for vaccine refusal included fear, lack of belief in the vaccine, concerns about its reliability, illness, and lack of access or time. Acceptance of the vaccine was associated with education, occupation, marital status, number of children at home, and income reduction due to COVID-19. The findings indicate that fear, lack of belief in the vaccine, concerns regarding its reliability, illness, and lack of access or time were the most important factors influencing reluctance to receive the vaccine. Health organizations should consider these factors when encouraging the population to receive the COVID-19 vaccine.

Impact of COVID-19 pandemic on influenza vaccination rate among health care workers

ABSTRACT Vaccinations against influenza are critical in mitigating the severity of the disease, preventing its transmission, and restricting its dissemination. Concerns about vaccination hesitancy among healthcare workers (HCWs) have been duly recognized during and following the COVID-19 pandemic. To examine the extent to which the COVID-19 pandemic has influenced the adoption of vaccinations among HCWs. A cross-sectional online survey was conducted four years after the COVID-19 pandemic among HCWs in Saudi Arabia. We performed a logistic regression analysis using influenza vaccination uptake as the dependent variable and perceived COVID-19 pandemic’s impact, age, gender, marital status, employment status, education level, monthly income, respondent’s overall health, doctor visits, tobacco use, number of adults in the household, and number of children in the household as independent variables. The study included 574 participants, an 86% response rate. Of the sample, 47% reported they had the influenza vaccination. HCWs who reported a greater negative impact due to the COVID-19 pandemic were 40% more likely to acquire the influenza vaccine (OR = 1.4, 95% CI [1.24, 1.58]). Compared to HCWs without children, HCWs with a child had a 44% lower likelihood of taking the influenza vaccination (OR = 0.34, 95% CI [0.16, 0.69]). The odds of HCWs obtaining the influenza vaccine were 4.5 times higher for those who reported one yearly medical visit, 2.6 times higher for two, and 1.4 times higher for three or more. HCWs who experienced more severe COVID-19 outcomes were more likely to get vaccinated against the virus. However, long-term monitoring of this inclination is necessary.

Seroprevalence of anti-SARS-CoV-2 IgM and IgG and COVID-19 vaccine uptake in healthy volunteers in Nairobi, Kenya: a cross-sectional study

IntroductionSeroprevalence of anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies in the postvaccination period in Kenya remains to be elucidated. This study aimed to determine the seroprevalence of anti-SARS-CoV-2 IgM and IgG and evaluate Covid-19 vaccination uptake in a university setting in Nairobi.MethodsThis cross-sectional study assayed serum anti-SARS-CoV-2 IgM and IgG levels using enzyme-linked immunosorbent assays. A structured questionnaire was used to determine vaccine uptake, vaccine hesitancy and reasons for hesitancy.ResultsA total of 189 participants were enrolled (median age, 21 years; female, 50.8%). The seroprevalence of anti-SARS-CoV-2 was 12.7% for IgM and 87.8% for IgG. Anti-SARS-CoV-2 IgG titers were higher among the vaccinated vs. non-vaccinated individuals (p < 0.001, U = 2817.5), females vs. males (p = 0.024, U = 3616), and those vaccinated ≤ 6 months before the study vs. those vaccinated >1 year earlier (p = 0.002, H = 12.359). The vaccination hesitancy rate was 43.4% and the underlying reasons included mistrust (22.4%), health concerns (19.7%), and lack of information (18.4%).DiscussionThe high seroprevalence of anti-SARS-CoV-2 IgG is an indication of high exposure to SARS-CoV-2 either through natural infection or through vaccination. The high vaccine hesitancy noted necessitates community engagement, and public education to dispel myths and misinformation prior to roll out of new vaccines and other health interventions.

Assessing acute kidney injury risk after COVID vaccination and infection in a large cohort study

Acute kidney injury (AKI) has been noticed after both COVID-19 vaccination and infection, affecting risk-benefit evaluations and vaccine hesitancy. We conducted a large-scale N3C cohort study to compare AKI incidence following COVID-19 vaccination and infection. Participants from December 2020 to August 2023 were divided into two groups based on their initially observed COVID-19 antigen exposure: COVID-19 vaccination group (n = 2,953,219) and COVID-19 infection group (n = 3,616,802). AKI was defined by diagnostic codes and serum creatinine changes within a 30 day follow-up window after exposure. The absolute risk of AKI was 0.66% in the vaccination group versus 4.88% in the infection group. After adjusting for various confounders, COVID-19 infection was associated with a significantly higher risk of AKI than COVID-19 vaccination (aHR = 10.31, P < 0.001). Our study reveals that COVID-19 vaccination is associated with a significant lower AKI risk compared to COVID-19 infection.

ATTITUDES AND AWARENESS OF THE POPULATION OF CENTRAL AND WESTERN REGIONS OF UKRAINE TOWARDS VACCINATION

In the modern world, vaccination is the most eff ective and evidence- based method of preventing the onset and severity of infectious diseases. Today, the WHO has identifi ed vaccine hesitancy as a global public health threat [25]. The social and cultural background of people infl uences their perception of vaccines, which prompted us to investigate this problem. Aim. To study the infl uence of sociodemographic factors on vaccination attitudes of children and adults in the central and western regions of Ukraine.Materials and methods. A cross- sectional study was conducted, which included a survey of the population of diff erent social status. The study was conducted in accordance with the tenets of the Declaration of Helsinki. The study protocol was approved by the bioethics committee. We also analyzed literature data from PubMed, Medscape and CSC. The work was performed within the framework of the research project 0122U000039 «Improvement of methods of diagnosis, treatment and rehabilitation of the most common diseases of childhood». No confl icts of interest exist.Research results and discussion. 1000 respondents were interviewed by questionnaire from Kyiv, Cherkasy, Kirovograd, Khmelnytsky, Zhytomyr, Chernivtsi, Ternopil, Rivne, Volyn, Ivano- Frankivsk, Lviv regions. The data obtained indicate that barriers to vaccination are caused by low awareness of vaccination, excessive negative infl uence of opinion leaders, prevalence of myths and falsifi cations about vaccination, lack of health care resources and low supply of recommended vaccines, and forced migration. Low awareness and low vaccination coverage are also associated with low awareness among health workers who do not work directly with vaccines, falsifi cation of vaccination data, and the presence of anti-vaccine health workers. The negative attitude of parents towards vaccination is also very important, as it aff ects their children.Conclusions.1. Fear of side eff ects, long-term complications, and doubts about the quality of vaccines have been identifi ed as factors in vaccine refusal.2. The most common groups of vaccine refusers are the elderly (53.3 %) and men (16.8 %).3. The high cost of vaccines that are not included in the list of mandatory vaccines is one of the reasons for the decrease in vaccination rates.4. Improved communication between the doctor and the patient is one of the factors increasing the vaccination rate among the population.5. Information about the availability of vaccines and places of vaccination, peculiarities of the post-vaccination period and information about the possible consequences of ignoring vaccination should be provided in the media (television, radio), especially among the elderly.

Variations in COVID-19 vaccine hesitancy over time: a serial cross-sectional study in five West African countries

ObjectivesThis study aims to identify the factors influencing vaccine hesitancy, willingness and its variation over time in order to inform more responsive strategies for increasing vaccination uptake. The specific objectives...

Children and adolescents’ experiences of mandatory SARS-CoV-2 testing in schools: a cross-sectional survey

BackgroundPublic health measures during the COVID-19 pandemic had dramatic consequences for children and adolescents. However, policy-makers and healthcare researchers did not give sufficient weight to children’s perspectives. One common public...