scholarly journals Increasing but inadequate intention to receive Covid-19 vaccination over the first 50 days of impact of the more infectious variant and roll-out of vaccination in UK: indicators for public health messaging

2021 ◽  
Author(s):  
Patrik Bachtiger ◽  
Alexander Adamson ◽  
William A Maclean ◽  
Jennifer K Quint ◽  
Nicholas S Peters
Keyword(s):  
Public Health ◽  
Language Processing ◽  
Herd Immunity ◽  
Vaccine Hesitancy ◽  
Free Text ◽  
New Variant ◽  
The Impact ◽  
To Receive ◽  
Roll Out ◽  
Health Messaging

ABSTRACTObjectivesTo inform critical public health messaging by determining how changes in Covid-19 vaccine hesitancy, attitudes to the priorities for administration, the emergence of new variants and availability of vaccines may affect the trajectory and achievement of herd immunity.Methods>9,000 respondents in an ongoing cross-sectional participatory longitudinal epidemiology study (LoC-19, n=18,581) completed a questionnaire within their personal electronic health record in the week reporting first effective Covid-19 vaccines, and then again after widespread publicity of the increased transmissibility of a new variant (November 13th and December 31st 2020 respectively). Questions covered willingness to receive Covid-19 vaccination and attitudes to prioritisation. Descriptive statistics, unadjusted and adjusted odds ratios (ORs) and natural language processing of free-text responses are reported, and how changes over the first 50 days of both vaccination roll-out and new-variant impact modelling of anticipated transmission rates and the likelihood and time to herd immunity.FindingsCompared with the week reporting the first efficacious vaccine there was a 15% increase in acceptance of Covid-19 vaccination, attributable in one third to the impact of the new variant, with 75% of respondents “shielding” – staying at home and not leaving unless essential – regardless of health status or tier rules. 12.5% of respondents plan to change their behaviour two weeks after completing vaccination compared with 45% intending to do so only when cases have reduced to a low level. Despite the increase from 71% to 86% over this critical 50-day period, modelling of planned uptake of vaccination remains below that required for rapid effective herd immunity – now estimated to be 90 percent in the presence of a new variant escalating R0 to levels requiring further lockdowns. To inform the public messaging essential therefore to improve uptake, age and female gender were, respectively, strongly positively and negatively associated with wanting a vaccine. 22.7% disagreed with the prioritisation list, though 70.3% were against being able to expedite vaccination through payment. Teachers (988, 12.6%) and Black, Asian and Minority Ethnic (BAME) (837, 10.7%) groups were most cited by respondents for prioritisation.InterpretationIn this sample, the growing impact of personal choice among the increasingly informed public highlights a decrease in Covid-19 vaccine hesitancy over time, with news of a new variant motivating increased willingness for vaccination but at levels below what may be required for effective herd immunity. We identify public preferences for next-in-line priorities, headed by teachers and BAME groups, consideration of which will help build trust and community engagement critical for maximising compliance with not only the vaccination programme but also all other public health measures.

Understanding Questions and Concerns Regarding COVID-19 and the COVID-19 Vaccine Among Populations Presenting at a COVID-19 Vaccine Clinic Hub (Preprint)

2021 ◽  
Author(s):  
Hari Krishnakumar ◽  
Taylor Holland ◽  
Monica Martinez ◽  
Lucas Hendrix ◽  
Michael Collins ◽  
...  
Keyword(s):  
Public Health ◽  
General Health ◽  
Healthy Lifestyle ◽  
Severity Of Illness ◽  
Vaccine Safety ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
School Of Nursing ◽  
To Receive ◽  
Health Messaging

BACKGROUND Skepticism among the public surrounding the COVID-19 vaccine is still prevalent despite vaccine-positive communication and many Americans having already received the vaccine. Side effects of the vaccine as well as its expeditious research and development are among the top concerns among those hesitant to receive the coronavirus vaccine. Moreover, there is additional concern regarding correlation between comorbidities and severity of illness due to the coronavirus pandemic. OBJECTIVE To address these areas of concern, we examined the concerns and questions that attendees of the vaccine clinic hub had about the pandemic and the vaccine with the goal of reducing misconceptions and vaccine hesitancy. A secondary aim of the study was to provide public health messaging in the form of an educational video to address the importance of maintaining a healthy lifestyle during the pandemic. METHODS An electronic survey accessible via a QR code on printed flyers was distributed throughout the waiting areas and observation rooms within the COVID-19 vaccine clinic at UT Health San Antonio School of Nursing from April 5-16, 2021. The survey contained questions designed to obtain information on concerns of the clinic attendees, regarding the COVID-19 pandemic and COVID-19 vaccine, as well as concerns about their lifestyle and difficulties with chronic health conditions during the pandemic. The data sets were analyzed qualitatively during this two-week period. RESULTS Out of 510 attendees, 277 attendees had provided 280 responses to the first question about the vaccine and life after they had received the vaccine. Six areas of interest were identified: immunity, future vaccinations, vaccine symptoms, protocol post-vaccination, vaccine safety, and child vaccinations. Regarding the responses collecting attendees’ concerns regarding their general health or health related concerns, several inquiries were identified surrounding the following health problems: diabetes, hypertension, mental health, sedentary lifestyle, and others that constituted a smaller percentage of questions. CONCLUSIONS This study provides a novel perspective on understanding questions and concerns regarding COVID-19, the COVID-19 vaccine, and general health within a vaccinated population. Attendees of the vaccine clinic hub were found to still have questions even after they had received their vaccine, suggesting that eliminating uncertainty surrounding the COVID-19 vaccine is not necessary to motivate individuals to receive the vaccine. Instead, addressing concerns through public health messaging can increase vaccine uptake and promote healthy living.

scholarly journals COVID-19 Vaccine Attitudes and Beliefs: A National Cross-Sectional Survey and Cluster Analysis (Preprint)

2021 ◽  
Author(s):  
Jamie L Benham ◽  
Omid Atabati ◽  
Robert J Oxoby ◽  
Mehdi Mourali ◽  
Blake Shaffer ◽  
...  
Keyword(s):  
Public Health ◽  
Cluster Analysis ◽  
Herd Immunity ◽  
Vaccine Hesitancy ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
African Caribbean ◽  
And Cluster Analysis ◽  
Health Messaging

BACKGROUND There are concerns that vaccine hesitancy may impede COVID-19 vaccine rollout and prevent the achievement of herd immunity. Vaccine hesitancy is a delay in acceptance or refusal of vaccines despite their availability. OBJECTIVE We aimed to identify which people are more and less likely to take a COVID-19 vaccine, and factors associated with vaccine hesitancy to inform public health messaging. METHODS A Canadian cross-sectional survey was conducted in October-November, 2020. Cluster analysis was performed to identify distinct clusters based on intention to take a COVID-19 vaccine, beliefs about COVID-19 and a COVID-19 vaccine, and adherence to non-pharmaceutical interventions. Vaccine hesitancy was measured by respondents answering the question “what would you do if a COVID-19 vaccine were available to you?” Multivariable logistic regression was used to identify factors associated with vaccine hesitancy. RESULTS Of 4,498 participants, 64% reported COVID-19 vaccine hesitancy. Vaccine hesitancy was significantly associated with female sex, lower education level, lower household income, and African/Caribbean/Central and South American ethnicity. Participants that reported vaccine hesitancy were less likely to believe that a COVID-19 vaccine would end the pandemic or that the benefits of a COVID-19 vaccine outweighed the risks. Vaccine hesitancy was associated with higher odds of being concerned about vaccine side effects, lower odds of being influenced by peers or healthcare professionals, and lower trust in government institutions. CONCLUSIONS These findings can be used to inform targeted public health messaging to combat vaccine hesitancy as COVID-19 vaccine administration continues. Messaging related to preventing COVID among friends and family, highlighting the benefits, emphasizing safety and efficacy of COVID-19 vaccination and ensuring healthcare workers are knowledgeable and supported in their vaccination counselling may be effective for vaccine hesitant populations.

scholarly journals Experience with Social Distancing Early in the COVID-19 Pandemic in the United States: Implications for Public Health Messaging

2020 ◽  
Author(s):  
Ryan C. Moore ◽  
Angela Lee ◽  
Jeffrey T. Hancock ◽  
Meghan Halley ◽  
Eleni Linos
Keyword(s):  
Public Health ◽  
Language Processing ◽  
Compliance Rate ◽  
Age Groups ◽  
The United States ◽  
Free Text ◽  
Social Distancing ◽  
Aged People ◽  
Natural Language Processing Tool ◽  
The Impact

Our goal is to inform ongoing public health policy on the design and communication of COVID-19 social distancing measures to maximize compliance. We assessed the US public’s early experience with the COVID-19 crisis during the period when shelter-in-place orders were widely implemented to understand non-compliance with those orders, sentiment about the crisis, and to compare across age categories associated with different levels of risk. We posted our survey on Twitter, Facebook, and NextDoor on March 14th to March 23rd that included 21 questions including demographics, impact on daily life, actions taken, and difficulties faced.1 We analyzed the free-text responses to the impact question using LIWC, a computational natural language processing tool2, and performed a thematic content analysis of the reasons people gave for non-compliance with social distancing orders. Stanford University’s IRB approved the study.In 9 days, we collected a total of 20,734 responses. 6,573 individuals provided a response (≥30 words) to the question, “Tell us how the coronavirus crisis is impacting your life.” Our data (Figure 1) show that younger people (18-31) are more emotionally negative, self-centered, and less concerned with family, while middle-aged people are group-oriented (32-44) and focused on family (32-64) (all p values < .05 corrected for multiple comparisons). Unsurprisingly, the oldest and most at-risk group (65+) are more focused on biological terms (e.g., health-related topics), but were surprisingly low in anxiety and high in emotionally positive terms relative to those at lower risk.We also content-analyzed 7,355 responses (kappa’s > .75) to the question, “What are the reasons you are not self-isolating more?” Of these participants, 39.8% reported not being compliant, with the youngest group (18-31) having the lowest compliance rate (52.4%) compared to the other age groups (all > 60%; all p values < .01). Table 1 describes the seven primary themes for non-compliance. Non-essential work requirements, concerns about mental and physical health, and the belief that other precautions were sufficient were the most common reasons, although other rationales included wanting to continue everyday activities and beliefs that society is over-reacting. Childcare was an important concern for a subset of respondents.Overall, our findings suggest that public health messages should focus on young people and 1) address their negative affect, 2) refocus their self-orientation by emphasizing the importance of individual behavior to group-level health outcomes, and 3) target the specific rationales that different people have regarding the pandemic to maximize compliance with social distancing.

scholarly journals Are public health measures and individualised care compatible in the face of a pandemic? A national observational study of bereaved relatives’ experiences during the COVID-19 pandemic

2021 ◽  
pp. 026921632110198
Author(s):  
Catriona R Mayland ◽  
Rosemary Hughes ◽  
Steven Lane ◽  
Tamsin McGlinchey ◽  
Warren Donnellan ◽  
...  
Keyword(s):  
Public Health ◽  
Family Support ◽  
Online Survey ◽  
Free Text ◽  
Professional Networks ◽  
Dying Patients ◽  
The Face ◽  
Individualised Care ◽  
The Impact ◽  
Informative Communication

Background: COVID-19 public health restrictions have affected end-of-life care experiences for dying patients and their families. Aim: To explore bereaved relatives’ experiences of quality of care and family support provided during the last days of life; to identify the impact of factors associated with perceived support. Design: A national, observational, open online survey was developed and disseminated via social media, public fora and professional networks (June–September 2020). Validated instruments and purposively designed questions assessed experiences. Analysis used descriptive statistics, logistic regression and thematic analysis of free-text responses. Participants: Individuals (⩾18 years) who had experienced the death of a relative/friend (all care settings) within the United Kingdome during the COVID-19 pandemic. Results: Respondents ( n = 278, mean 53.4 years) tended to be female ( n = 216, 78%); over half were ‘son/daughter’ (174, 62.6%) to the deceased. Deceased individuals (mean 81.6 years) most frequently died in their ‘usual place of care’ ( n = 192, 69.3%). Analysis established five conceptual themes affecting individualised care: (1) public health restrictions compounding the distress of ‘not knowing’; (2) disparate views about support from doctors and nurses; (3) challenges in communication and level of preparedness for the death; (4) delivery of compassionate care; (5) emotional needs and potential impact on grief. Male respondents (OR 2.9, p = 0.03) and those able to visit (OR 2.2, p = 0.04) were independently associated with good perceptions of family support. Conclusion: Despite public health restrictions, individualised care can be enabled by proactive, informative communication; recognising dying in a timely manner and facilitating the ability to be present before death.

Understanding vaccine hesitancy: the evidence

2021 ◽  
Vol 32 (7) ◽  
pp. 282-287
Author(s):  
Alison While
Keyword(s):  
Public Health ◽  
Health Professionals ◽  
Herd Immunity ◽  
Public Health Intervention ◽  
Health Intervention ◽  
Vaccine Hesitancy ◽  
Important Public Health ◽  
Positive Attitudes ◽  
The Uk

Vaccine hesitancy is a concern both globally and within the UK. Alison While reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield ‘herd’ immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations.

scholarly journals Application of natural language processing methods to extract coded data from administrative data held in the Scottish Prescribing Information System

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Clifford Nangle ◽  
Stuart McTaggart ◽  
Margaret MacLeod ◽  
Jackie Caldwell ◽  
Marion Bennie
Keyword(s):  
Information System ◽  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Drug Exposure ◽  
Drug Dose ◽  
Free Text ◽  
Wide Range ◽  
The Impact ◽  
Prescribing Information

ABSTRACT ObjectivesThe Prescribing Information System (PIS) datamart, hosted by NHS National Services Scotland receives around 90 million electronic prescription messages per year from GP practices across Scotland. Prescription messages contain information including drug name, quantity and strength stored as coded, machine readable, data while prescription dose instructions are unstructured free text and difficult to interpret and analyse in volume. The aim, using Natural Language Processing (NLP), was to extract drug dose amount, unit and frequency metadata from freely typed text in dose instructions to support calculating the intended number of days’ treatment. This then allows comparison with actual prescription frequency, treatment adherence and the impact upon prescribing safety and effectiveness. ApproachAn NLP algorithm was developed using the Ciao implementation of Prolog to extract dose amount, unit and frequency metadata from dose instructions held in the PIS datamart for drugs used in the treatment of gastrointestinal, cardiovascular and respiratory disease. Accuracy estimates were obtained by randomly sampling 0.1% of the distinct dose instructions from source records, comparing these with metadata extracted by the algorithm and an iterative approach was used to modify the algorithm to increase accuracy and coverage. ResultsThe NLP algorithm was applied to 39,943,465 prescription instructions issued in 2014, consisting of 575,340 distinct dose instructions. For drugs used in the gastrointestinal, cardiovascular and respiratory systems (i.e. chapters 1, 2 and 3 of the British National Formulary (BNF)) the NLP algorithm successfully extracted drug dose amount, unit and frequency metadata from 95.1%, 98.5% and 97.4% of prescriptions respectively. However, instructions containing terms such as ‘as directed’ or ‘as required’ reduce the usability of the metadata by making it difficult to calculate the total dose intended for a specific time period as 7.9%, 0.9% and 27.9% of dose instructions contained terms meaning ‘as required’ while 3.2%, 3.7% and 4.0% contained terms meaning ‘as directed’, for drugs used in BNF chapters 1, 2 and 3 respectively. ConclusionThe NLP algorithm developed can extract dose, unit and frequency metadata from text found in prescriptions issued to treat a wide range of conditions and this information may be used to support calculating treatment durations, medicines adherence and cumulative drug exposure. The presence of terms such as ‘as required’ and ‘as directed’ has a negative impact on the usability of the metadata and further work is required to determine the level of impact this has on calculating treatment durations and cumulative drug exposure.

scholarly journals Barriers to hospital electronic public health reporting and implications for the COVID-19 pandemic

2020 ◽  
Vol 27 (8) ◽  
pp. 1306-1309
Author(s):  
A Jay Holmgren ◽  
Nate C Apathy ◽  
Julia Adler-Milstein
Keyword(s):  
Public Health ◽  
Surveillance Data ◽  
Electronic Data ◽  
American Hospital ◽  
American Hospital Association ◽  
Public Health Agencies ◽  
Hospital Referral ◽  
Health Agencies ◽  
The Impact ◽  
To Receive

Abstract We sought to identify barriers to hospital reporting of electronic surveillance data to local, state, and federal public health agencies and the impact on areas projected to be overwhelmed by the COVID-19 pandemic. Using 2018 American Hospital Association data, we identified barriers to surveillance data reporting and combined this with data on the projected impact of the COVID-19 pandemic on hospital capacity at the hospital referral region level. Our results find the most common barrier was public health agencies lacked the capacity to electronically receive data, with 41.2% of all hospitals reporting it. We also identified 31 hospital referral regions in the top quartile of projected bed capacity needed for COVID-19 patients in which over half of hospitals in the area reported that the relevant public health agency was unable to receive electronic data. Public health agencies’ inability to receive electronic data is the most prominent hospital-reported barrier to effective syndromic surveillance. This reflects the policy commitment of investing in information technology for hospitals without a concomitant investment in IT infrastructure for state and local public health agencies.

Public Preferences for New Information on Opioids

2019 ◽  
Vol 45 (2) ◽  
pp. 311-339
Author(s):  
Paul F. Testa ◽  
Susan L. Moffitt ◽  
Marie Schenk
Keyword(s):  
Public Health ◽  
Opioid Epidemic ◽  
Information Campaigns ◽  
New Information ◽  
Health Strategy ◽  
Nationally Representative ◽  
Receive Treatment ◽  
Information Treatment ◽  
The Impact ◽  
To Receive

Abstract Context: Educating the public through information campaigns is a commonly used policy approach to public health problems. Yet, experimental methods that assess the impact of information campaigns may misestimate their effects by failing to account for respondents' willingness to receive new information. Methods: This article uses a doubly randomized survey experiment conducted on a nationally representative sample, where some subjects are randomly assigned to an informational treatment about opioids while other subjects are given the choice of whether to receive treatment or not, to examine how public willingness to seek new information shapes the way they update their preferences about policies related to the opioid epidemic. Findings: Among those likely to receive information, treatment has a large positive effect on increasing support for policies that address the opioid epidemic by about one half of a standard deviation. Among those who would avoid this information, preferences appear to be unmoved by treatment. These effects would be missed by standard experimental designs. Conclusion: While redressing information asymmetries is only one part of a public health strategy for addressing the opioid epidemic, our findings highlight the importance of access to and receptiveness toward new information.

Window of Opportunity for New Disease Surveillance: Developing Keyword Lists for Monitoring Mental Health and Injury Through Syndromic Surveillance

2016 ◽  
Vol 11 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Ursula Lauper ◽  
Jian-Hua Chen ◽  
Shao Lin
Keyword(s):  
Public Health ◽  
Mental Health ◽  
New York ◽  
Syndromic Surveillance ◽  
New York State ◽  
Hurricane Sandy ◽  
York State Department ◽  
Free Text ◽  
York State ◽  
The Impact

AbstractStudies have documented the impact that hurricanes have on mental health and injury rates before, during, and after the event. Since timely tracking of these disease patterns is crucial to disaster planning, response, and recovery, syndromic surveillance keyword filters were developed by the New York State Department of Health to study the short- and long-term impacts of Hurricane Sandy. Emergency department syndromic surveillance is recognized as a valuable tool for informing public health activities during and immediately following a disaster. Data typically consist of daily visit reports from hospital emergency departments (EDs) of basic patient data and free-text chief complaints. To develop keyword lists, comparisons were made with existing CDC categories and then integrated with lists from the New York City and New Jersey health departments in a collaborative effort. Two comprehensive lists were developed, each containing multiple subcategories and over 100 keywords for both mental health and injury. The data classifiers using these keywords were used to assess impacts of Sandy on mental health and injuries in New York State. The lists will be validated by comparing the ED chief complaint keyword with the final ICD diagnosis code. (Disaster Med Public Health Preparedness. 2017;11:173–178)

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