scholarly journals Trends in COVID-19 vaccination intent, determinants and reasons for vaccine hesitancy: results from repeated cross-sectional surveys in the adult general population of Greece during November 2020-June 2021

Author(s):  
Vana Sypsa ◽  
Sotirios Roussos ◽  
Vasiliki Engeli ◽  
Dimitrios Paraskevis ◽  
Sotirios Tsiodras ◽  
...  

Background: Vaccine hesitancy is a major barrier to achieve large-scale COVID-19 vaccination. We report trends in vaccination intention and associated determinants from surveys in the adult general population in Greece. Methods: Four cross-sectional phone surveys were conducted in November 2020, February, April and May 2021 on nationally representative samples of adults in Greece. Multinomial logistic regression was used on the combined data of the surveys to evaluate independent predictors of vaccination unwillingness/uncertainty. Results: Vaccination intention increased from 67.6% in November 2020 to 84.8%. in May 2021. Individuals aged 65 years or older were more willing to get vaccinated (May 2021: 92.9% vs. 79.5% in 18-39 years, p<0.001) but between age-groups differences decreased over time. Vaccination intention increased substantially in both sexes, though earlier among men than women and was higher in individuals with postgraduate studies (May 2021: 91.3% vs. 84.0% up to junior high). From multivariable analysis, unwillingness and/or uncertainty to get vaccinated was associated with younger age, female gender (in particular in the April 2021 survey), lower educational level and living with a child ≤12 years old. Among those with vaccine hesitancy, concerns about vaccine effectiveness declined over time (21.6% in November 2020 vs. 9.6% in May 2021, p=0.014) and were reported more often by men; safety concerns remained stable over time (66.3% in November 2020 vs. 62.1% in May 2021, p=0.658) and were reported more often by women. Conclusions: Vaccination intention increased substantially over time. Tailored communication is needed to address vaccine hesitancy and concerns regarding vaccine safety.

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e046529
Author(s):  
Eun-Hee Nah ◽  
Seon Cho ◽  
Suyoung Kim ◽  
Jieun Chu ◽  
Eunjoo Kwon ◽  
...  

ObjectivesThe health burden of chronic liver disease is increasing worldwide. Its main histological consequence is liver fibrosis, and eventually cirrhosis. This process is rarely diagnosed at the pre-cirrhotic stage due to it being asymptomatic. Little is known about the prevalence of liver fibrosis and associated risk factors in the general population. The aims of this study were to determine the prevalence and distribution of liver fibrosis using magnetic resonance elastography (MRE), as well as the risk factors associated with liver fibrosis in the asymptomatic general population.Design, setting and participantsThis cross-sectional retrospective study consecutively selected subjects who underwent health check-ups including MRE at 13 health promotion centres in Korea between 2018 and 2020. Liver fibrosis was estimated using MRE with cut-off values for significant and advanced liver fibrosis of 2.90 and 3.60 kPa, respectively.Primary and secondary outcome measuresThe Χ2 test was used to compare the prevalence of liver fibrosis according to sex and age groups. Multivariable logistic regression analyses were performed to identify the factors for significant and advanced liver fibrosis.ResultsAmong the 8183 subjects, 778 (9.5%) had ≥significant fibrosis (≥2.9 kPa), which included 214 (2.6%) subjects with ≥advanced fibrosis (≥3.6 kPa). Multivariable analysis revealed that liver fibrosis was associated with age (OR=1.34, 95% CI=1.18 to 1.51), male sex (OR=3.18, 95% CI=1.97 to 5.13), diabetes (OR=2.43, 95% CI=1.8 to 3.28), HBsAg positivity (OR=3.49, 95% CI=2.55 to 4.79), abnormal liver function test (OR=1.9, 95% CI=1.49 to 2.42) and obesity (OR=1.77, 95% CI=1.35 to 2.32) (all p<0.001), as well as metabolic syndrome (OR=1.4, 95% CI=1.05 to 1.87) (p=0.024).ConclusionsThe prevalence of significant or more liver fibrosis was high in the Korean general population and much higher among individuals with risk factors. This suggests that screening of liver fibrosis should be considered in general population, especially among high-risk groups.


Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1389
Author(s):  
Megumi Hara ◽  
Motoki Ishibashi ◽  
Atsushi Nakane ◽  
Takashi Nakano ◽  
Yoshio Hirota

Little is known about the differences in coronavirus disease (COVID-19) vaccine acceptance and hesitancy between the general population and healthcare workers in Japan. To compare these differences, a nationwide web-based cross-sectional survey was conducted on 19 January 2021, shortly before the initiation of COVID-19 vaccinations in Japan. A total of 6180 men and women aged 20–69 years and 1030 healthcare workers aged 20–69 years were enrolled. Data on COVID-19 vaccine acceptance, basic characteristics, including socioeconomic factors, and confidence in immunization in general were collected. COVID-19 vaccine acceptance was also evaluated under hypothetical vaccine effectiveness and adverse event frequencies. Factors associated with vaccine hesitancy were examined using multinomial logistic regression analysis. The COVID-19 vaccine acceptance rate was 48.6% among the general population and was lower among nurses (45.5%) and medical clerks (40.7%). Women and young adults had significantly higher COVID-19 vaccine hesitancy odds ratios, and current smokers had significantly lower odds ratios. The frequency of adverse events was a COVID-19 vaccine hesitancy factor. Even if these factors were adjusted, COVID-19 vaccine hesitancy among nurses was 1.4 times higher than that among the general population. Thus, interventions to improve health literacy and vaccine hesitancy among the general population and healthcare workers, especially nurses, are needed.


Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1292
Author(s):  
Valentina Baccolini ◽  
Erika Renzi ◽  
Claudia Isonne ◽  
Giuseppe Migliara ◽  
Azzurra Massimi ◽  
...  

Achieving high levels of vaccination coverage against COVID-19 may be hindered by vaccine hesitancy. We quantified over time the prevalence of COVID-19 vaccine hesitancy among university students, investigated its determinants, and analyzed student attitudes, risk perceptions and compliance with preventive measures. The survey was administered online from 1 March to 30 June 2021. A multivariable logistic regression model was built to identify predictors of hesitancy. Overall, we collected 5369 questionnaires that were grouped into three survey periods (March, April–May, and May–June). The response rate ranged from 81.2% to 76.4%, whereas vaccine hesitancy ranged from 22% to 29%. Multivariable analysis showed that April–May participants had higher odds of hesitancy than March respondents. Other positive predictors were being male, not being a healthcare student, having a lower academic level, and not disclosing a political position. Conversely, higher levels of perceived COVID-19 severity, concern for the emergency, confidence in vaccine safety and effectiveness, and self-reported adherence to mask wearing indoors and outdoors were negatively associated with hesitancy. We found that vaccine hesitancy changed over time and in relation to several factors. Strategies aimed at increasing the students’ awareness and engagement, restoring confidence in health authorities, and limiting disinformation around the vaccines should be devised.


2019 ◽  
Vol 68 (3) ◽  
pp. 139-153 ◽  
Author(s):  
Mazen El Ghaziri ◽  
Shellie Simons ◽  
Jane Lipscomb ◽  
Carla L. Storr ◽  
Kathleen McPhaul ◽  
...  

Background: Workplace Bullying (WPB) can have a tremendous, negative impact on the victims and the organization as a whole. The purpose of this study was to examine individual and organizational impact associated with exposure to bullying in a large U.S. unionized public sector workforce. Methods: A cross-sectional Web-based survey was conducted among 16,492 U.S. state government workers. Survey domains included demographics, negative acts (NAs) and bullying, supportiveness of the organizational climate, and individual and organizational impacts of bullying. Multinomial logistic regression was used to assess the impact among respondents who reported exposure to bullying. Findings: A total of 72% participants responded to the survey (n = 11,874), with 43.7% (n = 5,181) reporting exposure to NAs and bullying. A total of 40% (n = 4,711) participants who experienced WPB reported individual impact(s) while 42% ( n = 4,969) reported organization impact(s). Regular NA was associated with high individual impact (negatively impacted them personally; odds ratio [OR] = 5.03) when controlling for other covariates including: female gender (OR =1.89) and job tenure of 6 to 10 years (OR = 1.95); working in a supportive organizational climate and membership in a supportive bargaining unit were protective of high impact (OR = 0.04 and OR = 0.59, respectively). High organizational impact (transferring to another position) was associated with regular NA and bullying (OR = 16.26), female gender (OR = 1.55), providing health care and field service (OR = 1.68), and protective effect of organizational climate (OR = 0.39). We found a dose-response relationship between bullying and both individual and organizational-level impact. Conclusion/Application to Practice: Understanding the impacts of WPB should serve to motivate more workplaces and unions to implement effective interventions to ameliorate the problem by enhancing the organizational climate, as well as management and employee training on the nature of WPB and guidance on reporting.


Author(s):  
Miguel Ángel Hernández-Rodríguez ◽  
Ermengol Sempere-Verdú ◽  
Caterina Vicens-Caldentey ◽  
Francisca González-Rubio ◽  
Félix Miguel-García ◽  
...  

We aimed to identify and compare medication profiles in populations with polypharmacy between 2005 and 2015. We conducted a cross-sectional study using information from the Computerized Database for Pharmacoepidemiologic Studies in Primary Care (BIFAP, Spain). We estimated the prevalence of therapeutic subgroups in all individuals 15 years of age and older with polypharmacy (≥5 drugs during ≥6 months) using the Anatomical Therapeutic Chemical classification system level 4, by sex and age group, for both calendar years. The most prescribed drugs were proton-pump inhibitors (PPIs), statins, antiplatelet agents, benzodiazepine derivatives, and angiotensin-converting enzyme inhibitors. The greatest increases between 2005 and 2015 were observed in PPIs, statins, other antidepressants, and β-blockers, while the prevalence of antiepileptics was almost tripled. We observed increases in psychotropic drugs in women and cardiovascular medications in men. By patient´s age groups, there were notable increases in antipsychotics, antidepressants, and antiepileptics (15–44 years); antidepressants, PPIs, and selective β-blockers (45–64 years); selective β-blockers, biguanides, PPIs, and statins (65–79 years); and in statins, selective β-blockers, and PPIs (80 years and older). Our results revealed important increases in the use of specific therapeutic subgroups, like PPIs, statins, and psychotropic drugs, highlighting opportunities to design and implement strategies to analyze such prescriptions’ appropriateness.


Vaccines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 798
Author(s):  
Sami H. Alzahrani ◽  
Mukhtiar Baig ◽  
Mohammed W. Alrabia ◽  
Mohammed R. Algethami ◽  
Meshari M. Alhamdan ◽  
...  

Vaccine uptake could influence vaccination efforts to control the widespread COVID-19 pandemic; however, little is known about vaccine acceptance in Saudi Arabia. The present study aimed to assess the Saudi public’s intent to get vaccinated against COVID-19 and explore the associated demographic determinants of their intentions as well as the reasons for vaccine hesitancy. A cross-sectional, web-based survey was distributed to public individuals in Saudi Arabia between 25 December 2020 and 15 February 2021. Participants were asked if they were willing to get vaccinated, and the responses, along with demographic data were entered into a multinomial logistic regression model to assess the relative risk ratio (RRR) for responding “no” or “unsure” versus “yes”. Among 3048 participants (60.1% female, 89.5% Saudi), 52.9% intend to get vaccinated, 26.8% were unsure, and 20.3% refused vaccination. Vaccine hesitancy was significantly higher among females (RRR = 2.70, p < 0.0001) and those who had not been recently vaccinated for influenza (RRR = 2.63, p < 0.0001). The likelihood was lower among Saudis (RRR = 0.49, p < 0.0001), those with less than a secondary education (RRR = 0.16, p < 0.0001), perceived risks of COVID-19, and residents of the southern region (RRR = 0.46, p < 0.0001). The most often cited reasons for hesitancy were short clinical testing periods and concerns about adverse events or effectiveness. Vaccine hesitancy is mediated by many demographic factors and personal beliefs. To address vaccine-related concerns and amend deeply rooted health beliefs, communication should provide transparent information.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Abhinav J Appukutty ◽  
Lesli E Skolarus ◽  
Mellanie V Springer ◽  
William J Meurer ◽  
James F Burke

Introduction: Stroke incidence is reportedly increasing in younger adults. While increasing vascular risk factor prevalence has been suggested as a cause, the reasons for rising stroke incidence in the young are not clear. We explored several alternate explanations: trends in neurologically-focused emergency department (ED) visits, differential diagnostic classification of stroke and TIA over time, and changes in the use of advanced imaging in young and older adults. Methods: We performed a retrospective, serial, cross-sectional study on a nationally representative sample of all ED visits in the United States to quantify changes in patterns of neurologically-focused ED visits, stroke and TIA diagnoses, and rates of MRI utilization for young (18 – 44 years) and older (65+ years) adults over a 17-year period (1995 – 2000; 2005 – 2015) using National Hospital Ambulatory Medical Care Survey (NHAMCS) data. Results: In young adults, 0.4% (95% CI 0.3% – 0.5%) of neurologically-focused ED visits resulted in a primary diagnosis of stroke vs. 6.8% (95% CI 6.2% – 7.5%) for older adults. In both populations, the incidence of neurologically-focused ED visits has increased over time (+111/100,000 population/year, 95% CI +94 – +130 in the young vs. +70/100,000 population/year, 95% CI +34 – +108 in older adults). There was no evidence of differential classification of TIA to stroke over time (OR 1.001 per year, 95% CI 0.926 – 1.083 in the young; OR 1.003 per year, 95% CI 0.982 – 1.026 in older adults) and no evidence of disproportionate rise in MRI utilization for neurologically-focused ED visits in the young (OR 1.057 per year, 95% CI 1.028 – 1.086 in the young; OR 1.095 per year, 95% CI 1.066 – 1.125 in older adults). Conclusions: If the specificity of stroke diagnosis amongst ED visits is similar amongst young and older populations, then the combination of data observed here, including (1) a lower prior probability of stroke diagnoses in the young and (2) an increasing trend in neurologically-focused ED visits in both age groups, suggests that false positive diagnoses will increase over time, with a faster rise in the young compared to older adults. These data suggest a potential explanation that may contribute to higher stroke incidence in the young and merits further scrutiny.


2021 ◽  
Author(s):  
Zeyu Lyu ◽  
Hiroki Takikawa

BACKGROUND The availability of large-scale and fine-grained aggregated mobility data has allowed researchers to observe the dynamic of social distancing behaviors at high spatial and temporal resolutions. Despite the increasing attentions paid to this research agenda, limited studies have focused on the demographic factors related to mobility and the dynamics of social distancing behaviors has not been fully investigated. OBJECTIVE This study aims to assist in the design and implementation of public health policies by exploring the social distancing behaviors among various demographic groups over time. METHODS We combined several data sources, including mobile tracking data and geographical statistics, to estimate visiting population of entertainment venues across demographic groups, which can be considered as the proxy of social distancing behaviors. Then, we employed time series analyze methods to investigate how voluntary and policy-induced social distancing behaviors shift over time across demographic groups. RESULTS Our findings demonstrate distinct patterns of social distancing behaviors and their dynamics across age groups. The population in the entertainment venues comprised mainly of individuals aged 20–40 years, while according to the dynamics of the mobility index and the policy-induced behavior, among the age groups, the extent of reduction of the frequency of visiting entertainment venues during the pandemic was generally the highest among younger individuals. Also, our results indicate the importance of implementing the social distancing policy promptly to limit the spread of the COVID-19 infection. However, it should be noticed that although the policy intervention during the second wave in Japan appeared to increase the awareness of the severity of the pandemic and concerns regarding COVID-19, its direct impact has been largely decreased could only last for a short time. CONCLUSIONS At the time we wrote this paper, in Japan, the number of daily confirmed cases was continuously increasing. Thus, this study provides a timely reference for decision makers about the current situation of policy-induced compliance behaviors. On the one hand, age-dependent disparity requires target mitigation strategies to increase the intention of elderly individuals to adopt mobility restriction behaviors. On the other hand, considering the decreasing impact of self-restriction recommendations, the government should employ policy interventions that limit the resurgence of cases, especially by imposing stronger, stricter social distancing interventions, as they are necessary to promote social distancing behaviors and mitigate the transmission of COVID-19. CLINICALTRIAL None


Author(s):  
Farah Yasmin ◽  
Waleed Asghar ◽  
Maryam Salma Babar ◽  
Hiba Khan ◽  
Shoaib Ahmad ◽  
...  

Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.


2021 ◽  
Vol 10 (2) ◽  
pp. 69-74
Author(s):  
Aisha Sarfaraz ◽  
Dr Abdul Azeem ◽  
Mehwish Butt ◽  
Muhammad Umar

BACKGROUND & OBJECTIVE Stroke is a very common neurological condition affects various aspects of health. The primary objective of this study was to find out the frequency of functional disability and cognitive impairments in Sub-acute Stroke patients. MATERIAL AND METHODS A cross-sectional survey was conducted on 112 Sub-acute Stroke patients in Karachi, Pakistan. Using Barthel Index (BI) and Mini-Mental State Examination (MMSE) test was used to find out the frequency of functional disability and cognitive impairments of Sub-acute Stroke patients. RESULTS The correlation of BI scores with MMSE scores for the Male gender was 0.576 whilst the correlation of BI scores with MMSE scores for the Female gender was 0.440. The severity of functional disability concerning age groups assessed P-value was 0.026 using Chi-Square Test. The severity of functional disability (BI severity) concerning gender, P-value was found 0.097 using the same test. CONCLUSION Functional Disability is directly linked with age. However, there was no linkage established between Cognitive Impairment and age as well as gender. On close inspection, there was a trend between Functional disability and gender but not statistically significant.


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