Understanding national trends in COVID–19 vaccine hesitancy in Canada – April 2020 to March 2021

Objective: Key to reducing COVID–19 morbidity and mortality and reducing the need for further lockdown measures in Canada and worldwide is widespread acceptance of COVID–19 vaccines. Vaccine hesitancy has emerged as a key barrier to achieving optimal vaccination rates, for which there is little data among Canadians. This study examined rates of vaccine hesitancy and their correlates among Canadian adults. Methods: This study analyzed data from five age, sex and province–weighted population-based samples to describe rates of hesitancy between April 2020 and March 2021 among Canadians who completed online surveys as part of the iCARE Study, and various sociodemographic, clinical and psychological correlates. Vaccine hesitancy was assessed by asking: If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated? Responses were dichotomized into very likely, unlikely, somewhat unlikely (reflecting some degree of vaccine hesitancy) vs extremely likely to get the vaccine, which was the comparator. Results: Overall, 15,019 respondents participated in the study. A total of 42.2% of respondents reported vaccine hesitancy over the course of the study, which was lowest during surveys 1 (April 2020) and 5 (March 2021) and highest during survey 3 (November 2020). Fully adjusted multivariate logistic regression analyses revealed that women, those aged 50 and younger, non–Whites, those with high school education or less, and those with annual household incomes below the poverty line in Canada (i.e., $60,000) were significantly more likely to report being vaccine hesitant over the study period, as were essential and healthcare workers, parents of children under the age of 18, and those who do not get regular flu vaccines. Believing engaging in infection prevention behaviours (like vaccination) is important for reducing virus transmission and high COVID-19 health concerns (being infected and infecting others) were associated with 77% and 54% reduction in vaccine hesitancy, respectively, and having high personal financial concerns (worried about job or income loss) was associated with 1.33 times increased odds of vaccine hesitancy. Conclusion: Results point to the importance of targeting vaccine efforts to women, younger people and socioeconomically disadvantaged groups, and that vaccine messaging should emphasize the benefits of getting vaccinated, and how the benefits (particularly to health) far outweigh the risks. Future research is needed to monitor ongoing changes in vaccine intentions and behaviour, as well as to better understand motivators and facilitators of vaccine acceptance, particularly among vulnerable groups.

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Seroprevalence of anti-SARS-CoV-2 antibodies six months into the vaccination campaign in Geneva, Switzerland

10.1101/2021.08.12.21261929 ◽

2021 ◽

Author(s):

Silvia Stringhini ◽

María-Eugenia Zaballa ◽

Nick Pullen ◽

Javier Perez-Saez ◽

Carlos de Mestral ◽

...

Keyword(s):

Vaccination Campaign ◽

Age Groups ◽

Credible Interval ◽

Population Based ◽

Vaccine Hesitancy ◽

Socioeconomically Disadvantaged ◽

Cross Sectional ◽

Vaccination Rates ◽

Health Measures ◽

Random Samples

Background: Up-to-date seroprevalence estimates are critical to describe the SARS-CoV-2 immune landscape in the population and guide public health measures. We aimed to estimate the seroprevalence of anti-SARS-CoV-2 antibodies 15 months into the COVID-19 pandemic and six months into the vaccination campaign. Methods: We conducted a population-based cross-sectional serosurvey between June 1 and July 7, 2021, recruiting participants from age- and sex-stratified random samples of the general population. We tested participants for anti-SARS-CoV-2 antibodies targeting the spike (S) or nucleocapsid (N) proteins (Roche Elecsys immunoassays). We estimated the anti-SARS-CoV-2 antibodies seroprevalence following vaccination and/or infection (anti-S antibodies), or infection only (anti-N antibodies). Results: We included 3355 individuals, of which 1814 (54.1%) were women, 697 (20.8%) were aged <18 years and 449 (13.4%) were aged ≥65 years, 2161 (64.4%) tested positive for anti-S antibodies, and 906 (27.0%) tested positive for anti-N antibodies. The total seroprevalence of anti-SARS-CoV-2 antibodies was 66.1% (95% credible interval, 64.1-68.0). Considering the presence of anti-N antibodies, we estimated that 29.9% (28.0-31.9) of the population developed antibodies after infection; the rest having developed antibodies only via vaccination. Seroprevalence estimates were similar across sexes, but differed markedly across age groups, being lowest among children aged 0-5 years (20.8% [15.5-26.7]) and highest among older adults aged ≥75 years (93.1% [89.6-96.0]). Seroprevalence of antibodies developed via infection and/or vaccination was higher among participants with a higher educational level. Conclusions: Most adults have developed anti-SARS-CoV-2 antibodies, while most teenagers and children remain vulnerable to infection. As the SARS-CoV-2 Delta variant spreads and vaccination rates stagnate, efforts are needed to address vaccine hesitancy, particularly among younger individuals and socioeconomically disadvantaged groups, and to minimize spread among children.

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Long-Term Implications of the Infomedic during the COVID-19 Pandemic to US Adolescents’ HPV Vaccination Rates: Maternal Engagement with Pro- and Anti-vaccine Social Media Posts and Overarching Vaccine Hesitancy (Preprint)

10.2196/preprints.24970 ◽

2020 ◽

Author(s):

Young Argyris ◽

Yongsuk Kim ◽

Won Song

Keyword(s):

Hpv Vaccine ◽

Negative Impact ◽

Hpv Vaccination ◽

Population Based ◽

Vaccine Hesitancy ◽

Healthcare Facilities ◽

Vaccination Rates ◽

Novel Coronavirus ◽

The Impact

BACKGROUND The propagation of vaccine misinformation during the COVID-19 pandemic suggests that the pandemic may pose long-term harm on public health via depressed immunization rates. Between February 2020 and April 2020, the uptake rates of the HPV vaccine have decreased by 73%. Missing the critical age for HPV vaccination (i.e., 11-12 years old) will make adolescents susceptible to HPV-associated cancers in the next 20-30 years. Despite the importance, very few pro-vaccine interventions conducted on SM have succeeded in increasing HPV vaccination rates. OBJECTIVE Our overall objective is to identify the reasons why anti-vaccine messages effectively lower HPV vaccination rates while pro-vaccine messages do not increase such rates. In so doing, we suggest that overarching vaccine hesitancy is a reason for the discrepant outcomes of anti- vs. pro-vaccine SM posts. Our objective is pursued in two specific aims: we compare anti- and pro-vaccine posts in terms of (i) their roles in fostering overarching vaccine hesitancy among mothers (the main HPV vaccine decision-makers), and (ii) accompanying HPV vaccination rates among their adolescent children. METHODS In late December of 2019-mid January of 2020, we conducted a population-based survey among 426 mothers of US adolescents aged 13–18. The outbreak of the novel coronavirus in China occurred in December 2019, and awareness regarding the virus was increasing in the US during this time. Therefore, our data collected during this time allow us to infer the impact of increasing overarching vaccine hesitancy on HPV vaccination rates, while excluding the effects of access restrictions to healthcare facilities imposed since March of 2020. We developed a rigorous scale for engagement with anti- and pro-vaccine SM posts, measured adolescents’ HPV vaccination rates along the series initiation to completion, and conducted path analyses to assess the associations among them. RESULTS Our survey results show that mothers’ engagement with anti-vaccine content is negatively associated with their children’s HPV vaccine vaccination rates via their increased overarching vaccine hesitancy. In contrast, maternal engagement with pro-vaccine SM content is not associated with either overarching vaccine hesitancy or HPV vaccine vaccination rates. These results remained significant after controlling for socioeconomic, demographic, and accessibility factors, suggesting that mothers’ engagement with anti-vaccine messages on SM explains above and beyond what other known factors explain. CONCLUSIONS Our results suggest that increasing overarching vaccine hesitancy, heightened by the infodemic, can substantially reduce HPV vaccination rates, even after accessibility factors are controlled. Our results imply that the negative impact of the COVID-19 pandemic can be extended for many years to come through depressed HPV vaccination rates. As a result, there is an urgent need to develop interventions to increase HPV vaccination rates and to address vaccine hesitancy among mothers who feel emotionally challenged during the pandemic. CLINICALTRIAL N/A

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Determinants for Acceptance of COVID-19 Vaccine among Nigerians

10.21203/rs.3.rs-636090/v1 ◽

2021 ◽

Author(s):

Ugochukwu A Eze ◽

Kingsley I Ndoh Ndoh ◽

Babalola A. Ibisola ◽

Chinemerem D. Onwuliri ◽

Adenakan Osiyemi ◽

...

Keyword(s):

Ethnic Groups ◽

Tertiary Education ◽

Positive Association ◽

Population Based ◽

Cross Sectional Study ◽

Vaccine Hesitancy ◽

Significant Positive Association ◽

Cross Sectional ◽

Vaccination Rates ◽

Study Participants

Abstract AimTo assess the degree and determinants of COVID-19 Vaccine among NigeriansMaterials and methodsFollowing appropriate ethical protocol, a population-based cross-sectional study conducted from November 2020 to January 2021 using a pretested, self-administered questionnaire from a previous study adapted to suit the Nigeria setting and distributed among Nigerians aged 18 years and above. The country was grouped in to three regions: East, North and West representing the major ethnic groups in Nigeria. Participants were recruited based on six different catchments: residential, marketplace recreational areas, cooperate organizations, schools, and Faith-based organizations. Information obtained include socio-demographics, medical history related pertinent to COVID-19, level of knowledge, risk perception, and attitudes towards of COVID-19 and the vaccine amongst others. Descriptive and inferential statistics were done on the variables and results were summarized into percentages and associations noted.ResultsA total of 358 responses were obtained out of the 120 questionnaires distributed in each of the three regions of which. The mean age of respondents was 32years (± 11.2SD). Igbo and Yoruba were the major ethnic groups comprising 38% and 31% of study participants respectively. Three-quarter had tertiary education, 43% of them were civil servants and professionals, 34% of them were unemployed, and 8.9% of them were roadside traders. Majority (66.2%) were willing to accept the approved vaccine with male gender, identifying as Christian, Hausa ethnicity and living in the northern Nigeria had a significant positive association with COVID-19 vaccine uptake.Conclusiontwo out of three Nigerian adults indicated interest in accepting the corona virus vaccine. This calls with critical stakeholders and leaders at all levels to be involved in public education based on sound evidence and the discouragement of the spread of conspiracy theories to eliminate the negative associated factors will reduce vaccine hesitancy and increase COVID-19 vaccination rates in Nigeria.

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Interprovincial Variation in Antipsychotic and Antidepressant Prescriptions Dispensed in the Canadian Pediatric Population

The Canadian Journal of Psychiatry ◽

10.1177/0706743716649190 ◽

2016 ◽

Vol 61 (12) ◽

pp. 758-765 ◽

Cited By ~ 14

Author(s):

Nikita Arora ◽

Sandra Knowles ◽

Tara Gomes ◽

Muhammad M. Mamdani ◽

David N. Juurlink ◽

...

Keyword(s):

Selective Serotonin Reuptake Inhibitors ◽

Atypical Antipsychotics ◽

Pediatric Population ◽

Population Based ◽

Cross Sectional Study ◽

Future Research ◽

Sectional Study ◽

Cross Sectional ◽

Risks And Benefits ◽

National Trends

Objective: Although antidepressants and antipsychotics are valuable medications in the treatment of select psychiatric disorders, there is increasing focus on the balance of risks and benefits of these drugs as prescribed, particularly in the pediatric population. We examined recent national trends and interprovincial variation in dispensing of antipsychotic and antidepressant prescriptions to the Canadian pediatric population. Method: We conducted a population-based cross-sectional study of antidepressant and antipsychotic prescriptions dispensed by Canadian pharmacies to the pediatric population (≤18 years) between 2010 and 2013. Prescription volumes were obtained from IMS Health. Analysis was stratified by drug, year, quarter, and province and population-standardized using age-adjusted population estimates. Results: From the first quarter of 2010 to the fourth quarter of 2013, dispensing of antipsychotics to the pediatric population increased 33% (from 34 to 45 prescriptions per 1000) and dispensing of antidepressants increased 63% (from 34 to 55 per 1000). We observed a 1.5-fold interprovincial difference in dispensing rates for antidepressants (range: 189 per 1000 to 275 per 1000) and a 3.0-fold difference for antipsychotics (range: 85 per 1000 to 253 per 1000) in 2013. Among antidepressants, selective serotonin reuptake inhibitors were the most dispensed (76%), with fluoxetine being the leading agent. Among antipsychotics, atypical antipsychotics were the most dispensed (97%), with risperidone being the leading agent. Conclusions: Antipsychotic and antidepressant dispensing to the Canadian pediatric population increased from 2010 to 2013, with considerable interprovincial variation. Future research is required to explore reasons for observed patterns to optimize care for the Canadian pediatric population.

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Seroprevalence of anti-SARS-CoV-2 antibodies 6 months into the vaccination campaign in Geneva, Switzerland, 1 June to 7 July 2021

Eurosurveillance ◽

10.2807/1560-7917.es.2021.26.43.2100830 ◽

2021 ◽

Vol 26 (43) ◽

Author(s):

Silvia Stringhini ◽

María-Eugenia Zaballa ◽

Nick Pullen ◽

Javier Perez-Saez ◽

Carlos de Mestral ◽

...

Keyword(s):

Educational Level ◽

Vaccination Campaign ◽

Age Groups ◽

Credible Interval ◽

Population Based ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Vaccination Rates ◽

Random Samples ◽

Age And Sex

Background Up-to-date seroprevalence estimates are critical to describe the SARS-CoV-2 immune landscape and to guide public health decisions. Aim We estimate seroprevalence of anti-SARS-CoV-2 antibodies 15 months into the COVID-19 pandemic and 6 months into the vaccination campaign. Methods We conducted a population-based cross-sectional serosurvey between 1 June and 7 July 2021, recruiting participants from age- and sex-stratified random samples of the general population. We tested participants for anti-SARS-CoV-2 antibodies targeting the spike (S) or nucleocapsid (N) proteins using the Roche Elecsys immunoassays. We estimated the anti-SARS-CoV-2 antibodies seroprevalence following vaccination and/or infection (anti-S antibodies), or infection only (anti-N antibodies). Results Among 3,355 individuals (54.1% women; 20.8% aged < 18 years and 13.4% aged ≥ 65 years), 2,161 (64.4%) had anti-S antibodies and 906 (27.0%) had anti-N antibodies. The total seroprevalence was 66.1% (95% credible interval (CrI): 64.1–68.0). We estimated that 29.9% (95% Crl: 28.0–31.9) of the population developed antibodies after infection; the rest having developed antibodies via vaccination. Seroprevalence estimates differed markedly across age groups, being lowest among children aged 0–5 years (20.8%; 95% Crl: 15.5–26.7) and highest among older adults aged ≥ 75 years (93.1%; 95% Crl: 89.6–96.0). Seroprevalence of antibodies developed via infection and/or vaccination was higher among participants with higher educational level. Conclusion Most of the population has developed anti-SARS-CoV-2 antibodies, despite most teenagers and children remaining vulnerable to infection. As the SARS-CoV-2 Delta variant spreads and vaccination rates stagnate, efforts are needed to address vaccine hesitancy, particularly among younger individuals and to minimise spread among children.

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National Trends in Surgical Resection of Vestibular Schwannomas

Otolaryngology ◽

10.1177/0194599820932148 ◽

2020 ◽

Vol 163 (6) ◽

pp. 1244-1249

Author(s):

Yin Ren ◽

Rosh K. V. Sethi ◽

Konstantina M. Stankovic

Keyword(s):

Surgical Resection ◽

The United States ◽

Population Based ◽

Hospital Charges ◽

Future Research ◽

Seer Database ◽

Surgical Volume ◽

National Inpatient Sample ◽

Discharge Patterns ◽

National Trends

Objective To characterize the national trend for surgical resection of vestibular schwannoma (VS) and to assess changes in demographics, length of stay (LOS), discharge patterns, and hospital charges. Study Design Population-based inpatient registry analysis. Setting National Inpatient Sample and SEER database (Surveillance, Epidemiology, and End Results). Patients and Methods Retrospective review of the US National Inpatient Sample and the SEER database from 2001 to 2014 of all patients who underwent resection of VS. Results A total of 24,380 VS resections were performed. While the annual incidence of VS remained stable at 1.38 per 100,000, surgical volume declined by 36.1%, from 2807 in 2001 to 1795 in 2014 ( R2 = 0.58). Total hospital charges more than doubled, from $52,475 in 2001 to $115,164 in 2014 ($4478 per year, R2 = 0.96). While most procedures were performed at large-sized hospitals, this decreased from 89% in 2002 to 75.8% in 2014. Average LOS remained stable at 5.2 days during the study period. The number of discharges to a nursing facility increased from 113 (5.5%) in 2002 to 245 (13.6%) in 2014 ( P = .0002). Conclusion VS resection has evolved in the United States. While the incidence remained stable, surgical volume decreased by 36%, and hospital charges more than doubled. More cases are being performed at smaller hospitals. Although LOS did not vary significantly, there is an increase in nonroutine discharges. These data may guide future research in resource utilization in neurotology.

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Factors That Influence Risk Perceptions and Successful COVID-19 Vaccination Communication Campaigns With American Indians

Science Communication ◽

10.1177/10755470211056990 ◽

2021 ◽

pp. 107554702110569

Author(s):

Amanda D. Boyd ◽

Dedra Buchwald

Keyword(s):

American Indians ◽

Risk Perceptions ◽

Herd Immunity ◽

The United States ◽

Vaccine Hesitancy ◽

Future Research ◽

Vaccination Rates ◽

Culturally Congruent ◽

Communication Campaigns ◽

The Impact

COVID-19 vaccinations are the primary tool to end the pandemic. However, vaccine hesitancy continues to be a barrier to herd-immunity in the United States. American Indians (AI) often have higher levels of distrust in western medicine and lower levels of satisfaction with health care when compared to non-Hispanic Whites. Yet AIs have high COVID-19 vaccination rates. We discuss factors that influence AI risk perceptions of COVID-19 vaccinations including the impact of COVID-19 on AI Elders, community, and culture. We conclude with future research needs on vaccination communication and how culturally congruent communication campaigns may have contributed to high COVID-19 vaccination rates.

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Low-Wage Women’s Experiences of Workplace Incivilities

Journal of Applied Social Science ◽

10.1177/19367244211014737 ◽

2021 ◽

pp. 193672442110147

Author(s):

Katherine Tindell ◽

Irene Padavic

Keyword(s):

Customer Service ◽

Service Sector ◽

Food Service ◽

Future Research ◽

Income Loss ◽

Service Workers ◽

Bank Teller ◽

Depth Interviews ◽

Service Representative ◽

Research And Policy

Workplace incivility, also called bullying, mobbing, and harassment, is pervasive and takes a high toll on employees. This study draws on 18 in-depth interviews with women in the precarious, low-wage, service sector in jobs such as customer service representative, retail sales, food service, pharmacy technician, and bank teller. Women service workers are a particularly vulnerable group, and yet most research on workplace problems of this type focus on professional women’s experience. We find that in this sample, most incivilities came from supervisors, followed by customers and then coworkers. Among supervisors, women were the most common perpetrators, while customer and coworker perpetrators were largely men. The type of incivility varied depending on role: Disparagement was common on the part of supervisors and customers, while coworkers were far more likely to engage in sexual harassment, which was virtually nonexistent among supervisors. Consequences for targets of these incivilities included anxiety, which most had experienced, and income loss. We offer suggestions for future research and policy.

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Thrombotic Thrombocytopenia after COVID-19 Vaccination: In Search of the Underlying Mechanism

Vaccines ◽

10.3390/vaccines9060559 ◽

2021 ◽

Vol 9 (6) ◽

pp. 559

Author(s):

Piotr Rzymski ◽

Bartłomiej Perek ◽

Robert Flisiak

Keyword(s):

Direct Interaction ◽

Underlying Mechanism ◽

The United States ◽

Cross Reactivity ◽

Spike Protein ◽

Vaccine Hesitancy ◽

Future Research ◽

Platelet Factor ◽

Precautionary Measures ◽

Adenoviral Proteins

The rollout of COVID-19 vaccines brings hope for successful pandemic mitigation and getting the transmission of SARS-CoV-2 under control. The vaccines authorized in Europe displayed a good safety profile in the clinical trials. However, during their post-authorization use, unusual thrombotic events associated with thrombocytopenia have rarely been reported for vector vaccines. This led to the temporary suspension of the AZD1222 vaccine (Oxford/AstraZeneca) in various European countries and the Ad26.COV2 vaccine (Janssen/Johnson&Johnson) in the United States, with regulatory bodies launching investigations into potential causal associations. The thromboembolic reactions were also rarely reported after mRNA vaccines. The exact cause of these adverse effects remains to be elucidated. The present paper outlines the hypotheses on the mechanisms behind the very rare thrombotic thrombocytopenia reported after the COVID-19 vaccination, along with currently existing evidence and future research prospects. The following are discussed: (i) the role of antibodies against platelet factor 4 (PF4), (ii) the direct interaction between adenoviral vector and platelets, (iii) the cross-reactivity of antibodies against SARS-CoV-2 spike protein with PF4, (iv) cross-reactivity of anti-adenovirus antibodies and PF4, (v) interaction between spike protein and platelets, (vi) the platelet expression of spike protein and subsequent immune response, and (vii) the platelet expression of other adenoviral proteins and subsequent reactions. It is also plausible that thrombotic thrombocytopenia after the COVID-19 vaccine is multifactorial. The elucidation of the causes of these adverse events is pivotal in taking precautionary measures and managing vaccine hesitancy. It needs to be stressed, however, that the reported cases are currently sporadic and that the benefits of COVID-19 vaccines vastly outweigh their potential risks.

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Staying Home, Staying Alive: Campus Food Pantry Student Clients’ Experiences During the COVID-19 Pandemic

Journal of Applied Social Science ◽

10.1177/19367244211035671 ◽

2021 ◽

pp. 193672442110356

Author(s):

Elmira Jangjou

Keyword(s):

Coping Strategies ◽

Thematic Analysis ◽

Future Research ◽

Postsecondary Students ◽

Structured Interviews ◽

Short Term ◽

Income Loss ◽

Food Pantry ◽

Global Pandemic ◽

Seeking Help

In response to students’ food insecurity, a number of colleges and universities have taken action and established campus food pantries as part of their intervention plans. However, many of these pantries ceased operation due to COVID-19 campus shutdowns. The purpose of this study is to illustrate the short-term impacts of the COVID-19 pandemic on postsecondary students, who use a university-provided food pantry. Drawing from semi-structured interviews with 12 participants, the thematic analysis explored the initial coping strategies these students used to endure the pandemic. Findings revealed that many students experienced the immediate effects of the pandemic in the form of income loss, self-isolation, anxiety, and appetite change. Although the pandemic interrupted these students’ journeys to continue their studies and become independent in various ways, the affected students implemented various coping strategies, including seeking help from family or friends, using available resources, cooking at home, and even trying to save money. However, considering that the targeted population in this study was already at risk because of their basic needs insecurity, these postsecondary students require extra attention from their higher education institutions in the case of emergencies, such as a global pandemic. In addition to its timely and relevant findings, this study provides important avenues for future research and intervention efforts.

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