Essential Workers COVID-19 Vaccine Hesitancy, Misinformation and Informational Needs in the Republic of North Macedonia.

Introduction: The COVID-19 pandemic is a global health crisis that as of December 2021 has resulted in the death of over 5.2 million people. Despite the unprecedented development and distribution of vaccines, hesitancy to take the vaccine remains a wide-spread public health challenge, especially in Eastern European countries. In this study we focus on a sample of essential workers in North Macedonia to: 1) Describe rates of vaccine acceptance, risk perception and sources of COVID-19 information, 2) Explore predictors of vaccine hesitancy and 3) Describe informational needs of hesitant and non-hesitant essential workers. Methods: Descriptive statistics were used to present frequencies of vaccine acceptance. Logistic regression was used to explore predictors of vaccine acceptance based on sociodemographic characteristics, hesitancy to take other vaccines in the past, previous diagnosis of COVID-19, and individual risk perception of COVID-19. Chi square analysis was used to compare informational needs differences between hesitant and non-hesitant individuals across socio-demographic groups. Results: From a sample of 1003 individuals, 439 (44%) reported that they were very likely to get the vaccine, the rest reported some level of hesitancy. Older age, Albanian ethnicity, post-secondary school education, previous diagnosis of COVID-19, previous vaccine acceptance of other vaccines, and increased risk perception of COVID-19 infection were all found to be negatively associated with vaccine hesitancy. In particular hesitant individuals, compared to the non-hesitant, wanted to have more information and reassurance that all main international agencies (i.e. FDA, WHO, EMA) were all in accordance in recommending the vaccine and that they would be free to choose if getting the vaccine or not without consequences (p<0.01).

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Targeting COVID Vaccine Hesitancy in Rural Communities in Tennessee: Implications for Extending the COVID-19 Pandemic in the South

Vaccines ◽

10.3390/vaccines9111279 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1279

Author(s):

Donald J. Alcendor

Keyword(s):

Rural Communities ◽

Financial Incentives ◽

Vaccine Hesitancy ◽

The South ◽

Vaccine Acceptance ◽

Health Crisis ◽

Vaccination Rates ◽

Rural Counties ◽

Cultural Conservatism ◽

History Of

Approximately 40% of Tennesseans are vaccinated fully, due mainly to higher vaccination levels within urban counties. Significantly lower rates are observed in rural counties. Surveys suggest COVID-19 vaccine hesitancy is entrenched mostly among individuals identifying as white, rural, Republican, and evangelical Christian. Rural counties represent 70 of the total 95 counties in Tennessee, and vaccine hesitancy signifies an immediate public health crisis likely to extend the COVID-19 pandemic. Tennessee is a microcosm of the pandemic’s condition in the Southern U.S. Unvaccinated communities are the greatest contributors of new COVID-19 infections, hospitalizations, and deaths. Rural Tennesseans have a long history of cultural conservatism, poor health literacy, and distrust of government and medical establishments and are more susceptible to misinformation and conspiracy theories. Development of novel strategies to increase vaccine acceptance is essential. Here, I examine the basis of COVID-19 following SARS-CoV-2 infection and summarize the pandemic’s extent in the South, current vaccination rates and efforts across Tennessee, and underlying factors contributing to vaccine hesitancy. Finally, I discuss specific strategies to combat COVID-19 vaccine hesitancy. We must develop novel strategies that go beyond financial incentives, proven ineffective toward vaccinations. Successful strategies for vaccine acceptance of rural Tennesseans could increase acceptance among unvaccinated rural U.S. populations.

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Communication Strategies to Combat COVID-19 Vaccines Hesitancy

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i40b32266 ◽

2021 ◽

pp. 72-85

Author(s):

Destaw Bayable Yemer ◽

Minwuyelet Andualem Desta ◽

Melaku Bayu Workie

Keyword(s):

Communication Strategies ◽

Vaccination Campaign ◽

Effective Communication ◽

Vaccine Hesitancy ◽

Vaccine Acceptance ◽

Health Crisis ◽

The Public ◽

Media Messages ◽

Communication Techniques ◽

Social Media Platforms

COVID-19 infectious disease resulted in a pandemic that has threatened millions of people in the world. It is caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), and it has created a global health crisis. Hence, the present study aimed at assessing communication strategies used by Ethiopian Public Health Institute and Ministry of Health to address COVID-19 vaccine hesitancy, make analysis of vaccination messages, and hybrid media messages to label best practices of communication techniques to address vaccine hesitancy. To attain this objective, a qualitative research method was employed to analyze messages that were disseminated with the hybrid national and regional media and social media platforms. MOH and EPHI disseminated messages; ministers, prominent people, opinion leaders and activists’ speeches used as subjects of the study. COVID-19 vaccination messages were selected through purposive sampling method. The contents of messages regarding health communication were analyzed. The finding showed that building COVID-19 vaccine acceptance through effective communication is important to stop the spread of the virus. The participatory and presumptive style communications are the possible method to promote COVID-19 vaccination before it reaches on refusal stage. Moreover, the results revealed that communication strategies contributed to vaccine advocacy and vaccination campaign to improve vaccine acceptance. MOH and EPHI used the hybrid media to mold the unscientific information and the misinformation of the vaccine. In sum, using effective communication strategies is very important to create awareness about COVID-19 vaccines, and avoid vaccine hesitation to strength the public vaccines acceptability.

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Predictors of COVID-19 vaccine acceptability among patients living with HIV in northern Nigeria: A mixed methods study

Current HIV Research ◽

10.2174/1570162x19666211217093223 ◽

2021 ◽

Vol 19 ◽

Author(s):

Zubairu Iliyasu ◽

Aminatu A. Kwaku ◽

Amina A. Umar ◽

Fatimah Tsiga-Ahmed ◽

Nafisa S. Nass ◽

...

Keyword(s):

Mixed Methods ◽

Risk Perception ◽

Antiretroviral Treatment ◽

Antiretroviral Drugs ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

People Living With Hiv ◽

Northern Nigeria ◽

Vaccine Acceptance ◽

Living With Hiv

Background: People living with HIV (PLHIV) are at increased risk of COVID-19 acquisition, severe disease, and poor outcomes. Yet, little is known about COVID-19 vaccine hesitancy among PLHIV in high HIV burden countries such as Nigeria. Objective: This study aims to assess the acceptability of the COVID-19 vaccine and identify predictors and reasons for vaccine hesitancy among patients living with HIV and attending a tertiary hospital in Kano, northern Nigeria. Methods: Using a mixed-methods design, structured questionnaires were administered to a clinic-based sample of patients living with HIV (n=344), followed by 20 in-depth interviews with a sub-sample. Logistic regression and the framework approach were used to analyze the data. Results: Less than half (46.2%, n=159) of the respondents were willing to take the COVID-19 vaccine. Vaccine acceptance was higher among non-Muslim PLHIV (Adjusted Odds Ratio (aOR)=1.26, 95% Confidence Interval (95%CI): 1.10-4.00), persons with high-risk perception (aOR=2.43, 95%CI:1.18-5.00), those who were not worried about infertility-related rumors (aOR=13.54, 95%CI:7.07-25.94) and persons who perceived antiretroviral drugs are protective against COVID-19 (aOR = 2.76, 95%CI: 1.48-5.14). In contrast, vaccine acceptance was lower among persons who were not more concerned about the potential effects of COVID-19-HIV co-infection (aOR=0.20, 95%CI:0.10-0.39). The most common reasons for vaccine hesitancy included doubts about the existence of COVID-19, low-risk perception, anxiety about antiretroviral treatment-vaccine interactions, safety concerns, and infertility-related rumors. Conclusion: Covid-19 vaccine acceptance was low among PLHIV. COVID-19 vaccine acceptance was associated with respondents’ faith, risk perception, perception of the protective effects of antiretroviral treatment, concerns about COVID-19-HIV co-infection, and infertility-related rumors. Vaccination counseling should be integrated into HIV treatment services to improve COVID-19 vaccine uptake among PLHIV in Kano and similar settings.

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Predictors of COVID-19 Vaccine Acceptance, Intention, and Hesitancy: A Scoping Review

Frontiers in Public Health ◽

10.3389/fpubh.2021.698111 ◽

2021 ◽

Vol 9 ◽

Author(s):

Ashish Joshi ◽

Mahima Kaur ◽

Ritika Kaur ◽

Ashoo Grover ◽

Denis Nash ◽

...

Keyword(s):

Risk Perception ◽

General Population ◽

Vaccine Coverage ◽

Average Rate ◽

Vaccine Safety ◽

Demographic Variables ◽

Vaccine Hesitancy ◽

Vaccine Acceptance ◽

Large Variability ◽

Tailored Interventions

COVID-19 vaccine is regarded as the most promising means of limiting the spread of or eliminating the pandemic. The success of this strategy will rely on the rate of vaccine acceptance globally. The study aims to examine the factors that influence COVID-19 vaccine acceptance, intention, and hesitancy. PubMed was searched comprehensively for articles using the keyword “COVID-19 vaccine surveys.” Of the 192 records, 22 studies were eligible for the review. Eighty-two percent of these studies were conducted among the general population. Gender, age, education, and occupation were some of the socio-demographic variables associated with vaccine acceptance. Variables such as trust in authorities, risk perception of COVID-19 infection, vaccine efficacy, current or previous influenza vaccination, and vaccine safety affected vaccine acceptance. Globally, in March 2020, the average vaccine acceptance observed was 86% which dropped to 54% in July 2020 which later increased to 72% in September 2020. Globally, the average rate of vaccine hesitancy in April 2020 was 21%, which increased to 36% in July 2020 and later declined to 16% in October 2020. Large variability in vaccine acceptance and high vaccine hesitancy can influence the efforts to eliminate the COVID-19. Addressing the barriers and facilitators of vaccines will be crucial in implementing effective and tailored interventions to attain maximum vaccine coverage.

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Which older Brazilians will accept a COVID-19 vaccine? Cross-sectional evidence from the Brazilian Longitudinal Study of Aging (ELSI-Brazil)

BMJ Open ◽

10.1136/bmjopen-2021-049928 ◽

2021 ◽

Vol 11 (11) ◽

pp. e049928

Author(s):

James Macinko ◽

Brayan V Seixas ◽

Juliana Vaz de Melo Mambrini ◽

M Fernanda Lima-Costa

Keyword(s):

Longitudinal Study ◽

Contextual Factors ◽

Vaccine Hesitancy ◽

Secondary Outcome ◽

Cross Sectional ◽

Vaccine Acceptance ◽

Factors Associated ◽

Increased Risk ◽

Individual Disease ◽

Disease Specific

ObjectivesVaccine hesitancy may represent a barrier to effective COVID-19 immunisation campaigns. This study assesses individual, disease-specific and contextual factors associated with COVID-19 vaccine acceptance among a nationally representative sample of older Brazilian adults.DesignCross-sectional analysis of data from household interviews and a supplementary telephone survey.SettingBrazil and its five geographic regions.ParticipantsData are derived from 6584 individuals aged 50 years and over who participated in the second wave of the Brazilian Longitudinal Study of Aging.Primary and secondary outcome measuresSurvey-weighted multinomial logistic regression assesses factors associated with intending, not intending or being uncertain about one’s intention to vaccinate against COVID-19.FindingsSeventy-one per cent of study participants intend to receive a COVID-19 vaccine once available, while 17% (representative of nearly 9 million people) have no intention to vaccinate, and 12% are still undecided. Besides age, demographic and health-related factors related to COVID-19 severity and complications were not associated with intention to vaccinate. Those who most trusted social media or friends and family for COVID-19 information and those who did not trust any information source were 68% and 78% more likely to refuse vaccination, respectively, as compared with those who trusted official information sources. People who inconsistently used face masks when outside were 3.4 times more likely than consistent face mask users to intend to refuse vaccination. Higher municipal COVID-19 fatality rates were negatively associated with vaccine refusal.ConclusionsMost national COVID-19 immunisation strategies identify older individuals as among those prioritised for early vaccination, given their increased risk of more severe symptoms and complications of the disease. Because individual, disease-specific, and contextual factors were associated with vaccine acceptance, there is a clear need for multilevel and multichannel information and outreach campaigns to increase COVID-19 vaccine acceptance among vulnerable older populations.

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Therapeutic options in male osteoporosis

Osteologie/Osteology ◽

10.1055/s-0038-1630134 ◽

2013 ◽

Vol 22 (04) ◽

pp. 271-276 ◽

Cited By ~ 1

Author(s):

P. Farahmand ◽

J. D. Ringe

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Public Health Problem ◽

Male Osteoporosis ◽

Individual Risk ◽

Modes Of Action ◽

Increased Risk ◽

Study Results ◽

Long Term Treatment ◽

Male Patients

SummaryOsteoporosis in men is increasingly recognized as an important public health problem but affected patients are still under-diagnosed and -treated. As in women the diagnostic and therapeutic strategy has to be adapted to the individual case. In the practical management it is very important to detect possible causes of secondary osteoporosis, to explain the possibilities of basic therapy counteracting individual risk factors and communicate that osteoporosis is a chronic disease and adherence to a long-term treatment is crucial. In established severe osteoporosis a careful analgesic therapy is important to avoid further bone loss related to immobility. In elderly men with increased risk of falling insufficient Vitamin D supply or impaired activation of Vitamin D due to renal insufficiency must be taken into consideration. Specific medications available today for the treatment of male osteoporosis comprise among antiresorptive drugs the bis phosphonates alendronate, risedronate and zoledronic acid. Denosumab, the first biological therapy is approved for men with androgen deprivation therapy for prostate cancer. An important advantage of this potent antiresorptive drug is the increased adherence due to the comfortable application by sixmonthly subcutaneous injections. Study results from the 2-year multi-center randomized controlled ADAMO-Study will very soon allow the use of denosumab in all types of male osteoporosis. Teriparatide, the 34 N-terminal amino acid sequence of parathyroid hormone was approved for men with osteoporosis as an anabolic agent based on proven efficacy by different studies. Among drugs with other modes of action the D-hormone pro-drug alfacalcidol can be used in men alone or in combination with the advantage of pleiotropic effects on calcium absorption, parathyroids, bone and muscle. Recently also Strontium-ranelate was approved for male patients with the limitation to exclude men with clinical relevant cardiovascular risk factors. In general the possibilities to treat male osteoporosis have considerably improved during recent years. Today there is a choice of a spectrum of drugs from mild to strong potency with different modes of action on bone turnover to design strategies for individual male patients.

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Drinking Water Consumption Patterns: An Exploration of Risk Perception and Governance in Two First Nations Communities

Sustainability ◽

10.3390/su12176851 ◽

2020 ◽

Vol 12 (17) ◽

pp. 6851

Author(s):

Neal Spicer ◽

Brenda Parlee ◽

Molly Chisaakay ◽

Doug Lamalice

Keyword(s):

Drinking Water ◽

Risk Perception ◽

First Nations ◽

Water Consumption ◽

Local Community ◽

Indigenous Communities ◽

Bottled Water ◽

Consumption Patterns ◽

First Nation ◽

Individual Risk

Many Indigenous communities across Canada suffer from the lack of access to clean drinking water; ensuring individuals and communities have safe water to drink either from their home or from their local environment requires the consideration of multiple factors including individual risk perception. In collaboration with local leaders, semi-structured interviews (n = 99) were conducted over a two-year period in the Dene Tha’ First Nation and Kátł’odeeche First Nation to unpack the issue of risk perception and its meaning to local community members. These local metrics of risk perception including smell, taste, safety, health fears and level of concern were then used to explore patterns in other data on drinking water consumption patterns and bottled water use. The results are consistent with previous research related to water insecurity and indicate that both communities consume more bottled water than the average Canadian. Results also varied by jurisdiction; those in Alberta indicated much higher levels of concern and a greater degree of bottled water consumption.

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Real-World Acceptance of COVID-19 Vaccines among Healthcare Workers in Perinatal Medicine in China

Vaccines ◽

10.3390/vaccines9070704 ◽

2021 ◽

Vol 9 (7) ◽

pp. 704

Author(s):

Biyun Xu ◽

Xuelian Gao ◽

Xinyue Zhang ◽

Yali Hu ◽

Huixia Yang ◽

...

Keyword(s):

General Population ◽

Real World ◽

Healthcare Workers ◽

Vaccine Safety ◽

Vaccine Hesitancy ◽

Present Survey ◽

Perinatal Medicine ◽

Vaccine Acceptance ◽

Questionnaire Online ◽

Convincing Data

Surveys showed that vaccine hesitancy may influence the acceptance of COVID-19 vaccines in healthcare workers (HCWs) and the general population. Currently, the actual acceptance of COVID-19 vaccination in HCWs has rarely been reported. In the present survey, we investigated the real-world acceptance of COVID-19 vaccination in HCWs in perinatal medicine during the first three-month period of vaccination in China and to identify the main reason for the decline of vaccination. HCWs (1087) who participated in a Chinese national symposium on perinatal medicine during 16–18 April 2021 were invited to answer a 27-question questionnaire online. A total of 1051 HCWs completed the questionnaire. Of them, 86.2% (906/1051) accepted the COVID-19 vaccination and 13.8% (145/1051) declined the vaccination. Because of the vaccine hesitancy, one-fourth of the vaccinated participants did not accept the vaccination until consulted with others or requested by employers. The main reason for the decline of vaccination in 145 unvaccinated HCWs was the concern about vaccine safety. The results indicate that vaccination request by employers may promote vaccine acceptance. More convincing data on the safety of COVID-19 vaccines appears to be important to increase the acceptance of vaccination.

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Attitudes toward the SARS-CoV-2 Vaccine: Results from the Saudi Residents’ Intention to Get Vaccinated against COVID-19 (SRIGVAC) Study

Vaccines ◽

10.3390/vaccines9070798 ◽

2021 ◽

Vol 9 (7) ◽

pp. 798

Author(s):

Sami H. Alzahrani ◽

Mukhtiar Baig ◽

Mohammed W. Alrabia ◽

Mohammed R. Algethami ◽

Meshari M. Alhamdan ◽

...

Keyword(s):

Saudi Arabia ◽

Health Beliefs ◽

Multinomial Logistic Regression ◽

Demographic Data ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Relative Risk Ratio ◽

Cross Sectional ◽

Vaccine Acceptance ◽

Web Based

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.

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Prevalence and Determinants of Vaccine Hesitancy and Vaccines Recommendation Discrepancies among General Practitioners in French-Speaking Parts of Belgium

Vaccines ◽

10.3390/vaccines9070771 ◽

2021 ◽

Vol 9 (7) ◽

pp. 771

Author(s):

Cathy Gobert ◽

Pascal Semaille ◽

Thierry Van der Schueren ◽

Pierre Verger ◽

Nicolas Dauby

Keyword(s):

General Practitioners ◽

Online Survey ◽

Critical Role ◽

Personal Characteristics ◽

Vaccine Hesitancy ◽

Patient Acceptance ◽

Recent Experience ◽

Average Percentage ◽

Vaccine Recommendations ◽

Increased Risk

General practitioners (GPs) play a critical role in patient acceptance of vaccination. Vaccine hesitancy (VH) is a growing phenomenon in the general population but also affects GPs. Few data exist on VH among GPs. The objectives of this analysis of a population of GPs in the Belgian Wallonia-Brussels Federation (WBF) were to: (1) determine the prevalence and the features of VH, (2) identify the correlates, and (3) estimate the discrepancy in vaccination’s behaviors between the GPs’ children and the recommendations made to their patients. An online survey was carried out among the population of general practitioners practicing in the WBF between 7 January and 18 March 2020. A hierarchical cluster analysis was carried out based on various dimensions of vaccine hesitancy: perception of the risks and the usefulness of vaccines as well as vaccine recommendations for their patients. A total of 251 GPs answered the survey. The average percentage of moderate to high vaccine hesitancy was 50.6%. Three factors were independently associated with increased risk of vaccine hesitancy: an age <50 years old, having no children, and having no contact with selected vaccine-preventable disease (measles, complicated influenza, chronic hepatitis B (HBV), bacterial meningitis, or cervical cancer) in the past 5 years. VH was associated with controversies on vaccines’ safety. GPs who had vaccinated their children against six diseases (MMR, meningococcus C (MenC), HBV, and HPV) tended not to recommend the same vaccines to their patients. Among GPs with all children vaccinated against HBV, only 37.5% recommended catch-up HBV immunization to their patients. In this small cohort of GP, moderate to high VH was associated with controversies on vaccines’ safety and with specific personal characteristics (age <50, no children, and no recent experience with a serious VPD). As previously reported, GPs have different vaccine prescription attitude toward their patients and children. These findings should be confirmed in larger cohorts.

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