scholarly journals Addressing vaccine hesitancy and access barriers to achieve persistent progress in Israel’s COVID-19 vaccination program

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Bruce Rosen ◽  
Ruth Waitzberg ◽  
Avi Israeli ◽  
Michael Hartal ◽  
Nadav Davidovitch
Keyword(s):  
Young Adults ◽  
General Population ◽  
Minority Groups ◽  
Vaccine Uptake ◽  
High Rate ◽  
Vaccine Hesitancy ◽  
List Type ◽  
Access Barriers ◽  
Cultural Minority ◽  
Israeli Arabs

AbstractAs of March 31, 2021, Israel had administered 116 doses of vaccine for COVID-19 per 100 population (of any age) – far more than any other OECD country. It was also ahead of other OECD countries in terms of the share of the population that had received at least one vaccination (61%) and the share that had been fully vaccinated (55%). Among Israelis aged 16 and over, the comparable figures were 81 and 74%, respectively. In light of this, the objectives of this article are: To describe and analyze the vaccination uptake through the end of March 2021 To identify behavioral and other barriers that likely affected desire or ability to be vaccinated To describe the efforts undertaken to overcome those barriers Israel’s vaccination campaign was launched on December 20, and within 2.5 weeks, 20% of Israelis had received their first dose. Afterwards, the pace slowed. It took an additional 4 weeks to increase from 20 to 40% and yet another 6 weeks to increase from 40 to 60%. Initially, uptake was low among young adults, and two religious/cultural minority groups - ultra-Orthodox Jews and Israeli Arabs, but their uptake increased markedly over time.In the first quarter of 2021, Israel had to enhance access to the vaccine, address a moderate amount of vaccine hesitancy in its general population, and also address more intense pockets of vaccine hesitancy among young adults and religious/cultural minority groups. A continued high rate of infection during the months of February and March, despite broad vaccination coverage at the time, created confusion about vaccine effectiveness, which in turn contributed to vaccine hesitancy. Among Israeli Arabs, some residents of smaller villages encountered difficulties in reaching vaccination sites, and that also slowed the rate of vaccination.The challenges were addressed via a mix of messaging, incentives, extensions to the initial vaccine delivery system, and other measures. Many of the measures addressed the general population, while others were targeted at subgroups with below-average vaccination rates. Once the early adopters had been vaccinated, it took hard, creative work to increase population coverage from 40 to 60% and beyond.Significantly, some of the capacities and strategies that helped Israel address vaccine hesitancy and geographic access barriers are different from those that enabled it to procure, distribute and administer the vaccines. Some of these strategies are likely to be relevant to other countries as they progress from the challenges of securing an adequate vaccine supply and streamlining distribution to the challenge of encouraging vaccine uptake.

COVID-19 Vaccine Perceptions, Intentions, and Uptake in a Prospective College-based Cohort Study (Preprint)

2021 ◽  
Author(s):  
Stephen Gurley ◽  
Brady Bennett ◽  
Patrick Sullivan ◽  
Maryellen Kiley ◽  
Jamie Linde ◽  
...  
Keyword(s):  
Young Adults ◽  
Racial Differences ◽  
Ethnic Minorities ◽  
Minority Groups ◽  
Herd Immunity ◽  
P Uptake ◽  
Self Report ◽  
Vaccine Uptake ◽  
Racial And Ethnic Minorities ◽  
To Receive

BACKGROUND Uptake of the COVID-19 vaccine among US young adults, particularly those that belong to racial and ethnic minorities, remains low compared to their older peers. Understanding vaccine perceptions and their influence on vaccination uptake among this population remains crucial to achieving population herd immunity. OBJECTIVE We sought to also study the perceptions and uptake of the vaccines against COVID-19 among one population of college students, faculty, and staff. METHODS As part of a larger study aimed at investigating the dynamics of COVID-19 transmission, serology, and perception on a college campus, participants were asked about their views on the COVID-19 vaccine in February 2021. Vaccination status was assessed by self-report in April 2021. Logistic regression was used to calculate prevalence ratios with marginal standardization. RESULTS We found that non-White participants were 25% less likely to report COVID-19 vaccination compared to White participants. Among those who were unvaccinated, Black and other non-White participants were significantly more likely to indicate they were unwilling to receive the COVID-19 vaccine compared to White participants. The most common reason for unwillingness to receive the vaccine was belief that the vaccine approval process was rushed. CONCLUSIONS There are racial differences in perceptions of the COVID-19 vaccine among young adults, and these differences might differentially impact vaccine uptake among young racial and ethnic minorities. Efforts to increase vaccine uptake among college populations might require campaigns specifically tailored to these minority groups.

scholarly journals Changing the Narrative: Structural Barriers and Racial and Ethnic Inequities in COVID-19 Vaccination

2021 ◽  
Vol 18 (18) ◽  
pp. 9904
Author(s):  
Anuli Njoku ◽  
Marcelin Joseph ◽  
Rochelle Felix
Keyword(s):  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Structural Barriers ◽  
Structural Racism ◽  
Vaccination Rates ◽  
Promising Solution ◽  
The Impact

The COVID-19 pandemic has disproportionately affected racial and ethnic minority groups in the United States. Although a promising solution of the COVID-19 vaccination offers hope, disparities in access again threaten the health of these communities. Various explanations have arisen for the cause of disparate vaccination rates among racial and ethnic minorities, including discussion of vaccine hesitancy. Conversely, the role of vaccine accessibility rooted in structural racism as a driver in these disparities should be further explored. This paper discusses the impact of structural barriers on racial and ethnic disparities in COVID-19 vaccine uptake. We also recommend public health, health system, and community-engaged approaches to reduce racial disparities in COVID-19 disease and mortality.

scholarly journals Understanding COVID-19 vaccine hesitancy in Pakistan: The paradigm of Confidence, Convenience and Complacency; A Cross-sectional study.

2021 ◽  
Author(s):  
Naveen Siddique Sheikh ◽  
Mumtaz Touseef ◽  
Riddah Sultan ◽  
Kanwal Hassan Cheema ◽  
Sidra Shafiq Cheema ◽  
...  
Keyword(s):  
General Population ◽  
Healthcare Workers ◽  
Herd Immunity ◽  
Population Data ◽  
Cross Sectional Study ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vaccination Programs

Background and objectives: Vaccine hesitancy is a big obstacle for vaccination programs, as is anticipated for the COVID-19 vaccination program, resulting in low uptake of vaccines thereby hindering the process of reaching herd immunity. Bearing this in mind the current study was aimed to explore the determinants of vaccine hesitancy amongst the Pakistani population. Methodology: A cross-sectional study was carried out from the 23rd-31st January 2021. The conceptual framework of the study was based on the 3Cs (Confidence, Convenience, Complacency) model. Google-forms-based questionnaire was disseminated amongst the general population. Data collected were entered into SPSS version 26 and analyzed. Results: Of the 421 participants, 68.4% were females. Non-healthcare workers were 55.8% of respondents. Vaccine hesitant individuals, 26.13% reported they were very unlikely to get vaccinated. Vaccine was not safe as it came out too fast was agreed upon by 12.6% individuals, 50.6% were worried about experiencing side-effects, 18% believed vaccine will not offer protection and 5.9% believed vaccine would cause death. Low Practice of SOP in non-Healthcare workers was the strongest contributor to vaccine hesitancy (OR: 5.338, p=0.040, 95% CI: 1.082-26.330) followed by High complacency (p=0.026) and Moderate Complacency (OR: 0.212, p=0.007, 95% CI: 0.069-0.654) towards COVID-19 vaccination. In Healthcare workers the strongest contributor to vaccine hesitancy was having a Moderate Confidence (OR: 0.323, p=0.042, 95% CI: 0.109-0.958) in the vaccine followed by Moderate Convenience (OR: 0.304, p=0.049, 95% CI: 0.093-0.993) for vaccination Conclusion: Campaigning and communication strategies to reaffirm confidence in the COVID-19 vaccine and educating the general population about the vaccine could lead to increased perception of vaccine safety and effectiveness thereby restoring confidence in vaccine and decreasing vaccine hesitancy. Likewise, working to increase vaccine convenience and decreasing complacency towards the COVID-19 vaccine would translate into high vaccine uptake.

scholarly journals Early evidence of COVID-19 vaccine effectiveness within the general population of California

2021 ◽  
Author(s):  
Kristin Andrejko ◽  
Jake M Pry ◽  
Jennifer F Myers ◽  
Nicholas P Jewell ◽  
John Openshaw ◽  
...  
Keyword(s):  
General Population ◽  
Diagnostic Testing ◽  
Herd Immunity ◽  
Geographic Region ◽  
Vaccine Effectiveness ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Molecular Diagnostic ◽  
California Department ◽  
To Receive

Importance: Evidence is needed to determine COVID-19 vaccine effectiveness under real world conditions of use. Objective: To determine the effectiveness of authorized vaccines against COVID-19 in the context of substantial circulation of SARS-CoV-2 variants of concern, and identify vaccine uptake barriers. Design: We recruited cases (testing positive) and controls (testing negative) based on SARS-CoV-2 molecular diagnostic test results from 24 February-7 April 2021. Controls were individually matched to cases by age, sex, and geographic region. We identified cases and controls via random sampling within predetermined demographic strata. We conducted enrollment and administered study questionnaires via telephone-based facilitated interviews. Setting: Population-based surveillance of all SARS-CoV-2 molecular diagnostic testing reported to the California Department of Public Health. During the study period, 69% of sequenced SARS-CoV-2 isolates in California belonged to variants of concern B.1.1.7, B.1.427, or B.1.429. Participants: We enrolled 645 adults aged ≥18y, including 325 cases and 320 controls Exposures: We assessed participants' self-reported history of COVID-19 vaccine receipt (BNT162b2 and mRNA-1273). Individuals were considered fully vaccinated two weeks after second dose receipt. Main Outcomes and Measures: The primary endpoint was a positive SARS-CoV-2 molecular test result. For unvaccinated participants, we assessed willingness to receive vaccination, when eligible. We measured vaccine effectiveness via the matched odds ratio of prior vaccination, comparing cases with controls. Results: Among 325 cases, 23 (7%) and 13 (4%) received BNT162b2 and mRNA-1273, respectively; 8 (2%) were fully vaccinated with either product. Among 260 controls, 49 (19%) and 49 (19%) received BNT162b2 and mRNA-1273, respectively; 42 (16%) were fully vaccinated with either product. Among fully vaccinated individuals, vaccine effectiveness was 86% (95% confidence interval: 67-94%). Vaccine effectiveness was 66% (-69% to 93%) and 78% (23% to 94%) one week following a first and second dose, respectively. Among unvaccinated participants, 39% of those residing in rural regions and 23% of those residing in urban regions reported hesitancy to receive COVID-19 vaccines, when eligible. In contrast, vaccine hesitancy did not significantly differ by age, sex, household income, or race/ethnicity. Conclusions and Relevance: Ongoing vaccination efforts are preventing SARS-CoV-2 infection in the general population in California. Vaccine hesitancy presents a barrier to reaching coverage levels needed for herd immunity.

scholarly journals COVID-19 vaccine hesitancy among individuals with cancer, autoimmune diseases, and other serious comorbid conditions

2021 ◽  
Author(s):  
Richard Tsai ◽  
John Hervey ◽  
Kathleen D Hoffman ◽  
Jessica Wood ◽  
John Novack ◽  
...  
Keyword(s):  
Clinical Trials ◽  
General Population ◽  
Autoimmune Diseases ◽  
Online Survey ◽  
Safety Data ◽  
Vaccine Safety ◽  
Vaccine Hesitancy ◽  
List Type ◽  
Comorbid Conditions ◽  
Chronic Lung Diseases

AbstractBackgroundIndividuals with comorbid conditions have been disproportionately affected by COVID-19. Since regulatory clinical trials with COVID-19 vaccines excluded those with immunocompromising conditions, few patients with cancer and autoimmune diseases were enrolled. With limited vaccine safety data available, vulnerable populations may have conflicted vaccine attitudes.MethodsTo assess the incidence and reasons for COVID-19 vaccine hesitancy and to assess early vaccine safety, we conducted a cross-sectional online survey, fielded January 15, 2021 through February 22, 2021, with international participation (74% USA). A random sample of members of Inspire, an⍰online health⍰community⍰of over 2.2⍰million individuals⍰with comorbid conditions, completed a 55-item online survey.Results21,943 individuals completed the survey (100% with comorbidities including 27% cancer, 23% autoimmune diseases, 38% chronic lung diseases). 10% declared they would not, 4% stated they probably would not, and 5% were not sure they would agree to vaccination (hesitancy rate 19%). Factors associated with hesitancy included younger age, female gender, black-Pacific-Island-Native American heritage, less formal education, conservative political tendencies, resistance to masks or routine influenza vaccinations, and distrust of media coverage. 5501 (25%) had received at least one COVID-19 vaccine injection, including 29% of US participants. Following the first injection, 69% self-reported local and 40% systemic reactions, which increased following the second injection to 76% and 67%, respectively, with patterns mimicking clinical trials.ConclusionNearly one in five individuals with serious comorbid conditions harbor COVID-19 hesitancy. Early safety experiences among those who have been vaccinated should be reassuring.HighlightsIndividuals with serious comorbid conditions, including cancer, have been disproportionately affected by COVID-19 and therefore have been prioritized for vaccinationAn online survey of nearly 22,000 individuals with comorbid conditions revealed that nearly one in 5 expressed vaccine hesitancy.Reasons for hesitancy in this comorbid population mimicked surveys of the general population.Self-reported safety profiles among individuals with comorbid conditions were acceptable, and generally milder than reports in clinical trials among the general population.

scholarly journals COVID-19 vaccine hesitancy in care home staff: a survey of Liverpool care homes

2021 ◽  
Author(s):  
John S P Tulloch ◽  
Karen Lawrenson ◽  
Adam L Gordon ◽  
Sam Ghebrehewet ◽  
Matthew Ashton ◽  
...  
Keyword(s):  
Care Home ◽  
City Council ◽  
Vaccine Uptake ◽  
Care Homes ◽  
Vaccine Hesitancy ◽  
High Morbidity ◽  
List Type ◽  
Staff Members ◽  
Care Home Staff ◽  
Uptake Rates

AbstractBackgroundCOVID-19 has caused high morbidity and mortality in UK care homes. Vaccinating staff members and residents will protect care homes from severe clinical cases. Uptake of COVID-19 vaccine first doses in care homes has been higher among residents compared to staff members.MethodsWe aimed to identify causes of lower COVID-19 vaccine uptake amongst care home staff members within the Liverpool City Council region. An anonymised online survey was distributed to all care home managers between the 21st and the 29th of January 2021. Descriptive analysis was performed on responses.Results46/87 (53%) of Liverpool care homes responded. The mean staff vaccination rate per home was 51.4% (95% CI 43.9-58.8%). The most common reasons for staff not receiving the vaccine were: concerns about lack of vaccine research (37.0%), staff being off-site during vaccination sessions (36.5%), pregnancy and fertility concerns (5.6%), and concerns about allergic reactions (3.2%). Care home managers reported the necessity to combat vaccine hesitancy through meetings and conversations with health professionals, and provision of supporting evidence to dispel vaccine misinformation.ConclusionsVaccine hesitancy was the main cause for reduced vaccine uptake among care home staff members. These concerns could be addressed by targeted evidence-based training, and a public health communication campaign to build vaccine confidence and increase acceptance of COVID-19 vaccines. The speed of vaccination roll-out has also led to unexpected logistical issues that lowered vaccine uptake rates. Addressing both these challenges could increase uptake by more than 40%.Key PointsCOVID-19 vaccine uptake rates are lower in staff than residentsThree main causes of reduced uptake have been identified: vaccine hesitancy, logistical issues, and medical concerns.The main reasons for vaccine hesitancy were concerns about limited research into vaccine safety, and concerns about long-term impact on pregnancy and fertility.Addressing care home staff vaccination concerns should be given priority in these settings.

scholarly journals Factors Associated with COVID-19 Vaccine Hesitancy among Visible Minority Groups from a Global Context: A Scoping Review

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1445
Author(s):  
Candy Ochieng ◽  
Sabrita Anand ◽  
George Mutwiri ◽  
Michael Szafron ◽  
Khrisha Alphonsus
Keyword(s):  
Scoping Review ◽  
Minority Groups ◽  
Herd Immunity ◽  
Principal Component ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Exclusion Criteria ◽  
Global Context ◽  
Visible Minorities ◽  
Comprehensive Search

Vaccine hesitancy is one of the top ten greatest threats to global health. During the COVID-19 era, vaccine hesitancy poses substantial risks, especially in visible minorities, who are disproportionately affected by the pandemic. Although evidence of vaccine hesitancy exists, there is minimal focus on visible minorities and the reasons for hesitancy in this group are unclear. Identifying these populations and their reasons for vaccine hesitancy is crucial in improving vaccine uptake and curbing the spread of COVID-19. This scoping review follows a modified version of the Arksey and O’Malley strategy. Using comprehensive search strategies, advanced searches were conducted on Medline, CINAHL, and PubMed databases to acquire relevant articles. Full-text reviews using inclusion and exclusion criteria were performed to extract themes of vaccine hesitancy. Themes were grouped into factors using thematic qualitative analysis and were objectively confirmed by principal component analysis (PCA). To complement both analyses, a word cloud of titles and abstracts for the final articles was generated. This study included 71 articles. Themes were grouped into 8 factors and the top 3 recurring factors were safety and effectiveness of the vaccine, mistrust, and socioeconomic characteristics. Shedding light on these factors could help mitigate health inequities and increase overall vaccine uptake worldwide through interventions and policies targeted at these factors. Ultimately, this would help achieve global herd immunity.

scholarly journals Racial discrimination and covid-19 vaccine uptake: is mistrust of the health service behind vaccine refusal?

2021 ◽  
Author(s):  
Elise Paul ◽  
Daisy Fancourt ◽  
Mohammad Razai
Keyword(s):  
Health Service ◽  
Ethnic Minority ◽  
Minority Groups ◽  
Ethnic Discrimination ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Medical Setting ◽  
Ethnic Minority Groups ◽  
Vaccine Refusal ◽  
Racial Ethnic

Objectives To assess the role of racial and ethnic discrimination in determining covid-19 vaccine refusal in ethnic minority groups. Design Population based cohort study. Setting Survey data from the University College London COVID-19 Social Study. Participants Data from 633 adults belonging to ethnic minority groups who took part in the study from 23 July 2020 to 14 June 2021 were included. Experiences of racial/ethnic discrimination occurring since the start of the first lockdown were collected in the last week of July 2020. Structural equation modelling was used to model the direct effect of racial/ethnic discrimination on covid-19 vaccine refusal, as well as the indirect effects through low trust in the central UK government and the UK health service to handle the pandemic. The model adjusted for a range of demographic and covid-19-related covariates. Main outcome measures Data on covid-19 vaccination status was collected from 23 December 2020 to 14 June 2021 and operationalised as having had or agreed to have at least one dose versus having been offered but turned it down (refusal). Results Nearly one in ten (6.7%) who had refused a covid-19 vaccine reported having experienced racial/ethnic discrimination in a medical setting since the start of the pandemic and had experienced twice as many incidents of racial/ethnic discrimination than those who had accepted the vaccine. The total effect of racial/ethnic discrimination on refusing a covid-19 vaccine was nearly 4-fold (odds ratio [OR] = 3.9, 95% confidence interval [CI] = 1.4 to 10.9) and was mediated by low trust in the health system to handle the pandemic (indirect effect: OR = 2.5, 95% CI = 1.1 to 5.4). Conclusions Findings underscore the importance of addressing racial/ethnic discrimination in order to increase covid-19 vaccine uptake amongst ethnic minority adults. The results also highlight the crucial role the National Health Service must play in regaining trust from ethnic minority groups in order to overcome vaccine hesitancy.

scholarly journals What is the extent of COVID-19 vaccine hesitancy in Bangladesh? : A cross-sectional rapid national survey

2021 ◽  
Author(s):  
Mohammad Ali ◽  
Ahmed Hossain
Keyword(s):  
Logistic Regression ◽  
General Population ◽  
Low Income ◽  
Univariate Analysis ◽  
Vaccine Hesitancy ◽  
List Type ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Wide Range

AbstractobjectivesTo assess COVID-19 vaccine hesitancy in Bangladesh and identify population subgroups with higher odds of vaccine hesitancy.designA nationally representative cross-sectional survey was used. Univariate analysis was employed to compute vaccine hesitancy proportions and compare them across groups and multiple logistic regression analyses were performed to compute the adjusted odds ratio.settingBangladeshparticipantsA total of 1134 participants from the general population, aged 18 years and above.outcome measuresPrevalence and predictors of vaccine hesitancy.results32.5% of participants showed COVID-19 vaccine hesitancy. Hesitancy was high among respondents who were males, over age 60, unemployed, from low-income families, from central Bangladesh including Dhaka, living in rented houses, tobacco users, politically affiliated, participants who did not believe in the vaccine’s effectiveness for Bangladeshis and those who did not have any physical illnesses in the last year. In the multilevel logistic regression models, respondents who were transgender (AOR= 3.62), married (AOR=1.49), tobacco users (AOR=1.33), those who did not get any physical illnesses in the last year (AOR=1.49), those with political affiliations with opposition parties (AOR= 1.48), those who believed COVID-19 vaccines will not be effective for Bangladeshis (AOR= 3.20), and those who were slightly concerned (AOR = 2.87) or not concerned at all (AOR = 7.45) about themselves or a family member getting infected with COVID-19 in the next one year were significantly associated with vaccine hesitancy (p < 0.05).conclusionsGiven the high prevalence of COVID-19 vaccine hesitancy, it is important to promote evidence-based communication, mass media campaigns, and policy initiatives across Bangladesh to reduce vaccine hesitancy among the Bangladeshi population.Strengths and Limitations of the studyThis study is the first its kind to measure COVID-19 vaccine hesitancy in Bangladesh.In this study, randomly selected participants were interviewed face to face, enabling a nearly true representative sample of the Bangladeshi general population.This study identified a wide range of sub-groups of the general population with higher odds of COVID-19 vaccine hesitancy relating to their sociodemographic characteristics in Bangladesh; thus, providing baseline evidence for the low and middle-income and low-resourced countries worldwide.Traditional media and social media influence on COVID-19 vaccine hesitancy was not measured which is a major limitation of this study.

scholarly journals Role of Vaccine Hesitancy, eHealth Literacy, and Vaccine Literacy in Young Adults’ COVID-19 Vaccine Uptake Intention in a Lower-Middle-Income Country

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1405
Author(s):  
Rima Nath ◽  
Asif Imtiaz ◽  
Shobod Deba Nath ◽  
Emran Hasan
Keyword(s):  
Young Adults ◽  
Middle Income Country ◽  
Least Square ◽  
Control Measures ◽  
Vaccine Uptake ◽  
Income Country ◽  
Vaccine Hesitancy ◽  
Middle Income ◽  
Ehealth Literacy ◽  
Lower Middle Income Country

Various control measures, including vaccination, have been taken to flatten the COVID-19 epidemic curve across the globe. However, in Bangladesh, many young adults, considered the asymptomatic transmitter of the disease, are waiting to get their first shot. Therefore, the potential predictors of the young adults’ vaccine uptake intention are significant to ensure their maximum vaccination when available to them. This study examined how vaccine hesitancy, eHealth literacy, and vaccine literacy are associated with young adults’ COVID-19 vaccine uptake intention in a lower-middle-income country. A total of 343 young adults participated in the study. Using ordinary least square and probit estimation, we examined the effect of the explanatory variables of interest on vaccine uptake intention. Vaccine hesitancy emerged as the strongest predictor of vaccine uptake intention. eHealth literacy shared a positive association with vaccine uptake intention, while vaccine literacy had no significant association. To make young adults feel more confident about the vaccine, transmitting the latest vaccine safety updates through authentic channels is essential. The government can aim to enhance the eHealth literacy of young adults as an increased level of eHealth literacy will enable young adults to extract reliable health-related information more efficiently than ever.

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