Combatting a "Twin-demic": A quantitative assessment of COVID-19 and influenza vaccine hesitancy in primary care patients

Background: Public health officials anticipate severe health outcomes amidst the circulation of two major viruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza. This study investigated intent to be vaccinated against COVID-19 and influenza, and sought to identify attitudes towards vaccines and barriers for vaccine acceptance. Methods: This observational cross-sectional study was conducted in the Louisiana State University Medicine Clinic from September 2020 to December 2020. Intent to be vaccinated against the COVID-19 and influenza virus was assessed through a brief questionnaire. Additionally, hesitancy and attitudes regarding vaccines were ascertained using validated 5-point Likert scales. In total, 280 patients completed the questionnaire. Results: A total of 248 patients were included in the final analysis. Overall 167 (67%, 95% CI = 61.1-73.0%) of patients were unsure or did not intend to be vaccinated against COVID-19, while only 19.3% (95% CI = 14.4-24.5%) were unsure or did not intend to be vaccinated against the influenza vaccine. Reasons for COVID-19 vaccine hesitancy included concern regarding side effects, fear of getting sick from the vaccine, and the absence of vaccine recommendations from their doctor. Concerningly, African American patients demonstrated decreased likelihood of receiving the COVID-19 vaccine. Conclusion: This survey revealed that only 1 in 3 adults intended to be vaccinated against COVID-19, while 8 out of 10 adults intended to receive the influenza vaccine. Patients who intended on getting the COVID-19 vaccine were less likely to be African American. Given the degree of hesitancy against COVID-19 vaccination, a multifaceted approach to facilitate vaccine uptake that includes vaccine education, behavioral change strategies, and health promotion, is paramount.

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SARS-CoV-2: Vaccine Hesitancy among Underrepresented Racial and Ethnic Groups with HIV in Miami, Florida

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab154 ◽

2021 ◽

Author(s):

Deborah L Jones ◽

Ana S Salazar ◽

Violeta J Rodriguez ◽

Raymond R Balise ◽

Claudia Uribe Starita ◽

...

Keyword(s):

Race And Ethnicity ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Baseline Survey ◽

Advisory Group ◽

Medical Mistrust ◽

Cross Sectional ◽

Exact Test ◽

Novel Coronavirus

Abstract Background SARS-CoV-2 and HIV disproportionally affect underrepresented ethnoracial groups in the US. Medical mistrust and vaccine hesitancy will likely impact acceptability of SARS-CoV-2 vaccines. This study examined SARS-CoV-2 vaccine hesitancy among underrepresented ethnoracial groups with HIV and identified factors that may reduce vaccine uptake. Methods We conducted a cross-sectional study of adults ≥18 years with HIV residing in Miami, FL. Participants were invited to participate in the ACTION (A Comprehensive Translational Initiative on Novel Coronavirus) cohort study. A baseline survey was administered from April-August 2020 and followed by a COVID-19 vaccine hesitancy survey from August-November 2020. The COVID-19 vaccine hesitancy survey was adapted from the Strategic Advisory Group Experts survey. Comparisons by race and ethnicity were performed using the Freedman-Haltmann extension of Fisher’s exact test Results A total of 94 participants were enrolled, mean age 54.4 years, 52% female, 60% Black non-Latinx, and 40% non-Black Latinx. Black non-Latinx participants were less likely to agree that vaccinations are important for health when compared to non-Black Latinx (67.8% vs 92.1%, p=0.009), less likely to agree that vaccines are effective in preventing disease (67.8% vs 84.2%, p=0.029), less likely to believe that vaccine information is reliable and trustworthy (35.7% vs 71.1%, p=0.002), and less likely to believe vaccines were unnecessary because COVID-19 would disappear soon (11% vs 21%, p=0.049). Conclusion Medical mistrust, vaccine hesitancy and negative sentiments about SARS-CoV-2 vaccines are prevalent among underrepresented ethnoracial groups with HIV, particularly Black non-Latinx. Targeted strategies to increase vaccine uptake in this population are warranted.

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Knowledge, barriers and uptake of influenza vaccine among non-health college students at Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

Journal of Public Health Research ◽

10.4081/jphr.2020.1856 ◽

2020 ◽

Vol 9 (3) ◽

Author(s):

Malak M. Alhawsawi ◽

Amjad A. Alghamdi ◽

Balqees M. Alzayed ◽

Hessa M. Binmugren ◽

Raghad A. Alshehri ◽

...

Keyword(s):

Saudi Arabia ◽

Influenza Vaccine ◽

Sampling Technique ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Global Public Health ◽

Online Questionnaire ◽

Cross Sectional ◽

Knowledge Barriers ◽

Viral Influenza

Background: Viral influenza, one of the global public health problems is specifically important in Saudi Arabia due to high susceptibility of transmission in hajj and umrah seasons (Islamic pilgrimage to the Mecca), as it has the ability to spread widely to a large proportion, in addition the disease has a higher rate of complications that might lead to death. Vaccination is an important strategy in prevention of viral influenza. Design and methods: The study aimed to describe the association between uptake of influenza vaccine with knowledge as well as identify the barriers that prevent vaccination among Princess Nourah Bint Abdulrahman University (PNU) non-health colleges students. A descriptive cross-sectional study design was undertaken, including 385 students from non-health colleges using a convenience sampling technique. Data was collected using an Arabic self-administered online questionnaire Analysis done by JMP program. IRB approval as well as informed consent were taken. Results: The uptake of the influenza vaccine was 15.3% in the current year and 56.8% in the previous years. No significant association was found between knowledge, and uptake of the vaccine. For the unvaccinated students, the most common encounter barriers stated by study population were concerns regarding the vaccine effectiveness, reduction of immunity the uncertainty of complete protection in a percentage of 12.0% for all. Conclusions: Although the level of vaccine uptake is low for this year, it is not associated with knowledge. There were some barriers that need to be tackled by health education programs.

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Willingness, beliefs, and barriers regarding the COVID-19 vaccine in Saudi Arabia: a multiregional cross-sectional study

BMC Family Practice ◽

10.1186/s12875-021-01606-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Noura Altulahi ◽

Shouq AlNujaim ◽

Azzam Alabdulqader ◽

Abdullah Alkharashi ◽

Assaf AlMalki ◽

...

Keyword(s):

Saudi Arabia ◽

Herd Immunity ◽

Vaccine Safety ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Considerable Proportion ◽

Cross Sectional ◽

High School Degree ◽

Validated Questionnaire

Abstract Background The coronavirus disease 2019 (COVID-19) has spread worldwide, and the vaccine remains the ultimate cornerstone to overcoming its long-term impact. Vaccine hesitancy might obstruct the effort to achieve herd immunity and eradicate the virus. We assessed Saudi Arabian individuals’ willingness, beliefs, and barriers regarding the COVID-19 vaccine and their adherence to preventive measures during and after the pandemic. Methods A self-administered electronic validated questionnaire was distributed among the five major regions in Saudi Arabia between November and December 2020. The questionnaire addressed the sociodemographic data, beliefs, potential barriers, parents’ acceptance of COVID-19 vaccination for their children, and adherence to protective measures during and after the pandemic. Results Of 8,056 participants, 4,218 (52.4%) of a non-representative sample were willing to be vaccinated against COVID-19. Being a young adult, male, having less than a high school degree, being a smoker, having a chronic disease, and having a history of seasonal influenza vaccine uptake were positive predictors of COVID-19 vaccine acceptance. Hesitant participants reported concerns about vaccine side effects and safety as the main barriers to accepting the COVID-19 vaccine. Some refusers (26.1%) declared that they would reconsider vaccination only if the safety and effectiveness of the vaccine were reported by more studies. Conclusions Our study revealed a promising willingness to accept the vaccine among the population, with positive beliefs and attitudes toward COVID-19 vaccination. However, a considerable proportion of the population was reluctant to accept the vaccine. Thus, publicly providing information about vaccine safety and implementing health education programs is crucial for increasing the public’s confidence in the vaccine.

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1385Hesitancy for Adult Vaccination -A New Paradigm for Research in India

International Journal of Epidemiology ◽

10.1093/ije/dyab168.332 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Nikhita Kalra ◽

Tanisha Kalra ◽

Suruchi Mishra ◽

Saurav Basu ◽

Nidhi Bhatnagar

Keyword(s):

Healthcare Providers ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Health Concern ◽

Vaccine Hesitancy ◽

New Paradigm ◽

National Guidelines ◽

Cross Sectional ◽

Adult Vaccination ◽

Adult Immunization

Abstract Background Adult immunization has recently emerged as an area of emphasis in research and policy. Increasing life expectancy, outbreaks like COVID-19, and the endemic nature of diseases like dengue, malaria have underscored its importance. Therefore, this study was carried out with the aim to assess hesitancy and factors influencing the uptake of vaccines in adults. Methods An online cross-sectional study was conducted among adults (age more than 20 years). Data collection was done by convenience sampling in January 2021. Information on awareness and perceptions regarding adult vaccination and immunization status of participants was collected. Data analysis was done using SPSS version 21. Results A total of 461 adults responded to the survey. Among those who had never received any vaccine in adulthood (n = 158), the reasons were lack of recommendation by healthcare providers (38.6%), lack of knowledge of vaccines (15.8%) and fear of adverse effects following vaccination (7.6%). Hesitancy for vaccines among those who were informed by healthcare workers was as follows: shingles (97.8%), human papillomavirus (92.1%), pneumococcal (91.1%), influenza (79.7%), varicella (79.4%) and tetanus (57.6%). Conclusions Reduced vaccine uptake due to vaccine hesitancy in adulthood is a major health concern. Hesitancy was highest for the shingles vaccine and least for the tetanus vaccine. Key messages Coverage of adult vaccination can be improved by formulating national guidelines and encouraging healthcare providers to raise awareness. In-depth qualitative studies are needed to understand the perception of adults towards vaccination.

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Likelihood of COVID-19 Vaccination Among Individuals Living With Psoriatic Disease: Results From a Large Real-World Survey

Journal of Psoriasis and Psoriatic Arthritis ◽

10.1177/24755303211067822 ◽

2021 ◽

pp. 247553032110678

Author(s):

George C. Gondo ◽

Megan H. Noe ◽

Stacie J. Bell ◽

Christopher T. Ritchlin

Keyword(s):

Cross Sectional Study ◽

Individual Characteristics ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Annual Household Income ◽

Chi Square ◽

Cross Sectional ◽

Psoriatic Disease ◽

Flu Vaccine ◽

To Receive

Introduction: Development and dissemination of novel COVID-19 vaccines represent an opportunity to end the COVID-19 pandemic by vaccinating an estimated 80% of the population. Objectives: This study examines perceptions, and demographic and clinical factors influencing the likelihood of adults with psoriasis receiving a novel COVID-19 vaccine. Methods: A cross sectional study conducted from October–November 2020 of 1405 adults with psoriatic disease with prior contact to a patient advocacy organization. The main outcome of interest was the likelihood of receiving a COVID-19 vaccine. Chi-square tests and logistic regression examined the relationship between individual characteristics and likelihood of receiving a COVID-19 vaccine. Results: Most participants (65%) received a flu vaccination in the last 12 months and were (64.2%) likely to receive a COVID-19 vaccine, while 35.9% reported being unlikely receive a vaccine. Likelihood of COVID-19 vaccination was associated with receiving the flu vaccine, race, ethnicity, sex, BMI, age, income, severity of PsO and PsA. When controlling for ethnicity, race, male sex, overweight/obese status, age, biologic use, disease type, comorbidities linked with worse COVID-19 outcomes, PsA symptoms, and skin disease severity, individuals who received the flu vaccine and those with annual household income over $75,000 were most likely to receive a COVID-19 vaccine. Conclusions: Vaccine hesitancy among individuals with psoriatic disease is considerable. Dermatologists and rheumatologists can increase COVID-19 vaccine uptake by actively engaging their patients on this topic using guidance published by the National Psoriasis Foundation on the management of psoriatic disease during the COVID-19 pandemic.

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Cross-sectional study on factors associated with influenza vaccine uptake and pertussis vaccination status among pregnant women in Germany

Vaccine ◽

10.1016/j.vaccine.2014.06.007 ◽

2014 ◽

Vol 32 (33) ◽

pp. 4131-4139 ◽

Cited By ~ 54

Author(s):

Birte Bödeker ◽

Dietmar Walter ◽

Sabine Reiter ◽

Ole Wichmann

Keyword(s):

Influenza Vaccine ◽

Pregnant Women ◽

Cross Sectional Study ◽

Vaccination Status ◽

Vaccine Uptake ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated

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

10.1101/2021.07.12.21260409 ◽

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.

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