Cyberchondria, Fear of COVID-19, and Risk Perception Mediate the Association between Problematic Social Media Use and Intention to Get a COVID-19 Vaccine

Vaccination is the most effective way to control the COVID-19 pandemic, but vaccination hesitancy threatens this effort worldwide. Consequently, there is a need to understand what influences individuals’ intention to get a COVID-19 vaccine. Restriction of information gathering on societal developments to social media may influence attitudes towards COVID-19 vaccination through exposure to disinformation and imbalanced arguments. The present study examined the association between problematic social media use and intention to get the COVID-19 vaccine, taking into account the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception. In a cross-sectional survey study, a total of 10,843 residents of Qazvin City, Iran completed measures on problematic social media use, fear of COVID-19, cyberchondria, COVID-19 risk perception, and intention to get a COVID-19 vaccine. The data were analyzed using structural equation modeling (SEM). The results showed that there was no direct association between problematic social media use and intention to get a COVID-19 vaccine. Nonetheless, cyberchondria, fear of COVID-19, and COVID-19 risk perception (each or serially) mediated associations between problematic social media use and intention to get a COVID-19 vaccine. These results add to the understanding of the role of problematic social media use in COVID-19 vaccine hesitancy, i.e., it is not the quantity of social media use per se that matters. This knowledge of the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception can be used by public health experts and policymakers when planning educational interventions and other initiatives in COVID-19 vaccination programs.

Vaccine hesitancy in East Malaysia (Sabah): A survey of the national COVID-19 immunisation programme

The Malaysian government has introduced the National COVID-19 Immunisation Programme (PICK) as a new mechanism to address the transmission of coronavirus disease 2019 (COVID-19). Unfortunately, the number of PICK registrations is still unsatisfactory and is now even lower. The low level of participation of the Sabah (East Malaysia) population significantly impacts the PICK registrations. Therefore, this study aims to identify the factors that cause vaccine hesitancy among the people of Sabah. This study seeks to identify these trends based on zone and district boundaries. A total of 1024 respondents were sampled in this study. Raw data collected through the survey method were analysed using K-means clustering, principal component analysis (PCA), and spatial analysis. The study discovered that factors including confidence, authority, mainstream media, complacency, social media, and convenience are the top causes of vaccine hesitancy among respondents. This study also revealed that the Sabah population’s key variables causing vaccine hesitancy to vary by region (zones and districts). The conclusion is significant as a source of supporting data for stakeholders seeking to identify the Sabah population’s constraints in each region and therefore, it would help improve PICK management’s performance in Sabah.

COVID-19 vaccine brand hesitancy and other challenges to vaccination in the Philippines

Effective and safe COVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus, and prevent hospitalisations and deaths. However, COVID-19 vaccine uptake is challenged by vaccine hesitancy and anti-vaccination sentiments, a global shortage of vaccine supply, and inequitable vaccine distribution especially among low- and middle-income countries including the Philippines. In this paper, we explored vaccination narratives and challenges experienced and observed by Filipinos during the early vaccination period. We interviewed 35 individuals from a subsample of 1,599 survey respondents 18 years and older in the Philippines. The interviews were conducted in Filipino, Cebuano, and/or English via online platforms such as Zoom or via phone call. All interviews were recorded, transcribed verbatim, translated, and analysed using inductive content analysis. To highlight the complex reasons for delaying and/or refusing COVID-19 vaccines, we embedded our findings within the social ecological model. Our analysis showed that individual perceptions play a major role in the decision to vaccinate. Such perceptions are shaped by exposure to (mis)information amplified by the media, the community, and the health system. Social networks may either positively or negatively impact vaccination uptake, depending on their views on vaccines. Political issues contribute to vaccine brand hesitancy, resulting in vaccination delays and refusals. Perceptions about the inefficiency and inflexibility of the system also create additional barriers to the vaccine rollout in the country, especially among vulnerable and marginalised groups. Recognising and addressing concerns at all levels are needed to improve COVID-19 vaccination uptake and reach. Strengthening health literacy is a critical tool to combat misinformation that undermines vaccine confidence. Vaccination systems must also consider the needs of marginalised and vulnerable groups to ensure their access to vaccines. In all these efforts to improve vaccine uptake, governments will need to engage with communities to ‘co-create’ solutions.

What Accounts for the Variation in COVID-19 Vaccine Hesitancy in Eastern, Southern and Western Europe?

Attitudes towards vaccination have proven to be a major factor determining the pace of national COVID-19 vaccination campaigns throughout 2021. In Europe, large differences in levels of vaccine hesitancy and refusal have emerged, which are highly correlated with actual vaccination levels. This article explores attitudes towards COVID-19 vaccination in 27 European countries based on data from Eurobarometer (May 2021). The statistical analyses show that demographic variables have complex effects on vaccine hesitancy and refusal. Trust in different sources of health-related information has significant effects as well, with people who trust the Internet, social networks and ‘people around’ in particular being much more likely to express vaccine skepticism. As expected, beliefs in the safety and effectiveness of vaccines have large predictive power, but – more interestingly – net of these two beliefs, the effects of trust in Internet, online social networks and people as sources of health information are significantly reduced. This study shows that the effects of demographic, belief-related and other individual-level factors on vaccine hesitancy and refusal are context-specific. Yet, explanations of the differences in vaccine hesitancy across Europe need to consider primarily different levels of trust and vaccine-relevant beliefs, and to a lesser extent their differential effects.

COVID-19 infection and vaccination rates in healthcare workers in British Columbia, Canada: A Longitudinal Urban versus Rural Analysis of the Impact of the Vaccine Mandate

Purpose: Healthcare workers (HCWs) play a critical role in responding to the COVID-19 pandemic. Early in the pandemic, urban centres were hit hardest globally; rural areas gradually became more impacted. We compared COVID-19 infection and vaccine uptake in HCWs living in urban versus rural locations within, and between, two health authorities in British Columbia (BC), Canada. We also analyzed the impact of a vaccine mandate for HCWs. Methods: We tracked laboratory-confirmed SARS-CoV-2 infections, positivity rates, and vaccine uptake in 29,021 HCWs in Interior Health (IH) and 24,634 HCWs in Vancouver Coastal Health (VCH), by occupation, age, and home location, comparing to the general population in that region. We then evaluated the impact of infection rates as well as the mandate on vaccination uptake. Results: By October 27, 2021, the date that unvaccinated HCWs were prohibited from providing healthcare, only 1.6% in VCH yet 6.5% in IH remained unvaccinated. Rural workers in both areas had significantly higher unvaccinated rates compared with urban dwellers. Over 1,800 workers, comprising 6.4% of rural HCWs and 3.3% of urban HCWs, remained unvaccinated and set to be terminated from their employment. While the mandate prompted a significant increase in second doses, the impact on the unvaccinated was less clear. Conclusions: As rural areas often suffer from under-staffing, loss of HCWs could have serious impacts on healthcare provision as well as on the livelihoods of unvaccinated HCWs. Greater efforts are needed to understand how to better address the drivers of rural-related vaccine hesitancy as the pandemic continues.

The study about mindset of COVID-19 vaccination among health care employees and general population at tertiary care hospital

Background: Definitive treatment and vaccination are basic necessity to bring down the burden of COVID-19 disease. Due to rapid development of vaccine against COVID-19, associated anxiety and mistrust raises hesitancy for vaccination. We aim to study about the mindset of COVID-19 vaccination among health care employees (HCE) and general population at tertiary care hospital in north east India.Methods: This was a cross sectional and observational study; questionnaires were distributed among 200 HCE and 400 general populations visiting at different OPD regarding their mindset for vaccination. Questionnaires consisted of parameter such as history of previous COVID-19 infection or hospitalization, co-morbidities, job status during pandemic and educational qualification and contained specific questions for causes of vaccine hesitancy.Results: In the survey participants from general population were more hesitant for vaccination as compared to HCE (p<0.001). Most common cause for hesitancy among HCE was pregnancy/lactation followed by concern regarding adverse effects. Doubted efficiency and adverse effects were leading concerns (67%) for vaccine hesitancy among general population. Past history of infection or hospitalization due to COVID-19 did not affect the attitude for getting vaccinated (p>0.05). Among general population, 25% had their job affected during pandemic of which 78% were in favour of vaccination.Conclusions: Increased awareness and high risk of getting infected with COVID-19 makes HCE less hesitant for vaccination. It is important to increase awareness among the general population to bring down the concerns regarding adverse effect and potency of vaccine to reduce the hesitancy for vaccination.

Premorbid Echocardiography And Risk of Hospitalization In COVID-19

Background: COVID-19 has caused an unprecedented global pandemic, with cardiovascular risk factors predicting outcomes. We investigated whether baseline trans-thoracic echocardiography could refine risk beyond clinical risk factors. Methods: Symptomatic COVID-19 positive (RT-PCR) adults across St Luke’s University Health Network between March 1st-October 31st 2021, with trans-thoracic echocardiography (TTE) within 15-180 days preceding COVID-19 positivity were selected. Demographic/clinical/echocardiographic variables were extracted from patients’ EHR and compared between groups stratified by disease severity. Logistic regression was used to identify independent predictors of hospitalization. Results: 192 patients were included. 87 (45.3%) required hospitalization, 34 (17.7%) suffered severe disease (need for ICU care/mechanical ventilation/in-hospital death). Age, co-morbidities, and several echocardiographic abnormalities were more prevalent in moderate-severe versus mild disease. On multivariate analysis, age (OR 1.039, 95% CI 1.011-1.067), coronary artery disease (OR 4.184, 95% CI 1.451-12.063), COPD (OR 6.886, 95% CI 1.396-33.959) and left atrial (LA) diameter ≥4.0cm (OR 2.379, 95% CI 1.031-5.493) predicted need for hospitalization. Model showed excellent discrimination (ROC AUC 0.809, 95% CI 0.746-0.873). Conclusion: Baseline LA enlargement independently predicts risk of hospitalization in COVID-19. When available, baseline LA enlargement could identify patients for 1) closer outpatient follow-up, and 2) counseling vaccine-hesitancy.

Immunization Stress-Related Responses: Mitigating Patient Fears and Associated Side Effects Amidst a Global Vaccination Effort

The event of receiving a vaccine can lead to feelings of stress and anxiety for many patients and may present as adverse events. With coronavirus disease 2019 (COVID-19) mass vaccination efforts, adverse events following immunization, including immunization stress-related reactions (ISRR), have subsequently increased. Traditionally rare, but increasingly common, cluster events have also become a concern. Demonstrated in recent publications by Hause et al. concerning Janssen (Johnson & Johnson) COVID-19 vaccine clinics, these adverse events can lead to personal apprehension towards receiving vaccines, as well as public distrust towards the immunization process. To combat ISRRs, mass vaccination clinics across the United States must create administration protocols to mitigate these responses. Anticipation and swift management can play a substantial role in minimizing frequency and severity of these reactions and prevent future vaccine hesitancy.

Spatial clustering in vaccination hesitancy: the role of social influence and social selection

The phenomenon of vaccine hesitancy behavior has gained ground over the last three decades, jeopardizing the maintenance of herd immunity. This behavior tends to cluster spatially, creating pockets of unprotected sub-populations that can be hotspots for outbreak emergence. What remains less understood are the social mechanisms that can give rise to spatial clustering in vaccination behavior, particularly at the landscape scale. We focus on the presence of spatial clustering, and aim to mechanistically understand how different social processes can give rise to this phenomenon. In particular, we propose two hypotheses to explain the presence of spatial clustering: (i) social selection, in which vaccine-hesitant individuals share socio-demographic traits, and clustering of these traits generates spatial clustering in vaccine hesitancy; and (ii) social influence, in which hesitant behavior is contagious and spreads through neighboring societies, leading to hesitant clusters. Adopting a theoretical spatial network approach, we explore the role of these two processes in generating patterns of spatial clustering in vaccination behaviors under a range of spatial structures. We find that both processes are independently capable of generating spatial clustering, and the more spatially structured the social dynamics in a society are, the higher spatial clustering in vaccine-hesitant behavior it realizes. Together, we demonstrate that these processes result in unique spatial configurations of hesitant clusters, and we validate our models on both processes with fine-grain empirical data on vaccine hesitancy, social determinants, and social connectivity in the US. Finally, we propose, and evaluate the effectiveness of, two novel intervention strategies to diminish hesitant behavior. Our generative modeling approach informed by unique empirical data provides insights on the role of complex social processes in driving spatial heterogeneity in vaccine hesitancy.