Vaccine Apathy: Status, Challenges, and Prospects

Editors

Yudong Miao

Zhengzhou University

Clifford Silver Tarimo

Dar es Salaam Institute of Technology

Quanman Li

Zhengzhou University

Jian Wu

College of Public Health, Zhengzhou University

Dongsheng Hu

Zhengzhou University

Soumitra Bhuyan

University of Memphis

Impact

Relationship between HL, ML, and barriers to the COVID-19 vaccine and some of the demographic characteristics.

Original Research

08 November 2023

Barriers to COVID-19 vaccine uptake: classification and the role of Health Literacy and Media Literacy

Soheila Ranjbaran

, 2 more and

Towhid Babazadeh

Background: Vaccination is one of the most influential and cost-effective health interventions for preventing and reducing COVID-19 diseases. Unfortunately, the majority of the world's population is deprived of vaccination. Health Literacy (HL) and Media Literacy (ML) are essential to the COVID-19 vaccination. The present study investigates the barriers to COVID-19 vaccine uptake, focusing on classification and the roles of HL and ML.

Methods: A cross-sectional study was conducted among people 18–65 years old in Sarab City, located in East Azerbaijan, Iran, between September to October 2020. Multistage cluster sampling was employed to recruit 298 people from Health Care Services Centers (HCCs).

Results: The results of this research demonstrated that about 32.6% of participants reported that they have fully injected COVID-19 vaccines. Also, HL was positively associated with ML (r = 0.214, p < 0.05). Barriers of COVID-19 vaccine uptake were classified into personal, interpersonal, group and organizational, society and decision-making factors. Besides, barriers to the COVID-19 vaccine were significantly correlated with HL (r = −0.298, p < 0.05) and ML (r = 0.266, p < 0.05). Additionally, in the hierarchical regression model, demographic characteristics accounted for 8.2% of the variation in barriers to the COVID-19 vaccine (F = 4.34; p = 0.001), that monthly income (ß = −0.237; p < 0.05) and marriage statues (ß = 0.131; p < 0.05) were statistically associated with low barriers. HL as predictor variables explained an additional 14.4% of variation in barriers of COVID-19 vaccine (F = 53.84; p < 0.001) and ML explained an extra 9.2% of the variation (F = 38.83; p < 0.001). In total, demographic characteristics, HL dimensions and ML were able to explain 31.8% of the variation in barriers to COVID-19 vaccine.

Conclusions: According to the findings, various strategies are needed to increase the COVID-19 vaccination uptake. This is due to the fact that barriers to COVID-19 vaccination uptake are multifactorial. These facts can help health policymakers and healthcare providers design media-based interventions to reduce barriers to COVID-19 vaccination uptake among adults. Enhancing vaccine HL and ML for adults and improving vaccine confidence are of high priority.

2,000 views

8 citations

Racial/ethnic differences in odds of living in a county with higher COVID-19 vaccination barriers (“very high” vs. “high” and “low/medium”; “very high” and “high” vs. “low/medium”). COVID-19 vaccination barriers were treated as an ordinal variable. Adjusted odds ratios >1 indicate that the racial/ethnic group was more likely to live in a county with higher COVID-19 vaccination barriers compared to White adults (reference group). Weighted to be nationally representative within each racial/ethnic group. Adjusted for race/ethnicity, age, gender, annual household income, education level, political ideology, health insurance coverage, and high-risk chronic health condition. ELP, English Language Preference; SLP, Spanish Language Preference.

Original Research

12 October 2023

County-level barriers in the COVID-19 vaccine coverage index and their associations with willingness to receive the COVID-19 vaccine across racial/ethnic groups in the U.S.

Jessica R. Fernandez

, 3 more and

Allana T. Forde

Background: County-level vaccination barriers (sociodemographic barriers, limited healthcare system resources, healthcare accessibility barriers, irregular healthcare seeking behaviors, history of low vaccination) may partially explain COVID-19 vaccination intentions among U.S. adults. This study examined whether county-level vaccination barriers varied across racial/ethnic groups in the U.S. and were associated with willingness to receive the COVID-19 vaccine. In addition, this study assessed whether these associations differed across racial/ethnic groups.

Methods: This study used data from the REACH-US study, a large online survey of U.S. adults (N = 5,475) completed from January 2021-March 2021. County-level vaccination barriers were measured using the COVID-19 Vaccine Coverage Index. Ordinal logistic regression estimated associations between race/ethnicity and county-level vaccination barriers and between county-level vaccination barriers and willingness to receive the COVID-19 vaccine. Models adjusted for covariates (age, gender, income, education, political ideology, health insurance, high-risk chronic health condition). Multigroup analysis estimated whether associations between barriers and willingness to receive the COVID-19 vaccine differed across racial/ethnic groups.

Results: American Indian/Alaska Native, Black/African American, Hispanic/Latino ELP [English Language Preference (ELP); Spanish Language Preference (SLP)], and Multiracial adults were more likely than White adults to live in counties with higher overall county-level vaccination barriers [Adjusted Odd Ratios (AORs):1.63–3.81]. Higher county-level vaccination barriers were generally associated with less willingness to receive the COVID-19 vaccine, yet associations were attenuated after adjusting for covariates. Trends differed across barriers and racial/ethnic groups. Higher sociodemographic barriers were associated with less willingness to receive the COVID-19 vaccine (AOR:0.78, 95% CI:0.64–0.94), whereas higher irregular care-seeking behavior was associated with greater willingness to receive the vaccine (AOR:1.20, 95% CI:1.04–1.39). Greater history of low vaccination was associated with less willingness to receive the COVID-19 vaccine among Black/African American adults (AOR:0.55, 95% CI:0.37–0.84), but greater willingness to receive the vaccine among American Indian/Alaska Native and Hispanic/Latino ELP adults (AOR:1.90, 95% CI:1.10–3.28; AOR:1.85, 95% CI:1.14–3.01).

Discussion: Future public health emergency vaccination programs should include planning and coverage efforts that account for structural barriers to preventive healthcare and their intersection with sociodemographic factors. Addressing structural barriers to COVID-19 treatment and preventive services is essential for reducing morbidity and mortality in future infectious disease outbreaks.

2,241 views

8 citations

Original Research

06 January 2023

Analysis on the intention and influencing factors of free influenza vaccination among the elderly people aged 70 and above in Hangzhou in 2022

Xinren Che

, 9 more and

Jing Wang

Background: Although influenza vaccination is recommended for people aged 70 and above in Hangzhou, and the vaccine is provided free of charge, the elderly influenza vaccination rate is still low. The purpose of this study was to understand the barriers and motivations of older people in deciding to receive free influenza vaccine through questionnaires.

Methods: The method of stratified random sampling was adopted to take samples. A questionnaire survey was conducted among the elderly aged 70 years and above by face-to-face interview or telephone interview.

Results: A total of 11,663 elderly people aged 70–100 years were successfully and effectively interviewed. 85.98% of the respondent were willing to get the influenza shot, 8.91% were unwilling to get the influenza shot, and 5.11% were on vaccine hesitancy. The people of age of 70–79 years old (hesitancy: OR_70~79 = 0.668, 95%CI: 0.571 0.782, Unwilling: OR_{70 − 79} = 0.755, 95%CI: 0.622 0.916), primary school degree or below (hesitancy: OR_{Secondary school degree or above} = 1.467, 95%CI: 1.249 1.724, Unwilling: OR_{Secondary school degree or above} = 1.255, 95%CI: 1.028 1.535), remote areas (hesitancy: OR _{near central urban area} = 2.111, 95%CI: 1.604 2.778, OR_{central urban area} = 2.957, 95%CI: 2.255 3.877, Unwilling: OR _{near central urban area} = 1.687, 95%CI: 1.230 2.313. OR_{centralurbanarea} = 2.218, 95%CI: 1.626 3.027), and convenient for movement (hesitancy: OR_yes = 0.494, 95%CI: 0.420 0.580, Unwilling: OR_yes = 0.585, 95%CI: 0.480 0.713), understanding of the free vaccine policy (hesitancy: OR_understand = 0.204, 95%CI: 0.171 0.245, Unwilling: OR_understand = 0.164, 95%CI: 0.128 0.210), influenza knowledge level≥ 13 points (hesitancy: OR_≥13points = 0.628, 95%CI: 0.533 0.739, Unwilling: OR_≥13points = 0.538, 95%CI: 0.437 0.662), influenza vaccine knowledge level≥ 12 points (hesitancy: OR_≥12points = 0.422, 95%CI: 0.350 0.508, Unwilling: OR_≥12points = 0.370, 95%CI: 0.290 0.472), and social trust level ≥ 12 points (hesitancy: OR_≥12points = 0.134, 95%CI: 0.112 0.160, Unwilling: OR_≥12points = 0.220, 95%CI: 0.180 0.269) are more willing to receive free influenza vaccine.

Conclusion: The proportion of elderly people aged 70 and above who are willing to receive free influenza vaccine is high in Hangzhou. But the level of knowledge about influenza, vaccine and trust in society is low. The government should continue to improve the elderly's awareness and trust in society through medical staff, family members, television and radio media, and guide the elderly to actively vaccinate against influenza. Effective publicity should be carried out through the above channels to guide the elderly to actively vaccinate against influenza.

2,767 views

7 citations

Original Research

10 November 2022

A study of parental decision-making over the vaccination of girls, based on the protection motivation theory and the elaboration likelihood model

Qi Wang

, 2 more and

Chenjin Tang

This study proposed a new theoretical framework that combines the protection motivation theory and the elaboration likelihood model to examine how health information processing patterns influence parents' vaccination decision-making on behalf of their daughters. Based on survey data from 359 parents of girls aged 9–15, we tested the theoretical model by using structural equation model. The results showed that the central route, represented by information quality, affected the parents' perceptions of HPV severity and susceptibility; the peripheral route, represented by source credibility, influenced their perceptions of HPV severity, HPV susceptibility, vaccine response efficacy, and secondary risks. Also, Chinese parents' perceptions of HPV vaccines, not perceptions of HPV, affected their intention to vaccinate their daughters. The study suggests in addition to improving the quality of health information, the peripheral route, such as the release of vaccination photos, public immunization evaluations, and case narratives, should also be used to change parents' perceptions. Besides, reducing the traditional stigmatization of female sexuality and improving parents' understanding of the new generation's sexual attitudes will increase parents' intention to have their daughters vaccinated against HPV.

2,782 views

5 citations