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To investigate and compare the attitudes of parents who initiated their daughters' HPV vaccination with parents who did not. Data were collected through telephone interviews with a close-end questionnaire on parents' knowledge, attitudes towards the vaccine, and the reasons for vaccinating or not their daughters against HPV. The sample was random, stratified by geographic region and urbanization level, national, and representative of the general population of parents of girls aged 11-18 in Greece. Statistical analysis consisted of descriptives, an inferential analysis with hypothesis testing, and a logistic regression model. Overall, 996 parents were included in the analysis, 99.0% of which were women. Forty-seven percent of them initiated their daughters' HPV vaccination, with physician recommendation stated as the most important reason for this decision (50.2%). For those who had not initiated their daughters' HPV vaccination (53%), lack of information was the most important reason (25.6%). In the hypothesis testing, parents with unvaccinated daughters agreed more with the statements "I do not have enough information for the HPV vaccine to decide," and "My child is very young to be vaccinated for an STD" (P <.05), but no significant difference found for the statement "It's more possible for a vaccinated girl to begin sexual activities" (P >.05). Lack of information, young age of the daughter, and perceived effectiveness of the vaccine are the most important hesitation factors. Physician recommendation is the most important reason to initiate vaccination. [ABSTRACT FROM AUTHOR]

Background and Aim: The importance of immunization has increased even more during the pandemic. This study aimed to evaluate the reasons for healthcare professionals not being vaccinated against COVID-19 and to develop solutions for the causes. Subject and Methods: This qualitative study was carried out with in-depth interviews between July 2021 and October 2021, with 32 healthcare professionals and five key people who had never been vaccinated against COVID-19. Results: The most common reasons that healthcare professionals were not vaccinated against COVID-19 were concerns about vaccine side effects, believing that the vaccine is not effective, distrust of the vaccine content and COVID-19 treatment methods, the rapid production of the vaccine, the fact that the vaccine is produced with a new technology, thinking that the vaccine is not the definitive solution, seeing themselves as healthy and young, and the belief that they would have a mild case of the disease and recover. The main themes were COVID-19 vaccine-related reasons, individual reasons/group effects, contextual reasons, and vaccination-related general issues. The main sub-themes were vaccine production, distrust, risk perception, policies and infodemic. Conclusion: It has been seen that the uncertainty, infodemic, and insecurity that emerged especially during the pandemic period are related to each other. As knowledge and awareness about the disease increase, there is an increase in risk perception. For this reason, social information studies should be increased and physicians should be enabled to use media tools more effectively. [ABSTRACT FROM AUTHOR]

Pregnant women frequently use the Internet to get information, and the information they receive is effective in their decision-making. It is known that pregnant women get information about COVID-19 vaccines from the Internet. This study aims to determine whether decision-making based on Internet sources during pregnancy is a predictive factor for vaccine hesitancy in pregnant women during the pandemic. A descriptive, cross-sectional research design was used. The data were collected by using an online survey instrument. There was a positive, moderate, and significant relationship between the self-efficacy perception sub-dimension of the internet decision-making during pregnancy scale and the risk sub-dimension of the vaccine hesitancy in pandemics scale (r:.584, p <.05) and between the self-control sub-dimension of the internet decision-making during pregnancy scale and the risk sub-dimension of the vaccine hesitancy in pandemics scale (r:.546, p <.05). The perception of self-control (β:.291) affected the lack of confidence, and the perception of self-efficacy (β:.481) affected the risk perception more than other variables. There was a relationship between internet decision-making and COVID-19 vaccine hesitancy in pregnant women. Health professionals, information specialists, and librarians should orient people to reliable sources about vaccines. [ABSTRACT FROM AUTHOR]

This study aims to investigate the extent to which the public engages in imitative behavior in their vaccination decisions for newly developed vaccines in the Chinese context. Given the crucial role of newly developed vaccines in preventing and controlling the COVID-19 pandemic, a better understanding of how people make decisions about vaccination with new vaccines is important for overcoming vaccine hesitation and promoting widespread adoption of the vaccines. Our results indicate that the public's decision-making about the newly developed vaccine is influenced by a range of heuristics, including a privileged information heuristic, competence heuristic, and consensus heuristic. Specifically, individuals are more likely to imitate the vaccination behavior of those with privileged information, such as insiders, and those with perceived competence in the field, such as experts. Our findings also demonstrate the impact of majority influence, as the popularity of new vaccines leads to an increase in vaccination uptake through herd behavior. Our data highlights the importance of the first movers who are insiders with privileged information or experts with competence, as their behavior can significantly shape the vaccination decisions of others. Our study provides valuable insights into the complex interplay of heuristics and imitative behavior in vaccination decision-making for newly developed vaccines.

The anticipation of regret is known to be a primary motivator of receiving a vaccination. Aim of this study is to evaluate whether the use of messages that leverage the anticipated emotion of regret can increase the intention to get the flu vaccination. The participants (N = 110) randomly received a leaflet containing a standard prevention message (control condition) or message modified to induce the anticipation of regret over not being vaccinated (experimental condition), along with a questionnaire. The experimental condition’s participants reported significantly higher levels of regret and higher intention to vaccinate than the participants in the control condition. Anticipated regret resulted to be a significant mediator of the intention to get vaccinated. Manipulating the salience of regret appears to be a simple and inexpensive way of effectively promoting preventive behaviour. The implications of this result for reducing COVID-19 vaccine hesitation are discussed.

ABSTRACT Objectives: to synthesize scientific evidence on vaccine hesitancy in children under five years of age and its associated factors. Methods: a scoping review, conducted according to the methodological structure proposed by the JBI. Searches were carried out in the Latin American and Caribbean Center on Health Sciences Information, Scientific Electronic Library Online and PubMed databases, including gray literature. Studies in English, Spanish and Portuguese were included, without temporal delimitation. Editorials, studies that did not address vaccine hesitancy in children under five years of age and were not aligned with the objective and research question were excluded. The sample consisted of 18 articles. Results: misinformation, concern about adverse effects, distrust about efficacy, affliction regarding administration simultaneously, and insecurity in relation to the laboratories were the reported reasons. Conclusions: strategies are needed to combat the lack of information about immunobiological agents, as misinformation was the main factor in parents’ vaccine hesitation.

Abstract Background Given the accelerated speed of COVID-19 vaccine research and administration, the main barriers to herd immunity appear to be concerns about safety and efficacy. Men and women preparing for pregnancy may have the same concerns about COVID-19 vaccination, but few studies have focused on COVID-19 vaccine uptake and hesitation among them. Methods A cross-sectional study was conducted among men and women who were preparing for pregnancy in Southwest China. The questionnaire was designed based on the theory of planned behavior (TPB). Multiple logistic regression was used to explore the determinants of the behaviors of COVID-19 vaccination. Results A total of 2878 participants completed the survey. A total of 53.89% of participants received at least one dose of the COVID-19 vaccine. A total of 45.21% of participants would receive the COVID-19 vaccine in the future. A total of 0.90% of participants never thought about receiving the COVID-19 vaccine. Multiple logistic regression model 1 showed that female participants (OR:5.497, 95%CI: 4.292–7.041), participants who never received influenza vaccine (OR:2.664, 95%CI: 1.908–3.718), participants who had never been tested for COVID-19 (OR:2.244, 95%CI:1.504–3.349), participants who had higher score of negative attitude (OR:1.448, 95%CI: 1.219–1.719), participants who had lower scores of injunctive norms (OR:0.440, 95%CI: 0.360–0.537) and descriptive norms (OR:0.105, 95%CI: 0.088–0.126) were more likely to delay COVID-19 vaccination. Model 2 showed that participants who had lower scores for positive attitude (OR: 0.406, 95% CI: 0.230–0.716), injunctive norms (OR: 0.283, 95% CI: 0.130–0.614) and descriptive norms (OR: 0.060, 95% CI: 0.038–0.094) were more likely to refuse COVID-19 vaccination. Conclusions The COVID-19 vaccination rate of men and women preparing for pregnancy was significantly lower than the average vaccination rate of China. Gender, protective health behaviors, vaccination attitudes, and subjective norms had effects on the vaccination behaviors of couples preparing for pregnancy.

The anticipation of regret is known to be a primary motivator of receiving a vaccination. Aim of this study is to evaluate whether the use of messages that leverage the anticipated emotion of regret can increase the intention to get the flu vaccination. The participants (N = 110) randomly received a leaflet containing a standard prevention message (control condition) or message modified to induce the anticipation of regret over not being vaccinated (experimental condition), along with a questionnaire. The experimental condition's participants reported significantly higher levels of regret and higher intention to vaccinate than the participants in the control condition. Anticipated regret resulted to be a significant mediator of the intention to get vaccinated. Manipulating the salience of regret appears to be a simple and inexpensive way of effectively promoting preventive behaviour. The implications of this result for reducing COVID-19 vaccine hesitation are discussed. [ABSTRACT FROM AUTHOR]

Objective: With the approval of the use of COVID-19 vaccines for children, their administration has started in many countries. However, families have some hesitations about vaccinating their children with the COVID-19 vaccines. The aim of this study was to determine the COVID-19 vaccination rates in allergic children aged 12-19 years and to evaluate contributing factors to vaccine hesitation. Materials and Methods: This cross sectional study was carried out in a Pediatric Allergy Department of a university-affiliated hospital between 15th December 2021 and 15th February 2022. Parents of allergic children who agreed to participate in this study constituted the study population (n=261). Results: Of the 261 children with allergic diseases, 137 (52.4%) had two doses of the COVID-19 vaccine, and 89.3% of the mothers and 92.3% of the fathers had at least two doses of the COVID-19 vaccine. Among children who were not vaccinated (n=124), the leading reason was the novelty of the vaccine, and the second reason was the side effects. The perceived stress scale score of the parents in the vaccinated group was significantly (p <0.05) higher than in the unvaccinated group. Conclusion: Although there is an effective and safe vaccine for children during the pandemic, vaccination rates are not yet at the desired level. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy has dramatically decreased the speed of vaccination and stalled global health development. While the factors influencing vaccine hesitancy and mitigation measures have been explored in depth by existing studies, research from the perspective of human interaction is lacking. Based on the theory of collective action, this paper analyzes how free riding behavior affects vaccine hesitancy and how the vaccine hesitancy caused by free riding behavior can be solved. Using 2,203 survey data sets from China, this paper examines the influence of the collective action dilemma – represented by free riding behavior – on COVID-19 vaccine hesitancy. The empirical results show that the existence of free riding behavior is an essential cause of vaccine hesitancy. Based on this conclusion, this paper discusses how to further alleviate the problem of vaccine hesitancy caused by collective action dilemmas by promoting cooperation. The findings of this paper may be helpful to promote various types of vaccines and further suggest that countries should assume the perspective of solving the collective action dilemma to achieve increased vaccination rates.

Background: Given the accelerated speed of COVID-19 vaccine research and administration, the main barriers to herd immunity appear to be concerns about safety and efficacy. Men and women preparing for pregnancy may have the same concerns about COVID-19 vaccination, but few studies have focused on COVID-19 vaccine uptake and hesitation among them. Methods: A cross-sectional study was conducted among men and women who were preparing for pregnancy in Southwest China. The questionnaire was designed based on the theory of planned behavior (TPB). Multiple logistic regression was used to explore the determinants of the behaviors of COVID-19 vaccination. Results: A total of 2878 participants completed the survey. A total of 53.89% of participants received at least one dose of the COVID-19 vaccine. A total of 45.21% of participants would receive the COVID-19 vaccine in the future. A total of 0.90% of participants never thought about receiving the COVID-19 vaccine. Multiple logistic regression model 1 showed that female participants (OR:5.497, 95%CI: 4.292–7.041), participants who never received influenza vaccine (OR:2.664, 95%CI: 1.908–3.718), participants who had never been tested for COVID-19 (OR:2.244, 95%CI:1.504–3.349), participants who had higher score of negative attitude (OR:1.448, 95%CI: 1.219–1.719), participants who had lower scores of injunctive norms (OR:0.440, 95%CI: 0.360–0.537) and descriptive norms (OR:0.105, 95%CI: 0.088–0.126) were more likely to delay COVID-19 vaccination. Model 2 showed that participants who had lower scores for positive attitude (OR: 0.406, 95% CI: 0.230–0.716), injunctive norms (OR: 0.283, 95% CI: 0.130–0.614) and descriptive norms (OR: 0.060, 95% CI: 0.038–0.094) were more likely to refuse COVID-19 vaccination. Conclusions: The COVID-19 vaccination rate of men and women preparing for pregnancy was significantly lower than the average vaccination rate of China. Gender, protective health behaviors, vaccination attitudes, and subjective norms had effects on the vaccination behaviors of couples preparing for pregnancy. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy is a considerable obstacle to achieving vaccine protection worldwide. There needs to be more evidence-based research for interventions for vaccine hesitancy. Existing effectiveness evaluations are limited to one particular hypothesis, and no studies have compared the effectiveness of different interventions. A megastudy takes a large-scale, multi-intervention, uniform participant and the same evaluation criteria approach to evaluate many interventions simultaneously and find the most effective ones. Therefore, megastudies can help us find the most effective interventions for vaccine hesitancy. Additionally, considering the complex causes of vaccine hesitancy, we design interventions that involve social factors in megastudies. Lastly, quality control and justice are critical issues for megastudies in the future. [ABSTRACT FROM AUTHOR]

Many countries have initiated a booster dose for COVID-19 vaccination. However, little is known about the association between adverse events to vaccination and individual psychological status and willingness to receive the booster dose. From December 1, 2021 to February 1, 2022, 474 participants answered a questionnaire in a university town in China, and information about previous adverse events, anxiety status, and vaccination intention were collected. Chi-square test and logistic regression models were used to analyze the factors associated with willingness to receive booster dose of vaccine. Previous adverse events, such as pain at the injection site, fatigue, muscle pain and headache were associated with anxiety of the participants. About 76.2% of the participants were willing to receive booster dose of vaccine. However, adverse event was not associated with their willingness to receive the booster dose. Participants with age ≤25 were less willing to receive the booster dose, although the association was not statistically significant in the multivariable model. In conclusion, the adverse events of COVID-19 vaccination were associated with psychology status of the vaccinated people. It is still necessary to strengthen the public education on COVID-19 vaccination to improve the vaccination willingness of people, especially among the young people.

The aim of this article is to estimate the relevance of developing a public policy aimed at increasing the importance of critical thinking skills among pupils, students and citizens in general, using the problem of vaccination as a reference. I thus aim to contribute to the possibility of identifying solutions designed to increase the impact of educational activities for the creation of critical thinking skills. Because perhaps the most important cognitive problem in this context is the decision to vaccinate against SARS-CoV-2, I use the report on the vaccination problem as a context for assessing the effectiveness of critical thinking, trying to test the hypothesis of reducing vaccine hesitation by using critical thinking. The case study on vaccine hesitation considers the use of the attitude towards vaccination as a potential revealer of critical thinking skills, contributing for the identification of both problems and solutions to remedy them. Critical reflection on critical thinking implies the possibility of being aware of its specific limits. I approach some of the problems of defining critical thinking by suggesting in this way some risks aimed at its use for ideological purposes. I indicate the specific limits of the deficit model, thus contributing to the shaking of common places in the field of causal explanation for vaccine hesitation. I systematize the cognitive errors according to some specific causes and types of solving the existing problems in the specialized literature, thus generating a relevant frame of reference for the debates regarding the public policies in the area. [ABSTRACT FROM AUTHOR]

Aim: To determine the acceptability of the corona-virus disease 2019 (COVID-19) vaccine and the main reasons for vaccine hesitation in pregnant health care workers (HCWs). Materials and Methods: 135 pregnant HCWs were questioned face-to-face about perception and attitudes towards the COVID-19 vaccine and reasons for rejection of the vaccine. Participants were evaluated according to:(1) whether they wanted to be vaccinated, (2) whether they were actively working in COVID-19 units, and (3) whether they were a doctor or other healthcare professional. Results: Sixty-six (48.9%) participants stated that they want to be vaccinated if the COVID-19 vaccine is recommended to pregnant women. We observed that active staff in COVID-19 units and doctors had more intention to be vaccinated. The thought that the COVID-19 vaccine would be harmful to the baby was significantly higher in other HCWs group than doctors. Conclusion: The present study revealed that even if the rate of vaccine acceptance among pregnant HCWs was higher than pregnant non-HCWs, it remained below the rate required for "herd immunity" for COVID-19 disease. Lack of data on the safety of the vaccine in pregnant women is the most important obstacle. We can overcome obstacles only by including pregnant women in phase 3 studies of COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

ObjectDuring the later period of the COVID-19 pandemic, the public has been at risk of the evolving COVID-19 variants and hesitated to be vaccinated against COVID-19 to a certain extent. In this context, the health belief model (HBM) and the theory of planned behavior model (TPB) were used to compare and summarize the relationship between vaccine hesitation/non-hesitation and the intentions to get COVID-19 vaccines and its influencing factors.MethodsThe cross-sectional, population-based online survey was conducted from 14 April to 30 April 2021, and 1757 respondents were recruited to participate in the survey through the Wenjuanxing online survey platform. The HBM and TPB covariate scores were expressed using means and standard deviations and compared between groups using t-tests. Backward multiple linear regression models were used to explore the factors influencing the public's intentions to receive the COVID-19 vaccines.ResultsThis study found that educational background is one of the factors influencing vaccine hesitation. Most people with high education do not hesitate (65.24%), while a more significant proportion of people with low education have vaccine hesitation (66.00%). According to HBM, for the vaccine hesitation group, self-efficacy, family advice, and doctor's advice were the most critical factors affecting the public's future vaccination intentions; for the vaccine non-hesitation group, self-efficacy, doctor's advice, and perceived benefits are the most important influencing factors. According to the TPB, the subjective norm is the most critical factor affecting the future vaccination intention of the vaccine hesitation group, and the attitude toward behavior is the most critical factor affecting the future vaccination intention of the vaccine non-hesitation group.ConclusionsIn the context of COVID-19, the public's hesitation on the “current” vaccines will still affect future vaccination intentions. Using HBM and TPB would help health policymakers and healthcare providers formulate intervention plans.

Since the thrust of previous research investigations has been on people's willingness to get immunized against the COVID-19 infection, the underpinning principle of compliance has received very little attention. Addressing the possible drivers and mechanisms influencing vaccine acceptance may provide significant insights for limiting the pandemic. In response, we intend to investigate the influence of decision regret and the consequences of post-vaccination adverse effects on the inclination to undertake booster shots. An electronic survey that was self-administered was conducted in Rawalpindi, Pakistan. The questionnaire was completed by 1,369 participants, with a response rate of 41%. 1,343 of them (98.10%) had received both doses of the COVID-19 vaccination. Besides, the present research has also adopted a mediation model. Our findings demonstrate that unfavorable vaccination responses in healthcare workers significantly affect their likelihood of receiving booster shots. Interestingly, healthcare workers who had adverse experiences after being immunized were more prone to regret their prior immunization decisions, which in response affected their decision to get a booster shot. The motivation to receive the booster dosage and adverse post-vaccination responses were mediated by decision regret. The outcomes suggested indissociable connections between unfavorable vaccination responses, decision regret, and the likelihood of receiving a booster shot. To strengthen immunization acceptance intent and enhance the likelihood of receiving COVID-19 booster shots, it is recommended that awareness of these post-vaccination adverse events be extensively integrated into immunization awareness programs and policy measures supporting booster doses.

Because inappropriate built-in or managed vaccination campaigns, regardless of the causes of vaccine hesitation, can have side effects, the most important being the opposition to vaccination, the understanding of vaccination hesitation can have an influence on specific public policies. In this article we identify a set of possible explanations for vaccine hesitation, which can be used to assess situations, identify problems and adopt appropriate solutions. We highlight the fact that the vaccination hesitation is not just about vaccination, the approach of identifying explanatory hypotheses involves identifying all relevant frames of reference, all social areas that participate in establishing the appropriate interpretation context. The level of compliance with the rules could be an important explanatory hypothesis for the differences between different states in the share of vaccinated citizens. Other explanatory hypotheses: the structure of epistemic communities, community and individual cognitive resources on strategies facing the uncertainty and risk, distrust. We also assess the limits of using the deficit model. We keep in mind two cognitive asymmetries: inaction is perceived as less risky or responsible than action; the indecision is in a similar situation to the decision. Because the values that people adhere reflect their personal beliefs and convictions, and they guide the way they seek, receive, and interpret information, strategies to reduce vaccine hesitation should be based on verifying the compatibility of the intended outcome with individual values and to continue testing the various solutions to change the beliefs that contribute to the determination of vaccine hesitation or refusal. [ABSTRACT FROM AUTHOR]

Background The unprecedented rapid development of COVID-19 vaccines has faced SARS-CoV- (COVID-19) vaccine hesitancy, which is partially fueled by the misinformation and conspiracy theories propagated by anti-vaccine groups on social media. Research is needed to better understand the early COVID-19 anti-vaccine activities on social media. Methods This study chronicles the social media posts concerning COVID-19 and COVID-19 vaccines by leading anti-vaccine groups (Dr Tenpenny on Vaccines, the National Vaccine Information Center [NVIC] the Vaccination Information Network [VINE]) and Vaccine Machine in the early months of the COVID-19 pandemic (February–May 2020). Results Analysis of 2060 Facebook posts showed that anti-vaccine groups were discussing COVID-19 in the first week of February 2020 and were specifically discussing COVID-19 vaccines by mid-February 2020. COVID-19 posts by NVIC were more widely disseminated and showed greater influence than non-COVID-19 posts. Early COVID-19 posts concerned mistrust of vaccine safety and conspiracy theories. Conclusion Major anti-vaccine groups were sowing seeds of doubt on Facebook weeks before the US government launched its vaccine development program 'Operation Warp Speed'. Early anti-vaccine misinformation campaigns outpaced public health messaging and hampered the rollout of COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to determine the factors that influence vaccine hesitancy among parents and caregivers of children 2 years old and younger in selected urban communities in Manila, Philippines. Methodology: The study used a cross-sectional study design with a modified questionnaire adapted from the SAGE Working Group on Vaccine Hesitancy. Self-administered surveys were conducted in two highly urbanized barangays (smallest administrative divisions) in Manila, Philippines. Results: The survey was completed by 110 respondents, comprised mostly of 20–39-year-old mothers. Most respondents (95.5%) believed that vaccines are protective however vaccine hesitancy rates among the respondents reached 36.4%. Respondents who believed in the protective nature of vaccines were less likely to report vaccine hesitancy and were nine times less likely to refuse vaccination for their children because of negative media exposure. The main reasons identified for vaccine hesitancy were exposure to negative media information and concerns about vaccine safety. The main negative media information identified by the respondents was related to the dengue vaccine, Dengvaxia®. Health-care workers and political leaders were the main supporters of vaccination in the community. Discussion: The recent events surrounding the Dengvaxia® controversy contributed to a decrease in vaccine confidence. The role of mass media in vaccine hesitancy was highlighted in this study, supporting previous evidence that vaccine hesitant parents tend to be more susceptible to media reports. The lack of association between sociodemographic factors and vaccine hesitancy implies that the determinants of vaccine hesitancy can be highly varied depending on context and setting.

Vaccine hesitancy is a considerable obstacle to achieving vaccine protection worldwide. There needs to be more evidence-based research for interventions for vaccine hesitancy. Existing effectiveness evaluations are limited to one particular hypothesis, and no studies have compared the effectiveness of different interventions. A megastudy takes a large-scale, multi-intervention, uniform participant and the same evaluation criteria approach to evaluate many interventions simultaneously and find the most effective ones. Therefore, megastudies can help us find the most effective interventions for vaccine hesitancy. Additionally, considering the complex causes of vaccine hesitancy, we design interventions that involve social factors in megastudies. Lastly, quality control and justice are critical issues for megastudies in the future.

Objective: We conducted a survey to assess vaccination coverage, vaccination willingness, and variables associated with vaccination hesitancy to provide evidence on coronavirus disease (COVID-19) vaccination strategies. Methods: This anonymous questionnaire study conducted a multicenter, cross-sectional survey of outpatients and inpatients with epilepsy (PWE) registered in epilepsy clinics, in 2021, in 10 hospitals in seven cities of Shandong Province. Results: A total of 600 questionnaires were distributed, and 557 valid questionnaires were returned. A total of 130 people were vaccinated against COVID-19. Among 427 unvaccinated participants, 69.32% (296/427) were willing to receive the COVID-19 vaccine in the future, and the remaining 30.68% (131/427) were unwilling to receive vaccination. Most (89.9%) of the participants believed that the role of vaccination was crucial in response to the spread of COVID-19. A significant association was found between willingness to receive the COVID-19 vaccine and the following variables: age, marital status, level of education, occupation, residence, seizure type, and seizure control after antiepileptic drug therapy. It is noteworthy that education level, living in urban areas, and seizure freedom were significantly related to willingness to receive COVID-19 vaccination. Conclusions: Vaccination is a key measure for the prevention and control of COVID-19, and most PWE are willing to be vaccinated. Vaccine safety, effectiveness, and accessibility are essential in combatting vaccine hesitation and increasing vaccination rates. [ABSTRACT FROM AUTHOR]

Objective: We conducted a survey to assess vaccination coverage, vaccination willingness, and variables associated with vaccination hesitancy to provide evidence on coronavirus disease (COVID-19) vaccination strategies.Methods: This anonymous questionnaire study conducted a multicenter, cross-sectional survey of outpatients and inpatients with epilepsy (PWE) registered in epilepsy clinics, in 2021, in 10 hospitals in seven cities of Shandong Province.Results: A total of 600 questionnaires were distributed, and 557 valid questionnaires were returned. A total of 130 people were vaccinated against COVID-19. Among 427 unvaccinated participants, 69.32% (296/427) were willing to receive the COVID-19 vaccine in the future, and the remaining 30.68% (131/427) were unwilling to receive vaccination. Most (89.9%) of the participants believed that the role of vaccination was crucial in response to the spread of COVID-19. A significant association was found between willingness to receive the COVID-19 vaccine and the following variables: age, marital status, level of education, occupation, residence, seizure type, and seizure control after antiepileptic drug therapy. It is noteworthy that education level, living in urban areas, and seizure freedom were significantly related to willingness to receive COVID-19 vaccination.Conclusions: Vaccination is a key measure for the prevention and control of COVID-19, and most PWE are willing to be vaccinated. Vaccine safety, effectiveness, and accessibility are essential in combatting vaccine hesitation and increasing vaccination rates.

Objective: This study was planned to adapt the Vaccine Hesitancy Scale to Turkish and evaluate its validity and reliability. Material and Methods: This research was conducted methodologically. The sample of the study consisted of 317 individuals from the patient relatives in the waiting rooms, who have children between the ages 9-16, who applied to the Suleyman Demirel University Hospital policlinic in December 2019. A questionnaire developed by the researcher and the Vaccine Hesitancy Scale were used as data collection tools. Results: Explanatory factor analysis and confirmatory factor analysis methods were used to evaluate the validity and reliability of the Vaccine Hesitancy Scale. In the Vaccine Hesitancy Scale, the Kaiser-Mayer-Olkin coefficient was 0.897 and the Bartlett test's chi-square value was 1319.67 and the result was significant (P <0.001). Considering the factor loads of the items, it varies between 0.608 and 0.845. As a result of the explanatory factor analysis, it was seen that the scale consists of two factors. This finding is consistent with the original form of the scale. The internal consistency coefficient of the scale was found to be 0.86. Conclusion: As a result of the validity and reliability analysis, the Vaccine Hesitancy Scale was found to be a valid and reliable scale for the Turkish society, which consists of 9 items and 2 sub-dimensions. [ABSTRACT FROM AUTHOR]

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Background/Aim: Views of health sector workers on the safety and efficacy of a vaccine, which forms the basis of a vaccination program, can affect both the public perception of the vaccine and its implementation in the community. Accordingly, this study aimed to acknowledge potential hesitations of healthcare specialists and their views on the acceptability of a vaccine before initiating a vaccine policy program. Methods: A total of 442 healthcare professionals participated in this study by answering a 24-question survey online from their social media accounts. We analyzed the data and present the descriptive statistics with mean and standard deviation values. We performed t-test analysis and analysis of variance to examine physicians' attitudes toward vaccines and the coronavirus disease 2019 (COVID-19) infection, based on their demographic, and other characteristics. Tamhane and Sidak paired comparison tests were conducted to determine differences in groups after variance analysis. Results: Of the healthcare professionals, 55.9% agreed that the COVID-19 vaccine would end the pandemic. A total of 72.6% of healthcare workers reported that they were planning to get vaccinated with the free COVID-19 vaccine, which is to be distributed by the Ministry. The biggest drawback of the vaccination was its unknown long-term side effects. We noted a difference in the attitude toward vaccines in those older than 41 years and younger than 30 years of age. We also found a significant and positive relationship between the attitudes of the participants toward the measures taken regarding the COVID-19 infection and their attitudes toward the vaccine. Conclusion: Hesitation about a vaccine during a pandemic is a major obstacle to implementing vaccination campaigns. To continue the benefits of vaccination programs, understanding and addressing these hesitations held by healthcare professionals are crucial to the successful implementation of a vaccination program. [ABSTRACT FROM AUTHOR]

Background: Strategies to support health care professionals on how to address vaccine hesitancy are needed. Methods: We developed a 4-h Motivational Communication (MC) training program tailored to help physicians address hesitancy related to influenza vaccination among patients living with rheumatoid arthritis. Five MC competencies were evaluated at baseline and post-training with a standardized patient using the Motivational Interviewing Treatment Integrity [MITI] scale. Adherence to MC during clinical consultations and changes in vaccine intentions was measured as secondary outcomes. Results: Seven rheumatology physicians participated in the training. MITI scores increased in all participants, and 71% (n = 5) achieved thresholds of clinical competency (i.e., ≥3.5/5 at MITI global score and ≥3/5 on at least 3 individual competency score) post-training. Autonomy/support and empathy competencies reached competency thresholds (+2.4 ± 1.3 to +4.1 ± 0.7 and +2.1 ± 0.7 to +4.1 ± 0.7, respectively). Evocation and collaboration competencies improved but without reaching competency thresholds (+1.4 ± 0.8 to +3.1 ± 1.1; +1.4 ± 0.8 to +2.9 ± 1.1, respectively). Direction did not improve. Among 21 patient consultations post-training, 15 (71%) were MC-consistent. Of the 15 patients, 67% (10/15) intended to receive the influenza vaccine and 33% (5/15) received it. Conclusion: A brief MC training program targeting vaccine hesitancy increased MC competency among rheumatology physicians and promoted behavioral change among patients.

Since the declaration of coronavirus disease 2019 (COVID-19) as a pandemic, intensive measures were taken to mitigate its negative health, psychological, social, and economic impact. COVID-19 continues to pose serious threats globally, with vaccination as the central safe strategy to control the pandemic. However, COVID-19 vaccine hesitancy is a major concern, especially in the Middle East and North Africa (MENA). Concerns regarding vaccine safety, efficacy, and misinformation contribute to vaccine hesitancy. Addressing these concerns and providing accurate information is crucial for increasing COVID-19 vaccine acceptance and uptake in this region, where the coverage is low. Variable rates of COVID-19 vaccine hesitancy were found in the numerous studies conducted in the region. Complex factors contributed to vaccination hesitancy in the region including concerns about COVID-19 vaccine safety and efficacy, low trust in healthcare systems, complacency toward the risks of COVID-19, constraints hindering access to COVID-19 vaccination services, as well as the circulation of misinformation and conspiracy beliefs about COVID-19 and its vaccination. Effective approaches to address COVID-19 vaccine hesitancy in the MENA region rely on developing evidence-based communication strategies that are recommended to build trust in vaccination, highlight the disease risks, and counter COVID-19 vaccine-related misinformation. Ensuring COVID-19 vaccine affordability is also necessary besides the cautious consideration of implementing COVID-19 vaccine mandates. Based on the preceding discussion, this chapter aims to identify the common themes of COVID-19 vaccine hesitancy in the MENA region. In addition, the chapter highlights the importance of understanding the root causes of COVID-19 vaccination hesitancy and its associated determinants to develop effective strategies for promoting COVID-19 vaccine acceptance and uptake in the MENA region. To build community trust, promote community education and awareness, and counter misinformation for better COVID-19 vaccine coverage in the region, it is recommended to involve healthcare professionals and policymakers., (© 2024. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Many countries have initiated a booster dose for COVID-19 vaccination. However, little is known about the association between adverse events to vaccination and individual psychological status and willingness to receive the booster dose. From December 1, 2021 to February 1, 2022, 474 participants answered a questionnaire in a university town in China, and information about previous adverse events, anxiety status, and vaccination intention were collected. Chi-square test and logistic regression models were used to analyze the factors associated with willingness to receive booster dose of vaccine. Previous adverse events, such as pain at the injection site, fatigue, muscle pain and headache were associated with anxiety of the participants. About 76.2% of the participants were willing to receive booster dose of vaccine. However, adverse event was not associated with their willingness to receive the booster dose. Participants with age ≤25 were less willing to receive the booster dose, although the association was not statistically significant in the multivariable model. In conclusion, the adverse events of COVID-19 vaccination were associated with psychology status of the vaccinated people. It is still necessary to strengthen the public education on COVID-19 vaccination to improve the vaccination willingness of people, especially among the young people.

This study aims to investigate the extent to which the public engages in imitative behavior in their vaccination decisions for newly developed vaccines in the Chinese context. Given the crucial role of newly developed vaccines in preventing and controlling the COVID-19 pandemic, a better understanding of how people make decisions about vaccination with new vaccines is important for overcoming vaccine hesitation and promoting widespread adoption of the vaccines. Our results indicate that the public's decision-making about the newly developed vaccine is influenced by a range of heuristics, including a privileged information heuristic, competence heuristic, and consensus heuristic. Specifically, individuals are more likely to imitate the vaccination behavior of those with privileged information, such as insiders, and those with perceived competence in the field, such as experts. Our findings also demonstrate the impact of majority influence, as the popularity of new vaccines leads to an increase in vaccination uptake through herd behavior. Our data highlights the importance of the first movers who are insiders with privileged information or experts with competence, as their behavior can significantly shape the vaccination decisions of others. Our study provides valuable insights into the complex interplay of heuristics and imitative behavior in vaccination decision-making for newly developed vaccines., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Inc.)

Vaccine hesitancy has dramatically decreased the speed of vaccination and stalled global health development. While the factors influencing vaccine hesitancy and mitigation measures have been explored in depth by existing studies, research from the perspective of human interaction is lacking. Based on the theory of collective action, this paper analyzes how free riding behavior affects vaccine hesitancy and how the vaccine hesitancy caused by free riding behavior can be solved. Using 2,203 survey data sets from China, this paper examines the influence of the collective action dilemma - represented by free riding behavior - on COVID-19 vaccine hesitancy. The empirical results show that the existence of free riding behavior is an essential cause of vaccine hesitancy. Based on this conclusion, this paper discusses how to further alleviate the problem of vaccine hesitancy caused by collective action dilemmas by promoting cooperation. The findings of this paper may be helpful to promote various types of vaccines and further suggest that countries should assume the perspective of solving the collective action dilemma to achieve increased vaccination rates.

Background And aim: The importance of immunization has increased even more during the pandemic. This study aimed to evaluate the reasons for healthcare professionals not being vaccinated against COVID-19 and to develop solutions for the causes., Subject and Methods: This qualitative study was carried out with in-depth interviews between July 2021 and October 2021, with 32 healthcare professionals and five key people who had never been vaccinated against COVID-19., Results: The most common reasons that healthcare professionals were not vaccinated against COVID-19 were concerns about vaccine side effects, believing that the vaccine is not effective, distrust of the vaccine content and COVID-19 treatment methods, the rapid production of the vaccine, the fact that the vaccine is produced with a new technology, thinking that the vaccine is not the definitive solution, seeing themselves as healthy and young, and the belief that they would have a mild case of the disease and recover. The main themes were COVID-19 vaccine-related reasons, individual reasons/group effects, contextual reasons, and vaccination-related general issues. The main sub-themes were vaccine production, distrust, risk perception, policies and infodemic., Conclusion: It has been seen that the uncertainty, infodemic, and insecurity that emerged especially during the pandemic period are related to each other. As knowledge and awareness about the disease increase, there is an increase in risk perception. For this reason, social information studies should be increased and physicians should be enabled to use media tools more effectively., Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-023-01822-7., Competing Interests: Conflict of interestThe authors declare no conflict of interest regarding this article., (© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Object: During the later period of the COVID-19 pandemic, the public has been at risk of the evolving COVID-19 variants and hesitated to be vaccinated against COVID-19 to a certain extent. In this context, the health belief model (HBM) and the theory of planned behavior model (TPB) were used to compare and summarize the relationship between vaccine hesitation/non-hesitation and the intentions to get COVID-19 vaccines and its influencing factors., Methods: The cross-sectional, population-based online survey was conducted from 14 April to 30 April 2021, and 1757 respondents were recruited to participate in the survey through the Wenjuanxing online survey platform. The HBM and TPB covariate scores were expressed using means and standard deviations and compared between groups using t-tests. Backward multiple linear regression models were used to explore the factors influencing the public's intentions to receive the COVID-19 vaccines., Results: This study found that educational background is one of the factors influencing vaccine hesitation. Most people with high education do not hesitate (65.24%), while a more significant proportion of people with low education have vaccine hesitation (66.00%). According to HBM, for the vaccine hesitation group, self-efficacy, family advice, and doctor's advice were the most critical factors affecting the public's future vaccination intentions; for the vaccine non-hesitation group, self-efficacy, doctor's advice, and perceived benefits are the most important influencing factors. According to the TPB, the subjective norm is the most critical factor affecting the future vaccination intention of the vaccine hesitation group, and the attitude toward behavior is the most critical factor affecting the future vaccination intention of the vaccine non-hesitation group., Conclusions: In the context of COVID-19, the public's hesitation on the "current" vaccines will still affect future vaccination intentions. Using HBM and TPB would help health policymakers and healthcare providers formulate intervention plans., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Li, Ji and Sun.)

Since the thrust of previous research investigations has been on people's willingness to get immunized against the COVID-19 infection, the underpinning principle of compliance has received very little attention. Addressing the possible drivers and mechanisms influencing vaccine acceptance may provide significant insights for limiting the pandemic. In response, we intend to investigate the influence of decision regret and the consequences of post-vaccination adverse effects on the inclination to undertake booster shots. An electronic survey that was self-administered was conducted in Rawalpindi, Pakistan. The questionnaire was completed by 1,369 participants, with a response rate of 41%. 1,343 of them (98.10%) had received both doses of the COVID-19 vaccination. Besides, the present research has also adopted a mediation model. Our findings demonstrate that unfavorable vaccination responses in healthcare workers significantly affect their likelihood of receiving booster shots. Interestingly, healthcare workers who had adverse experiences after being immunized were more prone to regret their prior immunization decisions, which in response affected their decision to get a booster shot. The motivation to receive the booster dosage and adverse post-vaccination responses were mediated by decision regret. The outcomes suggested indissociable connections between unfavorable vaccination responses, decision regret, and the likelihood of receiving a booster shot. To strengthen immunization acceptance intent and enhance the likelihood of receiving COVID-19 booster shots, it is recommended that awareness of these post-vaccination adverse events be extensively integrated into immunization awareness programs and policy measures supporting booster doses., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Rehman, Rehman and Jianglin.)

We investigated longitudinal relations between individual willingness to undergo vaccination against COVID-19 and three social factors: conspiracy mentality, prosociality, and authoritarianism. This longitudinal study comprised four measurement points. The first wave sample included 1130 responses and was representative of the Polish population in terms of gender, age, and place of residence. Analyses were performed using random intercept cross-lagged panel models. We observed bidirectional positive cross-lagged relationships between prosociality and willingness to undergo vaccination in the first three waves of measurement. Authoritarianism and conspiracy mentality translated into a lower willingness to vaccinate between the third and fourth points of measurement when the vaccination became a near-term possibility. Eliciting prosocial motivation to vaccinate can be paramount in overcoming vaccine hesitancy. Because conspiracy thinking may be a crucial barrier to willingness to be vaccinated, it is critical to focus on planning interventions and campaigns undermining conspiracy theories about COVID-19. • We conducted longitudinal study of vaccine hesitancy. • Analyses were performed using random-intercept cross-lagged panel models. • Bidirectional positive cross-lagged relationships between prosociality and willingness to undergo vaccination was observed. • Authoritarianism and conspiracy mentality translated into a lower willingness to undergo vaccination [ABSTRACT FROM AUTHOR]

Background: Strategies to support health care professionals on how to address vaccine hesitancy are needed. Methods: We developed a 4-h Motivational Communication (MC) training program tailored to help physicians address hesitancy related to influenza vaccination among patients living with rheumatoid arthritis. Five MC competencies were evaluated at baseline and post-training with a standardized patient using the Motivational Interviewing Treatment Integrity [MITI] scale. Adherence to MC during clinical consultations and changes in vaccine intentions was measured as secondary outcomes. Results: Seven rheumatology physicians participated in the training. MITI scores increased in all participants, and 71% (n = 5) achieved thresholds of clinical competency (i.e., ≥3.5/5 at MITI global score and ≥3/5 on at least 3 individual competency score) post-training. Autonomy/support and empathy competencies reached competency thresholds (+2.4 ± 1.3 to +4.1 ± 0.7 and +2.1 ± 0.7 to +4.1 ± 0.7, respectively). Evocation and collaboration competencies improved but without reaching competency thresholds (+1.4 ± 0.8 to +3.1 ± 1.1; +1.4 ± 0.8 to +2.9 ± 1.1, respectively). Direction did not improve. Among 21 patient consultations post-training, 15 (71%) were MC-consistent. Of the 15 patients, 67% (10/15) intended to receive the influenza vaccine and 33% (5/15) received it. Conclusion: A brief MC training program targeting vaccine hesitancy increased MC competency among rheumatology physicians and promoted behavioral change among patients. [ABSTRACT FROM AUTHOR]