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This article presents an Integrative Model of Sustainable Health Decision-Making and a toolkit to equip U.S. Extension professionals with knowledge and skills to engage in adult immunization education. The objective was to reduce mistrust and increase willingness and confidence toward delivering vaccination education. The model was developed through an explanatory parallel mixed methods design. Data collection included a needs assessment survey, interviews, workshops, and Neuromarketing message testing. The resulting toolkit was pilot tested before final delivery. Four key needs were identified: tailoring trainings based on Extension roles, prioritizing preserving community trust and professional credibility, establishing connections with medical experts, and strengthening Science Media Literacy skills to counter misinformation and communicate emerging science. Correlations among constructs supported an integrated model focused on a professional development core of Science Media Literacy, Motivational Interviewing, and Neuromarketing Science that strengthens communication relationships between priority populations and trusted partners. The model and work described in this article can serve as a general framework for engaging key influencers in communities in communication education intended to promote sustainable well-being, such as increasing vaccine uptake.

Background: The availability of COVID-19 vaccines worldwide necessitates measuring healthcare workers’ (HCWs’) willingness to recommend or receive these vaccines. Therefore, we conducted a local study in Jordan to assess HCWs’ willingness to recommend or receive a third dose of a COVID-19 vaccine and the predictors of such a decision. A cross-sectional study investigated Jordanian HCWs’ willingness regarding a third dose of a COVID-19 vaccine using a self-administered online questionnaire through WhatsApp, a mobile phone application. A total of 300 HCWs participated in the current study. Of these HCWs, 65.3% were physicians, 25.3% were nurses, and 9.3% were pharmacists. HCWs’ overall willingness regarding a third vaccine dose was 68.4% (49.4% certainly and 19.0% probably), whereas the overall willingness of HCWs to recommend a third dose to their patients was 73.3% (49.0% certainly and 24.3% probably). Males had significantly higher willingness than females (82.1% vs. 60.1%, p < 0.05). Physicians reported more willingness than nurses and pharmacists. HCWs’ willingness was not significantly affected by direct contact with a patient infected with COVID-19 or by a personal history of COVID-19 infection. Only 31% of HCWs were certainly willing to recommend the vaccine to their patients with chronic diseases, and only 28% of the participants were certainly willing to recommend it to people aged 65 or older. HCWs’ willingness to receive a third dose of a COVID-19 vaccine is limited in Jordan. This has affected their certainty in recommending this vaccine to their patients or people older than 60. Decision-makers and health-promotion programs in Jordan should focus on addressing this public health problem.

Aimed at advancing the reform of the Paid Use of Residential Land, this study investigates the willingness to pay among farmers and its underlying factors. Based on a Logistic Regression analysis of a micro-survey of 450 pieces of data from the Sichuan Province in 2023, we evaluated the effects of three factors, namely individual, regional and cultural forces. Further, Random Forest analysis and SHAP value interpretation refined our insights into these effects. Firstly, the research reveals a significant willingness to pay, with 83.6% of sample farmers being ready to participate in the reform, and 53.1% of them preferring online payment (the funds are mostly expected to be used for village infrastructure improvements). Secondly, the study implies that Individual Force is the most impactful factor, followed by regional and cultural forces. Thirdly, the three factors show different effects on farmers’ willingness to pay from different income groups, i.e., villagers with poorer infrastructure and lower clarity of homestead policy systems tend to be against the reform, whereas farmers with strong urban identity and collective pride support it. Based on these findings, efforts should be made to increase the publicity of Paid Use of Residential Land. Moreover, we should clarify the reform policies, accelerate the development of the online payment platform, use the funds for village infrastructure improvements, and advocate for care-based fee measures for disadvantaged groups.

Background: The public’s attitude towards Mpox vaccination is a critical factor in the success of immunisation programmes. Understanding the factors contributing to vaccine acceptance or hesitancy is critical for developing effective health communication strategies. This systematic review and meta-analysis aims to bring together evidence from observational studies on attitudes towards Mpox vaccination, including willingness and rejection. Methods: From this review’s inception until June 2023, a comprehensive search was conducted across four major electronic databases: PubMed, Web of Science, Scopus, and EBSCO. The inclusion criteria included studies investigating public attitudes towards Mpox vaccination, as defined by acceptance and willingness to be vaccinated versus rejection and unwillingness. Results: Thirty studies met the inclusion criteria among the screened literature. An analysis of 27 studies involving 81,792 participants revealed that 45,926 (56.14%) were willing to receive the Mpox vaccination. In contrast, ten studies involving 7448 participants revealed that 2156 people (28.94%) were unwilling to receive the Mpox vaccination. Females were less willing to receive the vaccine than males, with an odds ratio (OR) of 0.61 (95% CI, 0.43–0.86). Furthermore, homosexuals were found to be more willing than heterosexuals, with an OR of 1.44 (95% CI, 1.14–1.80). Conclusion: Vaccination is emerging as a critical strategy for preventing Mpox infection and fostering herd immunity against potential outbreaks. Improving public awareness and acceptance of vaccination is critical to avoiding a situation similar to the COVID-19 pandemic. Targeted educational and outreach programmes could explain the benefits of vaccination, bridging the information gap and encouraging a proactive public health approach to emerging infectious diseases.

To reduce the number of COVID-19 cases, vaccines were rapidly made available worldwide. For a strategically targeted response to the COVID-19 pandemic, population vaccination coverage was to be maximized. The target groups also included healthy children. In this context, it is important to understand the determinants and beliefs that lead parents to favor or oppose COVID-19 immunization in children. This study aimed to investigate parents’ COVID-19 vaccination willingness in Germany for children aged 5–11 years in 2021/2022. For this purpose, the determinants and beliefs behind parents’ vaccination decisions were examined. Descriptive analysis and bivariate correlations were performed on COVID-19 vaccination willingness and parents’ mental health status, general vaccination attitudes, and SARS-CoV-2 politics perceptions. In total, 2401 participants fully participated in this cross-sectional study. The COVID-19 vaccination uptake (71.4%) outweighed the vaccination refusal (19.4%). Correlations revealed higher vaccine acceptance in parents presenting full vaccination certificates (90.9%), COVID-19 immunizations (99.9%), or increased COVID-19 fear (93.6%). Vaccination-refusal was associated with higher perceived pressure by COVID-19 vaccination campaigns (87.7%), higher experienced restrictions due to COVID-19 protective measures in parents’ social environment (83.6%), and engagement against COVID-19 protective measures (51.6%). Besides general anxiety, no significant correlations were observed between parents’ mental health variables and vaccination willingness. Although several factors are ultimately associated with vaccination willingness, future vaccination campaigns should prioritize reducing pressure, increasing trust, and considering parents’ differentiation between familiar and unfamiliar pathogens during their vaccination decision-making process.

Background/Objectives: COVID-19 has significantly impacted lives, and data show that receiving a booster vaccination has been demonstrated to lower the spread of COVID-19 and reduce the severity of the risk of infection. The Saudi government has actively promoted booster dose vaccines among university students who can spread the virus to older populations, especially in high-density environments, where the risk of virus transmission and spread is elevated. This study focuses on the acceptance of COVID-19 booster shots among students at Imam Abdulrahman bin Faisal University. The study assessed students' willingness to receive a COVID-19 booster dose and the factors influencing their decision. Methods: A descriptive, cross-sectional study design using an online self-administered survey was conducted among medical and non-medical students at Imam Abdulrahman bin Faisal University. A convenience sampling technique was used to recruit participants via email and social media platforms (WhatsApp version 2.3). Quantitative analysis was performed using IBM SPSS version 28.0. using descriptive statistics. Logistic regression analysis was used to predict factors affecting COVID-19 booster dose acceptance and hesitancy. Results: Among 315 respondents, 171 (54.3%) were males, and 144 (45.7%) were females. All the respondents fell in the 18-25 years age group. About 173 (54.9%) respondents were from health-related colleges. Overall, 24.44% (77/315) agreed to get a COVID-19 vaccine booster dose. However, 77.14% (243/315) were confident of getting the vaccine whenever they wanted. About 48.88% (154/315) of respondents considered COVID-19 a serious severe infection, while 14.06% (46/315) of respondents were concerned about the probability of receiving COVID-19 immunization (World Health Organization, 2021). Conclusions: The study revealed that students were not accepting COVID-19 booster doses, highlighting the need for awareness campaigns to dispel myths and improve vaccination rates.

Background: This cross-sectional survey was designed to evaluate pregnant women’s awareness regarding Respiratory Syncytial Virus (RSV) infection and willingness to receive the vaccine during pregnancy and to vaccinate their newborn against RSV. Methods: An anonymous survey was administered from 20 April to 30 June 2023, to pregnant women aged ≥ 18 years attending gynecology wards of randomly selected public hospitals in southern Italy. A minimum sample size of 427 participants was calculated. The survey assessed women’s socio-demographic characteristics, health-related information, their source(s) of information, and attitudes regarding RSV. Results: A total of 490 women participated. Those who were married/cohabiting, with a high-school degree compared to those who had a university degree, and those who needed additional information were more concerned that the newborn could acquire the RSV infection. The perceived utility of a future RSV vaccine administered during pregnancy was higher among those who were married/cohabiting, with a university degree, those with very good perceived health status, those who received information from healthcare workers, and those who needed additional information. Only 45.9% were willing to be vaccinated during pregnancy, and this was more likely among those with a university degree, with a very good perceived health status, who had received information from healthcare workers, and who needed more information. Finally, almost two-thirds (61.1%) were willing to vaccinate their newborn, and this was more likely among women with a university degree, with a very good perceived health status, and who needed additional information. Conclusions: An education campaign regarding RSV infection and its vaccine is needed in order to improve women’s perception and to support healthcare workers in promoting it when it will be available.

Because of the increased expansion of the non-agricultural industry spurred on by vigorous urbanization, labor migration or transfer from farm to urban regions is to become more predominant in China. Studying the effect of labor transfer on farmers’ willingness to withdraw from land is conducive to deepening the understanding of the reality of the “separation of human and farmland”. As most rural livelihoods, directly and indirectly, depend upon farming, the socio-economic impact of leaving the homestead fosters profound research value. Moreover, it would provide a decision-making reference for the government to improve the design of the rural land withdrawal system and related support policies. This article uses the survey data of 953 farmers in Shaanxi, Sichuan, and Anhui, China, to empirically analyze labor transfer’s effect on farmers’ willingness to withdraw from farmland. We construct a bivariate Probit model by eliminating the endogenous issue to craft its findings. This study outlines its findings: (i) 61.805% of the farmers were unwilling, and 18.048% were willing to withdraw from the contracted land and homestead. While 12.067% of the farmers were only willing to withdraw from the contracted land, 8.080% of the farmers were only willing to withdraw from the homestead. Further testing found a positive correlation between farmers’ willingness to withdraw from contracted land and the homestead. (ii) The overall labor transfer of households can increase the willingness of farmers to quit contracted land and homestead farming. The incomplete labor transfer of households can improve the willingness of farmers to quit contracted land. Still, it has no significant impact on the willingness of farmers to quit their homesteads. The family’s complete labor transfer incentivizes farmers’ willingness to withdraw from contracted land and the homestead, which is more potent than incomplete family labor transfer. (iii) Incomplete labor transfer of female households has an incentive effect on farmers’ willingness to quit contracted land, and the effect is more robust than that of incomplete household labor transfer. Seemingly, complete female labor transfer of households has an incentive effect on farmers’ willingness to quit contracted land and the homestead, and the effect is stronger than the complete labor transfer of the family. Because of this, the government should respect the wishes of farmers and strengthen the effective connection and mutual promotion between the homestead and contracted land withdrawal policy. Moreover, pay concentrated attention to the vital role of different types of labor transfer, and targeted labor transfer mechanisms should be used to guide farmers in an orderly manner.

This cross-sectional survey was conducted to investigate the willingness and uptake of recommended vaccinations against influenza, meningococcal B and ACWY, pneumococcal, rotavirus and the influencing factors among 565 parents of children aged 6 months to 5 years with chronic medical conditions in Italy. Only 34.9% of the sample received all vaccinations. Parents whose selected child was vaccinated against the five diseases were those who had received recommendations from physicians, who did not believe that children should get fewer vaccinations at the same time, those whose child was aged 2–3 and 4–5 years compared to 6 months–1 year, and those who acquired information from physicians. Only 17.9% were willing to vaccinate their child. Parents with a university degree, those who acquired information from physicians, and those whose child had a more recent diagnosis were more likely to be willing to vaccinate their child. Parents who believed that children should get fewer vaccines at the same time, those without a university degree, and those who did not acquire information from physicians were more likely to not have vaccinated their child because they were concerned about vaccines’ side effects. Public health policymakers should provide efforts to promote the uptake for an adequate protection of this high-risk group.

This study focuses on exploring the factors influencing individuals’ preparedness for disasters. Drawing upon the protection motivation theory (PMT) and the prototype willingness model (PWM), a conceptual framework was proposed to investigate the determinants of willingness to prepare for disasters and its impact on disaster preparedness. Data was collected through an online survey, involving 377 participants with disabilities and medical special needs residing in the Rio Grande Valley (RGV). The collected data was analyzed using generalized structural equation modeling (GSEM) to examine the associations among the selected study variables. The findings indicate that both coping appraisal and threat appraisal significantly influence individuals’ willingness to prepare for disasters, which, in turn, has a notable impact on disaster preparedness. Recognizing the significance of disaster preparedness in building resilience and effectively responding to and recovering from disasters, it is crucial to acknowledge the importance of the willingness component in these efforts to cope effectively with future extreme events.

This systematic review and meta-analysis sought to evaluate the acceptability levels for COVID vaccine(s) in various states in India. Published articles in PubMed/Scopus/Cochrane/DOAJ/the Web of Science that focused on assessing COVID-19 vaccine hesitation/vaccine acceptance using a survey/questionnaire were included. After extensive research, 524 records were found, and after screening on the basis of eligibility criteria, only 23 papers were added to this review. Increased vaccine assumption percentage (>70%) among the population was found in two surveys nationwide (92.8%) and in Delhi (79.5%). For pooled estimates of COVID-19 vaccine acceptance and heterogeneity, twenty-three studies (23) consisting of 39,567 individuals reported for acceptance of COVID 19 vaccine in India.. Out of these, 26,028 individuals accepted the COVID-19 vaccine, giving a pooled estimate of 62.6% (95% CI: 55.6–69.4) with considerable heterogeneity (χ2 = 3397.3, p < 0.0001; I2 = 99.40%). The results of this study give a brief insight into the percentage acceptance and hesitancy among the Indian population regarding COVID-19 vaccine immunisation. Future research and vaccine education initiatives can be steered by the findings of this work as a starting point.

The Special Issue “The Willingness toward Vaccination: A Focus on Non-mandatory Vaccinations”, published in the journal Vaccines, has the main aim of gathering more data on vaccine hesitancy and the willingness of individuals to receive vaccinations, particularly in the context of non-mandatory vaccines. The aim is to address vaccine hesitancy and improve vaccine coverage rates, in addition to identifying the determinants of vaccine hesitancy itself. This Special Issue garners articles that examine the external and internal factors that can influence the decision-making process of individuals regarding vaccination. Given that vaccine hesitancy is present in a significant part of the general population, it is crucial to have a better analytical understanding of the areas where hesitancy arises to determine appropriate strategies to address this issue.

This study aims to investigate the causes of COVID-19 vaccine hesitancy among the Chinese population. The LDA model and content analysis were used to analyze the content of COVID-19 vaccine hesitancy expressed by the Chinese on Weibo from 2020 to 2022, the leading causes of vaccine hesitancy, and the changes in the reasons for vaccine hesitancy over time. The study found that when the Chinese expressed vaccine hesitancy, it usually involved themes such as information access (18.59%), vaccination services (13.91%), and physical illness (13.24%), and topics such as vaccination process (6.83%), allergic diseases (6.59%), and international news (6.43%). Constraints (35.48%), confidence (17.94%), and calculation (15.99%) are the leading causes of vaccine hesitancy on Weibo. These findings provide a comprehensive picture of how the Chinese express vaccine hesitancy in social media and the reasons and changes for vaccine hesitancy, which can help inspire public health experts, health organizations, or governments in various countries to improve the phenomenon of vaccine hesitancy.

As the global trend for healthy eating grows, firms are emphasising dairy functional foods (DFFs). This study looks into the relationship between consumer attitudes and readiness to consume DFFs, taking into account how a healthy lifestyle might both motivate and deter people from using them. Hungary was chosen because consumer behaviour towards functional foods is under-researched in comparison to Western Europe. Data were generated using a survey questionnaire from 313 respondents. The results of Partial Least Squares (PLS) analysis revealed that consumer attitudes had a considerable influence on the desire to consume DFFs. Furthermore, the motivators and barriers had a direct influence on willingness through the consumer attitudes that serve as mediators. These findings show the need for targeting consumer attitudes and lifestyle characteristics in order to increase the market acceptance of DFFs.

High-risk populations are at increased risk of severe influenza-related illness, hospitalization, and death due to influenza. The aim of our study was to assess the willingness of high-risk populations to take the influenza vaccine for the 2022–2023 season, and to investigate the factors associated with such willingness. We conducted a cross-sectional study in Greece in September 2022 using a convenience sample. We considered demographic characteristics, COVID-19-related variables, resilience, social support, anxiety, depression, and COVID-19-related burnout as potential predictors. Among participants, 39.4% were willing to accept the seasonal influenza vaccine, 33.9% were unwilling, and 26.8% were hesitant. Multivariable analysis identified that increased age and increased family support were associated with increased influenza vaccination willingness. Moreover, participants that have received COVID-19 booster doses were more willing to accept the influenza vaccine. In contrast, adverse effects because of COVID-19 vaccination and exhaustion due to measures against COVID-19 reduced influenza vaccination willingness. We found that the intention of high-risk populations to receive the influenza vaccine was low. Our study contributes to an increased understanding of the factors that affect vaccination willingness. Public health authorities could use this information to update vaccination programs against influenza. Emphasis should be given on safety and effectiveness issues.

Speech pauses between turns of conversations are crucial for assessing conversation partners’ cognitive states, such as their knowledge, confidence and willingness to grant requests; in general, speakers making longer pauses are regarded as less apt and willing. However, it is unclear if the interpretation of pause length is mediated by the accent of interactants, in particular native versus non-native accents. We hypothesized that native listeners are more tolerant towards long pauses made by non-native speakers than those made by native speakers. This is because, in non-native speakers, long pauses might be the result of prolonged cognitive processing when planning an answer in a non-native language rather than of a lack of knowledge, confidence or willingness. Our experiment, in which 100 native Polish-speaking raters rated native and non-native speakers of Polish on their knowledge, confidence and willingness, showed that this hypothesis was confirmed for perceived willingness only; non-native speakers were regarded as equally willing to grant requests, irrespective of their inter-turn pause durations, whereas native speakers making long pauses were regarded as less willing than those making short pauses. For knowledge and confidence, we did not find a mediating effect of accent; both native and non-native speakers were rated as less knowledgeable and confident when making long pauses. One possible reason for the difference between our findings on perceived willingness to grant requests versus perceived knowledge and confidence is that requests might be more socially engaging and more directly relevant for interpersonal cooperative interactions than knowledge that reflects on partners’ competence but not cooperativeness. Overall, our study shows that (non-)native accents can influence which cognitive states are signaled by different pause durations, which may have important implications for intercultural communication settings where topics are negotiated between native and non-native speakers.

COVID-19 booster doses for high-risk groups such as nurses are necessary to reduce the impacts of the pandemic and promote public health. We examined the relationship between COVID-19-related burnout and booster vaccination willingness among nurses, and we assessed whether social support can buffer this relationship. We conducted a cross-sectional study with 963 fully vaccinated nurses working in healthcare settings in Greece. We used the multidimensional scale of perceived social support to measure social support and the COVID-19 burnout scale to measure COVID-19-related burnout. We measured vaccination willingness with a scale from 0 (extremely unlikely to take a booster dose) to 10 (extremely likely). Among nurses, 37.1% reported being very likely to be vaccinated, 34.4% reported being uncertain about their likelihood of vaccination, and 28.6% reported being very unlikely to be vaccinated with a booster dose. We found that COVID-19-related burnout reduced vaccination willingness, while social support functioned as a partial mediator of this relationship. In conclusion, nurses who experienced burnout were less likely to accept a booster dose. Furthermore, increasing nurses’ social support reduced the negative effects of burnout, resulting in improved booster vaccination willingness. Immunization awareness programs should be implemented in order to address nurses’ concerns and support booster doses.

Vaccination is an important measure to control the spread of COVID-19 among elderly high-risk groups; however, the propensity to receive COVID-19 vaccine boosters has not been evaluated in these populations. Here, we aimed to investigate the willingness to receive a COVID-19 vaccine booster among the elderly chronic disease population in Taizhou, China. A cross-sectional, hospital-based survey was conducted in the outpatient department of a tertiary care hospital between 6 July and 11 August 2021 in Taizhou, China, and the data were uploaded to Wen-Juan-Xing, one of the largest online platforms used to collect survey data in China. The targeted population was non-oncology chronic disease patients aged 60 years and above. The minimum sample size was 229, determined by the G*Power software (v3.1.9.2, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany). A total of 254 patients with valid data were enrolled in this study, with a response rate of 82.5% (254/308). Chi-square tests and one-way binary regression were used to compare the proportions and the degree of influence of categorical factors. The magnitude of the effect for the comparisons was measured by Gramer’s V. A multivariate binary logistic regression model was used to correct for confounders and to identify factors. All data were analyzed using SPSS v24.0 (IBM Corporation, Armonk, NY, USA). A total of 198 respondents (77.9%) were willing to receive a COVID-19 vaccine booster dose, and 77.6% of respondents were willing to receive the primary dose. Age < 70 years (OR 2.82), stable disease control (OR 2.79), confidence in the effectiveness of the COVID-19 vaccine (OR 3.11), and vaccine recipient (OR 5.02) were significantly associated with the willingness to receive a COVID-19 vaccine booster dose. Promoting primary dose vaccination is essential for advancing booster vaccination, and it is important to focus on elderly patients’ confidence in the vaccine, in addition to strengthening health management and promoting disease stability. Follow-up studies should focus on elderly patients who belong to specific disease groups.

The external environment has an important impact on farmers’ willingness to withdraw from rural homesteads. Based on the data from 392 farmers in Wuhan and Suizhou City from July to November 2021, we explored the significant role that the external environment played in farmers’ willingness to withdraw from rural homesteads. The empirical results, according to the binary Logit model, showed that the number of homesteads, location, and economy positively affect farmers’ intention to withdraw from their rural homesteads, and the effect in turn decreases. Famers in a village with no tourism resources are more likely to be willing to withdraw from their homesteads. Based on the empirical findings, this paper finally proposed that local governments should adopt a targeted policy to encourage farmers to orderly withdraw from their rural homesteads.

Background: Vaccination has been effective in preventing COVID-19 infections and related mortality. However, waning immunity after two-dose vaccination prompted health authorities to recommend a third dose of COVID-19 vaccine to boost immunity. The aim of our study was to assess willingness to receive a third (booster) dose among patients with inflammatory bowel disease (IBD). Methods: A cross-sectional study was performed at an IBD tertiary care center. Patients were recruited at the infusion room from 1 January 2022 to 31 March 2022. The primary outcome was the prevalence of a third (booster) dose of the BNT162b2 vaccine in infliximab- or vedolizumab-treated patients with IBD. The secondary outcome evaluated whether the prevalence of a third (booster) dose of the BNT162b2 vaccine differed based on type of COVID-19 vaccine, gender, age, type of biologic therapy, and citizenship. Results: In total, 499 patients with IBD were included in this study. The median age was 34.5 years, and 60% had ulcerative colitis (UC). Among the study participants, 302 (60.5%) patients were vaccinated with BNT162b2, and 197 (39.5%) were vaccinated with ChAdOx1 nCoV-19. Of the total number of participants, 400 (80.2%) were receiving infliximab, and 99 (19.8%) were receiving vedolizumab. Overall, 290 (58.1%) of the included patients were willing to receive the third (booster) dose. Patients vaccinated with BNT162b2 were more likely to be willing to receive a booster dose compared to patients vaccinated with ChAdOx1 nCoV-19 (201 (66.5%) vs. 103 (52.0%), p = 0.014). Infliximab-treated patients were more likely to be willing to receive a booster dose compared to patients receiving vedolizumab (310 (77.5%) vs. 62 (62.6%), p = 0.002). There was no statistical difference in willingness to receive a booster dose in terms of age, nationality, or gender. Conclusions: The percentage of patients with IBD willing to receive or having already received a third (booster) dose of BNT162b2 vaccine was lower compared to the general population. In addition, patients who received two doses of BNT162b2 vaccines were more likely to be willing to receive a third (booster) dose compared to patients who received ChAdOx1 nCoV-19. Patients treated with infliximab were more likely to be willing to receive a third (booster) dose of COVID-19 vaccine.

The emergence of breakthrough infections and new highly contagious variants of SARS-CoV-2 threaten the immunization in individuals who had completed the primary COVID-19 vaccination. This systematic review and meta-analysis investigated, for the first time, acceptance of the first COVID-19 booster dose and its associated factors among fully vaccinated individuals. We followed the PRISMA guidelines. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL and medrxiv from inception to 21 May 2022. We found 14 studies including 104,047 fully vaccinated individuals. The prevalence of individuals who intend to accept a booster was 79.0%, while the prevalence of unsure individuals was 12.6%, and the prevalence of individuals that intend to refuse a booster was 14.3%. The main predictors of willingness were older age, flu vaccination in the previous season, and confidence in COVID-19 vaccination. The most important reasons for decline were adverse reactions and discomfort experienced after previous COVID-19 vaccine doses and concerns for serious adverse reactions to COVID-19 booster doses. Considering the burden of COVID-19, a high acceptance rate of booster doses could be critical in controlling the pandemic. Our findings are innovative and could help policymakers to design and implement specific COVID-19 vaccination programs in order to decrease booster vaccine hesitancy.

Although many research studies have concentrated on people’s willingness to take the COVID-19 vaccine, little attention has been paid to the underlying mechanism of consent. An understanding of potential factors and mechanisms that affect the willingness to receive a vaccination can contribute information critical for containing the pandemic. This study explored the effects of post-vaccination adverse reactions on the willingness to take the booster dose and the role of decision regret. A self-administered online survey was carried out in Taizhou, China. Questionnaires were completed by 1085 healthcare workers (HCWs), 1054 (97.1%) of whom had completed two doses of the COVID-19 vaccine. Mediation analysis methodology was applied in this study. Our study showed that post-vaccination adverse reactions in HCWs could decrease their willingness to take the booster dose. Of note, HCWs who experienced adverse reactions after vaccination would be more likely to regret their previous vaccination decisions, which, in turn, further reduced their willingness to receive a booster shot. Decision regret mediated the relationship between adverse post-vaccination reactions and a willingness to take the booster dose. The findings implied inextricable relationships among post-vaccination adverse reactions, decision regret, and willingness to take the booster dose. It is suggested that notice of these post-vaccination adverse reactions should be further incorporated into vaccine communication campaigns and policy interventions advocating booster doses to improve vaccine uptake intent and increase the willingness to receive booster doses of a COVID-19 vaccine.

Various COVID-19 vaccines have been developed in an unprecedented time and were rolled out across the world to save lives during the COVID-19 pandemic. Yet statistics show that COVID-19 uptake and acceptance in the Horn of Africa have been very low. To examine factors associated with COVID-19 vaccine uptake and acceptance in Somaliland, we carried out a cross-sectional study using a structured questionnaire both in offline and online modes. The study population was adults from the age of 18 years and above. Of the 704 respondents who participated in the survey, only 37% took the vaccine. Surprisingly, about 65% of those who have not taken the vaccine were unwilling to get vaccinated. Using a binomial logistic regression, we find that older people, the more educated and those who are employed are more likely to take the vaccine. Our results also show that the perceived threat of the virus and the perceived safety of the vaccine significantly increase vaccine uptake and acceptance. Results of this study will help the government and other concerned parties shape policies that can boost vaccine uptake and acceptance.

Cervical cancer can be prevented by human papillomavirus (HPV) vaccination. However, parents can have concerns about vaccinating their daughters. Consequently, there is a need to identify prevalence and risk factors for HPV vaccine hesitancy among parents in Kenya. A descriptive cross-sectional study was conducted among parents with children aged 9–14 years attending a leading referral hospital in Kenya. Data on sociodemographic traits, HPV knowledge, beliefs and vaccine hesitancy were collected. Out of 195 participants, 183 (93.5%) were aged >30 years. Thirty-four (46.4%) of males and 39 (35.1%) of females did not know that the vaccine is given to prevent HPV infection. Encouragingly, levels of vaccine acceptance were high (90%) although one-third (37.9%) had a negative perception about the effectiveness of the vaccine, with vaccine hesitancy attributed to safety concerns (76%) and feelings that the child was too young (48%). Positive beliefs and knowledge of the vaccine were positively associated with parental willingness to vaccinate their children. Low levels of parenteral education and a younger age among mothers were negatively associated with willingness to vaccinate. Most parents (59%) would consult their daughters before vaccination, and 77% (n = 150) recommended early sex education. Despite low knowledge levels, there was high parental willingness to have their children vaccinated.

Neuroenhancement is rapidly re-emerging as a research topic because of the development of minimally invasive brain intervention technologies, including neurofeedback. However, public attitude toward enhancement technologies remains relatively unexplored. To fill this gap in the literature, we conducted an online survey of 1258 people in Japan who were presented with four scenarios depicting minimally and highly invasive enhancement interventions. Approximately 20% of the respondents stated that they were willing to use enhancement technologies, whereas 80% were not. Most respondents were cautious about using enhancement technologies. We used a generalized linear mixed-effects model to study the association between the type of intervention and participants’ willingness to use such technologies. Factors related to willingness to use these technologies included interventions’ degree of invasiveness, as well as participants’ gender, educational attainment, and limit or suppression experiences. We also examined the influence of others’ choices and behaviors, and participants’ tolerance toward others’ use of enhancement technologies. We explored important aspects of policymaking vis à vis enhancement technologies. This study could provide valuable insights for a debate on the ethics and regulation of enhancement technologies.

Given the concerns of waning immunity from the primary COVID-19 vaccines and the first booster dose, we conducted an online cross-sectional study in May 2022 to investigate willingness to receive a second COVID-19 booster dose or a new COVID-19 vaccine and its associated factors. Overall, 62% of the participants were willing to be vaccinated, 25.8% were unsure, and 12.3% were unwilling to be vaccinated. The main reasons against accepting a second COVID-19 booster dose/new COVID-19 vaccine were concerns about the side effects and the effectiveness and the opinion that further vaccination is unnecessary. Males, younger individuals, participants without a previous COVID-19 diagnosis, and those with good/very good self-perceived physical health were significantly more frequently willing to receive a second COVID-19 booster dose or a new COVID-19 vaccine. Additionally, increased fear of the COVID-19, increased trust in COVID-19 vaccinations, and decreased fear of a second booster dose or a new COVID-19 vaccine was associated with increased willingness. Our results show some hesitancy and unwillingness toward further COVID-19 vaccination and indicate that the fear of COVID-19 and trust in COVID-19 vaccination affects public opinion.

Telerehabilitation is an appealing service delivery option for optimising recovery. Internationally, the equity of telerehabilitation services for people from culturally and linguistically diverse (CALD) backgrounds has been questioned. Using a 31-item survey, our study explored the access, readiness and willingness of 260 patients receiving allied health services from a large tertiary health service located in Sydney, Australia, to use telerehabilitation for adults. Overall, 72% patients reported having access to technology, 38% met our readiness criteria and 53% reported willingness to engage in telerehabilitation. There were no differences in access, readiness and willingness to engage in telerehabilitation between patients from CALD and non-CALD backgrounds. Age was the only factor that influenced access (OR = 0.94, 95% CI 0.90 to 0.97), readiness (OR = 0.95, 95% CI 0.92 to 0.98) and willingness (OR = 0.97, 95% CI 0.95 to 1.00) to engage in telerehabilitation. Past experience of telerehabilitation was related to willingness (OR = 2.73, 95% CI 1.55-4.79) but not access (OR = 1.79, 95% CI 0.87 to 3.68) or readiness (OR = 1.90, 95% CI 0.93 to 3.87). Our findings highlight the importance of ensuring positive patient experiences to promote ongoing willingness to use telerehabilitation. Efforts are needed to improve patients' digital health literacy, especially patients from older age groups, to ensure equitable engagement in telerehabilitation services.

Background: Older individuals have a high risk of morbidity and mortality due to COVID-19, and one of the most effective ways to prevent COVID-19 is vaccination. Little is known about older people’s willingness to receive a COVID-19 vaccine. Therefore, the objective of this study was to assess the acceptance of and factors influencing the intention to receive a COVID-19 vaccination among older adults in Shanghai, China. Methods: A cross-sectional study was conducted among older adults (≥60 years old) in Shanghai. Face-to-face interviews with a questionnaire were conducted in community health service centers, recording several parameters: demographic information, health-related factors; perceived likelihood, severity, and burden of COVID-19; perceived safety, effectiveness, necessity, and benefit of the COVID-19 vaccine, as well as their trust in the vaccine delivery system and doctors; willingness to receive a COVID-19 vaccination. Bivariate analysis between several survey items and the willingness to receive a COVID-19 vaccination was conducted using a chi-square test. Logistic regression was used to assess to what degree each variable affected the willingness to receive a COVID-19 vaccination. Results: Of the 1067 participants, 90.91% (970/1067) confirmed that they were willing to receive a COVID-19 vaccination. The participants were more likely to be willing to be vaccinated if they were immigrants (OR = 1.988, 95%CI = 1.062–3.717), had an education level of junior high school (OR = 2.724, 95%CI = 1.000–7.423) or high school or above (OR = 3.993, 95%CI = 1.576–10.119), and had a monthly income of CNY 3000–5000 (OR = 32.770, 95%CI = 1.144–6.711) or CNY >5000 (OR = 2.309, 95%CI = 1.003–5.319). The participants were also more likely to be willing to be vaccinated if they had received a pneumonia vaccination previously (OR = 2.138, 95%CI = 1.016–4.500), perceived the safety of the COVID-19 vaccine (OR = 1.508, 95%CI = 1.073–2.119), perceived the necessity of the COVID-19 vaccine (OR = 2.604, 95%CI = 1.946–3.484), or trusted the suggestions of doctors (OR = 1.706, 95%CI = 1.115–2.618). The participants were less likely to be willing to be vaccinated if they were aged ≥76 years (OR = 0.498, 95%CI = 0.264–0.939), reported a physical health condition of bad or below (OR = 0.229, 95% CI = 0.095–0.549), or were worried about the adverse effects of a COVID-19 vaccination (OR = 0.503, 95%CI = 0.364–0.695). Conclusions: Under the free vaccination policy for COVID-19, older adults have a high intention to be vaccinated to prevent COVID-19 in Shanghai, China. Widely publicizing the safety and necessity of COVID-19 vaccination is necessary.

Seasonal influenza vaccination is highly recommended for 6–59-month-old children. To determine the impact of seasonal influenza and the factors affecting influenza vaccine uptake among children, we conducted an opt-in Internet panel survey of parents from 21 March 2018 to 1 April 2018. Overall, 40.5% (1913/4719) of children experienced influenza-like illness (ILI), 92.4% of parents sought medical care for children with ILI (outpatients: 61.2%, inpatients: 12.8%), 39.6% of parents preferred to take their sick child to a tertiary hospital, and 57.3% of family members requested leave to care for children with ILI. There was a median of three days of absenteeism (2, 5) per sick child, and 39.4% of children received the influenza vaccine during the 2017–2018 influenza season. Vaccine coverage among children aged 6–11 months and 48–59 months was lower than that among 12–47-month-old children. The top three reasons for not vaccinating were: the influenza vaccine was not recommended by healthcare workers (21.1%), no knowledge about the influenza vaccine (19.2%), and lack of confidence in the vaccine’s effectiveness (14.3%). Our findings highlight the need for awareness about the severity of influenza, hygiene behavior, and effectiveness of the influenza vaccine among children and their family members in China.

Vaccination is the most effective intervention to prevent infection and subsequent complications from SARS-CoV-2. Because of their multiple comorbidities, the elderly population experienced the highest number of deaths from the COVID-19 pandemic. Although in most countries, older people have top priority for COVID-19 vaccines, their actual willingness and attitudes regarding vaccination are still unclear. Thus, we conducted a cross-sectional study to investigate their willingness, attitudes, awareness, and knowledge of COVID-19 through a web-based questionnaire after the first local outbreak of COVID-19 in Taiwan. A total of 957 questionnaires were completed, and 74.9% of elderly individuals were likely to receive COVID-19 vaccines. The results from a multiple logistic regression demonstrated that older people who need to visit the outpatient department and have a high level of concern about the safety of COVID-19 vaccines are prone to having a negative willingness to accept COVID-19 vaccines. The following items related to awareness of the COVID-19 pandemic were attributed to the acceptance of COVID-19 vaccines: “understanding the risk of being infected by SARS-CoV-2”, “understanding the effectiveness of COVID-19 vaccines”, “willingness to accept the COVID-19 vaccine for protecting others”, and “safety of COVID-19 vaccines is a key factor for you to accept them”. Furthermore, a positive association between COVID-19 vaccination and attitudes toward accepting booster doses of the COVID-19 vaccine was observed. Our results show that these factors could affect the willingness of older people to accept COVID-19 vaccines and that they are important for policymakers and medical staff to develop vaccination plans during the COVID-19 pandemic.

To address the novel coronavirus disease (COVID-19) pandemic, development and regulatory evaluations have been accelerated for vaccines, authorizing emergency use. To anticipate vaccine preparedness in adolescents, we studied COVID-19 vaccination awareness and willingness to vaccinate before the vaccine became available. We conducted a cross-sectional survey among 9153 (4575 boys, 50%) students with a mean age of 14.2 years old in four cities in China to collect information on demographic characteristics and their COVID-19 vaccination concerns. Multinomial logistic regression was used to analyze the influencing factors of vaccine hesitancy (“not sure”) and resistance (“do not want it”). The results showed that 2891 (31.6%) were hesitant and 765 (8.4%) were resistant to being vaccinated. Additionally, multivariable analyses showed that vaccine hesitancy and vaccine resistance were associated with living in the Beijing area (OR = 1.62; 95% CI: 1.40–1.88; OR = 1.81; 95% CI: 1.44–2.28), lack of influenza vaccination experience (OR = 1.33; 95% CI: 1.14–1.55; OR = 1.57; 95% CI: 1.25–1.98), no perceived susceptibility (OR = 1.72; 95% CI: 1.50–1.97; OR = 3.57; 95% CI: 2.86–4.46), and perceiving no cues to action (OR = 3.24; 95% CI: 2.56–4.11; OR = 27.68; 95% CI: 21.81–35.13). Postulating a highly effective vaccine (OR = 0.84; 95% CI: 0.72–0.98; OR = 0.66; 95% CI: 0.52–0.83) decreased both vaccine hesitancy and resistance. Vaccine hesitancy alone was associated with girls (OR = 1.21; 95% CI: 1.09–1.36) and was less common among students boarding at school (OR = 0.79; 95% CI: 0.68–0.92), postulating convenient vaccine access (OR = 0.84; 95% CI: 0.73–0.96), and having doctors’ recommendation (OR = 0.86; 95% CI: 0.76–0.98). In conclusion, the results of the study showed that vaccine hesitancy among students in China was associated with limited health literacy and lower risk awareness. Our findings in China suggest that educating youth regarding COVID-19 and the safety and effectiveness of immunization help reduce concerns and increase vaccine confidence and acceptance.

The aims of the present investigation were (i) to determine psychological relapses of COVID-19 booster vaccine; (ii) to identify the determining factors affecting willingness to receive COVID-19 vaccine; and (iii) to study the relationship among emotional characteristics (anxiety, stress, depression, optimism), social media information, and the mandatory political choices (i.e., green-pass) in Croatian people. A cross-sectional online survey was conducted for 1003 participants (median age: 40 years) from Croatia during December 2021. Results showed a significant association between vaccinated and unvaccinated participants in all sociodemographic variables, except for gender (p = 0.905). For psychological variables, significant differences were found only for levels of optimism (p < 0.001). People with a postgraduate degree (OR: 2.25, [1.14–4.46], p = 0.020) and PhD (OR: 1.97, [95% CI: 1.01–3.52], p = 0.021) had higher odds of being vaccinated than participants with high school diplomas. Additionally, participants seeking information on TV and radio (OR: 2.35, [1.71–3.23], p < 0.001) or from general practitioner (OR: 2.53, [1.78–3.61], p < 0.001) had higher odds of being vaccinated. Conversely, participants seeking information on social networks (OR: 0.36, [0.27–0.49], p < 0.001), general internet/blogs forums (OR: 0.34, [0.22–0.52], p < 0.001), and from friends or acquaintances (OR: 0.66, [0.48–0.91], p = 0.011) had lower odds of being vaccinated. Additionally, results showed that information policies have failed to fully convince the population to vaccinate and that depression (p = 0.491), anxiety (p = 0.220), and stress (p = 0.521) were not determining factors leading to the decision to receive COVID-19 vaccine. Most of the vaccinated participants perceived the green-pass as potentially useful. In contrast, most unvaccinated participants believed that the green-pass is a form of discrimination and not useful (88%). Further and broader research into possible reasons for continuing or undertaking vaccination is needed. It is recommended to introduce a measure of conformism that represents a change of attitude, belief, or behavior in a narrower sense.

This cross-sectional study, conducted in Naples (Italy) between 16 November and 6 December 2021, explored the willingness to receive the booster dose of the COVID-19 vaccine among a random sample selected from the list of those who had completed a primary vaccination series at the immunization center of a teaching hospital in Naples and the associated factors. Females had a significantly higher perceived risk of getting the SARS-CoV-2 infection, whereas those not-having a cohabitant were less worried. 85.7% were willing to receive the booster dose. Those older respondents who perceived a better health status after the primary vaccination series, who have friends/family members who were diagnosed with COVID-19, who had received information from official government organizations, and those who did not need information would be willing to get the booster dose. 24.7% was hesitant with a Vaccine Hesitancy Scale (VHS) score ≥ 25. Respondents who self-rated a lower health status after the primary vaccination series, who did not have friends/family members who were diagnosed with COVID-19, who had not received information from official government organizations, and who needed information were hesitant. Information and communication regarding the benefits and efficacy of the booster dose are needed in order to control the pandemic.

The current study uses data surveyed between August and September 2021 in four ASEAN (Association of South East Asian Nations) countries to identify drivers of COVID-19 vaccine acceptance with different levels of the pandemic severity. It also examines the impact of the drivers on vaccine acceptance. The results show that the number of respondents who accept vaccines significantly dominates that of those who do not. In addition, the number of respondents who get the vaccine if the pandemic becomes more severe dominates that of those if it becomes less severe. Results generated from the logistic regressions show that the impact of the drivers on the COVID-19 vaccine acceptance with different levels of the pandemic severity varies in terms of magnitude and direction. Practical recommendations are made based on the findings.

Since 2019, the COVID-19 pandemic has resulted in sickness, hospitalizations, and deaths of the old and young and impacted global social and economy activities. Vaccination is one of the most important and efficient ways to protect against the COVID-19 virus. In a review of the literature on parents’ decisions to vaccinate their children, we found that widespread vaccination was hampered by vaccine hesitancy, especially for children who play an important role in the coronavirus transmission in both family and school. To analyze parent vaccination decision-making for children, our review of the literature on parent attitudes to vaccinating children, identified the objective and subjective influencing factors in their vaccination decision. We found that the median rate of parents vaccinating their children against COVID-19 was 59.3% (IQR 48.60~73.90%). The factors influencing parents’ attitudes towards child vaccination were heterogeneous, reflecting country-specific factors, but also displaying some similar trends across countries, such as the education level of parents. The leading reason in the child vaccination decision was to protect children, family and others; and the fear of side effects and safety was the most important reason in not vaccinating children. Our study informs government and health officials about appropriate vaccination policies and measures to improve the vaccination rate of children and makes specific recommendations on enhancing child vaccinate rates.

In French Guiana, a French overseas territory in South America facing a fourth wave of COVID-19, vaccination coverage is very low, both in the population and among health care workers (HCWs). Vaccine hesitancy concerned 35.7% of the latter in early 2021. The objective of this complementary study is to understand barriers and levers and to adapt messages to increase vaccination coverage among HCWs. We conducted a regional cross-sectional survey of HCWs with a questionnaire containing open-ended questions exploring factors associated with vaccine hesitancy and the needs to adapt the vaccination campaign in French Guiana. The discourses were analyzed using a qualitative approach based on grounded theory, with open coding of data by themes and construction of abstract categories. The analysis of the 357 responses collected from January to March 2021 reveals several trends. The ethical aspect of the HCWs’ role emphasizes the importance of getting vaccinated themselves (to protect patients, to set an example...) and of vaccinating as many people as possible, including the most geographically or socially distant, such as undocumented migrants. However, some HCWs remain suspicious of the vaccine with concerns over the efficacy and side effects, of health institutions, and of the pharmaceutical industry. The role of fake news circulating on social networks has been widely discussed. Efforts to explain and convince HCWs must be continued in French Guiana using the identified levers to improve the acceptability of vaccination.

Background: The SARS-CoV-2 vaccine has been widely rolled out globally in the general populations. However, specific data on vaccination confidence, willingness or coverage among health care workers (HCWs) has been less reported. Methods: A cross-sectional online survey was conducted to specify the basic data and patterns of vaccination confidence, willingness and coverage among HCWs nationwide. Results: In total, 2386 out of 2583 (92.4%) participants were enrolled for analysis, and the rates of confidence in vaccine, professional institutes and government were 75.1%, 85.2% and 85.4%, respectively. The overall vaccination coverage rate was 63.6% which was adjusted as 82.8% for participants under current medical conditions or having contraindications. Confidence in vaccine safety was shown to be the most related factor to willingness among doctors, nurses, medical technicians and hospital administrators, while confidence in vaccine effectiveness as well as trust in government played the key role in formulating public health employees’ willingness. 130 (7.1% of 1833) participants reporting willingness still not been vaccinated regardless of contraindications. Multivariate analysis among willingness participants showed that males, aged over 30 years, public health employees and higher vaccination confidence had significantly higher vaccination rates with ORs (95% confidence intervals) as 1.64 (1.08–2.49), 3.14 (2.14–4.62), 2.43 (1.46–4.04) or 2.31 (1.24–4.33). Conclusions: HCWs’ confidence, willingness and coverage rates to the vaccine were generally at high levels. Heterogeneity among HCWs should be considered for future vaccination promotion strategies. The population’s confidence in vaccination is not only the determinant to their willingness, but also guarantees their actual vaccine uptake.

Background: This study was conducted to assess parents' willingness to vaccinate their children with the RSV vaccine and the key predictors of this intention among parents in Italy., Methods: Data were collected using an anonymous self-administered questionnaire from April to November 2023, targeting parents in public kindergartens and nursery schools in southern Italy. The survey assessed parents' socio-demographic characteristics, health-related details, their child's health status, attitudes toward RSV infection and its vaccine, and their source(s) of information., Results: A total of 404 parents agreed to participate in the study. Only 18.2% of participants were very concerned that their children could get infected by RSV, and this concern was more likely among parents whose child had been diagnosed with bronchiolitis, those who received information from HCWs, those who had heard of RSV, and those who needed additional information. Almost half (51.3%) were willing to vaccinate their child, and this inclination was more likely among fathers, employed parents, those with daughters, those who had heard of RSV, those who received information from HCWs, and those who needed additional information., Conclusions: An educational campaign regarding a future RSV vaccine, especially about its safety and efficacy, is needed in order to improve parents' willingness.

Background: This cross-sectional survey investigated the knowledge, attitudes, and coverage of recommended vaccinations among a random sample of patients with chronic medical conditions, at higher risk of vaccine-preventable diseases (VPDs), in Italy., Methods: The survey was conducted via telephone-based interviews., Results: Multinomial regression analysis showed that the patients who believed that VPDs were severe were more likely to know one recommended vaccination; those who believed that VPDs were severe and those who were advised from a general practitioner (GP) were more likely to know two vaccinations; those who were older, graduated, with more time from diagnosis, who believed that VPDs were severe, who did not need additional information, and who were advised from a GP were more likely to know three or four vaccinations. Patients who knew at least one vaccination, who perceived themselves at risk, and who were advised from a GP were more likely to have received one vaccination; those who knew more than one vaccination and who were advised from a GP were more likely to receive two or three vaccinations. Among the unvaccinated, patients who were unmarried/not cohabiting, those who needed information, and who believed that vaccinations were useful and safe were more willing to receive the recommended vaccinations., Conclusions: Educational interventions are needed to improve the adherence of individuals with chronic medical conditions., Competing Interests: The authors declare no conflicts of interest.

The current study aims to identify psychosocial factors based on protection motivation theory (PMT) influencing Chinese adults’ willingness to receive the COVID-19 vaccine after the emergency use authorization of the New Coronavirus Inactivated Vaccine in China. A cross-sectional online survey was conducted among Chinese residents aged 18–59 years, and 2528 respondents from 31 provinces and autonomous regions were included in the current study. Based on PMT, threat appraisals and coping appraisals were measured. Hierarchical multiple regressions and multivariate logistic regressions were used to identify the relationships between the PMT constructs and vaccination willingness after other covariates were controlled for. A total of 1411 (55.8%) respondents reported being willing to receive the COVID-19 vaccine. The PMT model explained 26.6% (p < 0.001) of the variance in the vaccine willingness. The coping appraisals, including response efficacy, self-efficacy, and response costs, were significantly correlated with the willingness to receive the COVID-19 vaccine, and response efficacy was the strongest influencing factor (adjusted OR = 2.93, 95% CI: 2.42–3.54). In conclusion, the coping appraisals for vaccination, instead of threat appraisals regarding the pandemic itself, mainly influenced people’s willingness to get vaccinated after the emergency use authorization of the COVID-19 vaccine in China. These findings are helpful for developing education and interventions to promote vaccination willingness and enhance public health outcomes during a pandemic.

The impact of COVID-19 vaccination programmes on disease transmission, morbidity and mortality relies heavily on the population’s willingness to accept the vaccine. We explore Ghanaian adult citizens’ vaccine hesitancy attitudes and identify the likelihood of participation or non-participation in the government’s effort to get citizens vaccinated. A fully anonymised cross-sectional online survey of 2345 adult Ghanaians was conducted from 23 to 28 February 2021. Differences in intentions regarding COVID-19 vaccination were explored using Pearson Chi-square tests. Additionally, multinomial logistic regression was used to analyse the factors associated with willingness to receive vaccines. Responses were weighted using the iterative proportional fitting technique to generate a representative sample. About half (51%) of mostly urban adult Ghanaians over 15 years are likely to take the COVID-19 vaccine if made generally available. Almost a fifth (21%) of the respondents were unlikely to take the vaccine, while another 28% were undecided. Additionally, we find differences in vaccine hesitancy among some socio-demographic characteristics such as age, gender, and primary sources of information. Attaining the proverbial 63% to 70% herd immunity threshold in Ghana is only possible if the preventive vaccination programmes are combined with an enhanced and coordinated public education campaign. Such a campaign should focus on promoting the individual and population-level benefits of vaccination and pre-emptive efforts towards addressing misinformation about vaccines.

Major hindrances to getting a COVID-19 vaccine include vaccine hesitancy, skepticism, refusal, and anti-vaccine movements. Several studies have been conducted on attitudes of the public towards COVID-19 vaccines and the potential influencing factors. The purpose of this scoping review is to summarize the data available on the various factors influencing public attitudes towards COVID-19 vaccination. This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Statement. PubMed, Embase, Web of Science, and Cochrane Central were searched without restrictions to reclaim all publications on the factors that shape individuals’ attitudes towards COVID-19 vaccines from 1 January 2020 to 15 February 2021. Fifty studies were included. The scoping review revealed that the factors influencing public attitudes towards COVID-19 vaccines were embedded within the different levels of the socio-ecological model. These factors included the sociodemographic characteristics of the individuals, individual factors, social and organizational factors. In addition, certain characteristics of COVID-19 vaccines themselves influenced public attitudes towards accepting the vaccines. Understanding various population needs and the factors shaping public attitudes towards the vaccines would support planning for evidence-based multilevel interventions in order to enhance global vaccine uptake.

Objectives: We aimed to (1) assess parental hesitancy about category A (Expanded Program on Immunization (EPI)) and B (non-EPI) vaccines, (2) assess parental willingness for COVID-19 and influenza vaccinations, and (3) explore the association of vaccination hesitancy of parents and healthcare workers (HCWs). Methods: The study was performed in Wuxi, eastern China between 21 September 2020 and 17 October 2020. Parents of children aged p = 0.000). Overall, 59.3% and 52.4% of parents reported willingness to avail COVID-19 and influenza vaccination for their children, respectively; 51.2% of the HCWs wanted to be vaccinated against COVID-19. Parental category B VHS scores were associated with HCW category B VHS scores (r = 0.928, p = 0.008). Conclusions: In China, parents are more hesitant about category B vaccines than category A vaccines. More than 40% of parents showed hesitancy and a refusal to use COVID-19 and influenza vaccines.

To control the spread of the novel coronavirus disease 2019 (COVID-19), COVID-19 vaccination has been quickly developed. However, the COVID-19 pandemic will not be controlled if the COVID-19 vaccination uptake willingness is low. Therefore, the study aim was to explore the COVID-19 vaccination uptake willingness among the outpatient population and healthcare workers in Taiwan during the worldwide pandemic period without community outbreaks. A cross-sectional survey was conducted among healthcare workers (HCWs; n = 500; mean age = 32.96 years) of National Cheng Kung University Hospital (NCKUH) and outpatients (n = 238; mean age = 34.43 years) arriving at NCKUH. We used an online survey conducted between September 24 and 21 November 2020, for healthcare workers, and between 27 October and 31 December 2020, for the outpatient sample. Information regarding willingness to receive vaccination, willingness to rapid test, fear of COVID-19, risk perception, and preventive behaviors was collected in both samples; information regarding willingness to care for patients was collected in healthcare workers. Willingness to receive vaccination was the main variable in the present study; willingness to rapid test, willingness to care for patients, fear of COVID-19, risk perception, and preventive behaviors were the secondary variables in the study. The factors associated with vaccination willingness were identified through logistic regression analysis. The participants’ willingness to receive vaccination was low for both healthcare workers (23.4%) and the outpatient sample (30.7%). Similarly, their willingness to take rapid tests was low (23.6% for healthcare workers and 28.6% for outpatient sample). Risk perception (crude odds ratio (COR) = 1.29; 95% confidence interval (CI) = 1.03, 1.63), willingness to take rapid test (COR = 9.24; 95% CI = 5.76, 14.83), and preventive COVID-19 infection behaviors (COR = 2.32; 95% CI = 1.52, 3.56) were significant factors explaining the healthcare workers’ willingness to receive vaccination. Willingness to take a rapid test (COR = 8.91; 95% CI = 4.71, 16.87) and preventive COVID-19 infection behaviors (COR = 1.69; 95% CI = 1.09, 2.60) were significant factors explaining the outpatient sample’s willingness to receive vaccination. Willingness to vaccinate against COVID-19 among HCWs and outpatients is low due to the relatively safe status of COVID-19 infection in Taiwan. These findings can help policymakers advocate for the effectiveness of and provide transparent information on COVID-19 vaccination uptake in a country/region with a relatively safe COVID-19 outbreak status.

Understanding whether members of the university population are willing to receive a future vaccination against COVID-19 and identifying barriers may help public health authorities to develop effective strategies and interventions to contain COVID-19. This cross-sectional study explored the willingness to accept a future SARS-CoV-2 vaccine in a university population in Southern Italy. The perceived risk level of developing COVID-19 was 6.5 and it was significantly higher among females, younger subjects, and those who agreed/strongly agreed that COVID-19 is a severe disease. Only 21.4% of respondents were not worried at all regarding the safety of the vaccine. Males, not being married/cohabitant, being a faculty member, those who perceived a lower risk of developing COVID-19, and those who did not need information regarding the vaccination against COVID-19 were significantly more likely to have no concern at all regarding the safety of the vaccine. The vast majority (84.1%) were willing to receive a future vaccine against COVID-19. Almost coherently with predictors of concern on the safety of the vaccine, being male, not being married/cohabitant, being a faculty member, not being concerned at all that COVID-19 vaccination might not be safe, and agreeing that COVID-19 can have serious health consequences were significant predictors of the willingness to receive the vaccine against COVID-19. A considerable proportion of the population had a positive willingness to receive the future COVID-19 vaccine, although some concerns have been expressed regarding the effectiveness and safety and public health activities seem necessary to achieve the rate that can lead to the protection of the community.

In the wake of the COVID-19 pandemic, vaccines are being developed by many countries for the safety of their population. However, people of various nations have revealed hesitancy towards being vaccinated, citing reasons such as side effects, safety, a lack of trust in vaccine effectiveness, etc. This study aimed to explore the willingness of people in Japan to be vaccinated or not be vaccinated and the reasons for either decision. A sample of 1100 respondents was drawn from an internet research panel, and a questionnaire survey was administered to evaluate their willingness to be vaccinated by gender, age group, place of living, and underlying illness history. After using descriptive statistics and the chi-squared test to evaluate categorical variables, 65.7% of the participants indicated a willingness to be vaccinated; among them were older age groups, those in rural areas, and those with underlying medical conditions. In addition, males showed less hesitancy towards being vaccinated. Although selectivity bias exists, this study is the first to examine the willingness of Japanese people to be vaccinated. Since vaccine hesitancy and refusal ratio were found to be higher in Japan than in other countries, policy efforts are needed to make the country’s vaccination program viable.

In mobile ad hoc networks, network nodes cooperate by packet forwarding from the source to the destination. As the networks become denser, more control packets are forwarded, thus consuming more bandwidth and may cause packet loss. Recently, game theory has been applied to address several problems in mobile ad hoc networks like energy efficiency. In this paper, we apply game theory to reduce the control packets in dense networks. We choose a proactive routing protocol, Optimized Link State Routing (OLSR) protocol. We consider two strategies in this method: willingness_always and willingness_never to reduce the multipoint relay (MPR) ratio in dense networks. Thus, nodes with less influence on other nodes are excluded from nomination as MPRs. Simulations were used to confirm the efficiency of using our improved method. The results show that the MPR ratio was significantly reduced, and packet delivery ratio was increased compared to the conventional protocol.

This work provides an overview of a Spanish survey on research data, which was carried out within the framework of the project Datasea at the beginning of 2015. It is covered by the objectives of sustainable development (goal 9) to support the research. The purpose of the study was to identify the habits and current experiences of Spanish researchers in the health sciences in relation to the management and sharing of raw research data. Method: An electronic questionnaire composed of 40 questions divided into three blocks was designed. The three Section s contained questions on the following aspects: (A) personal information; (B) creation and reuse of data; and (C) preservation of data. The questionnaire was sent by email to a list of universities in Spain to be distributed among their researchers and professors. A total of 1063 researchers completed the questionnaire. More than half of the respondents (54.9%) lacked a data management plan; nearly a quarter had storage systems for the research group; 81.5% used personal computers to store data; “Contact with colleagues” was the most frequent means used to locate and access other researchers’ data; and nearly 60% of researchers stated their data were available to the research group and collaborating colleagues. The main fears about sharing were legal questions (47.9%), misuse or interpretation of data (42.7%), and loss of authorship (28.7%). The results allow us to understand the state of data sharing among Spanish researchers and can serve as a basis to identify the needs of researchers to share data, optimize existing infrastructure, and promote data sharing among those who do not practice it yet.

The main objectives of this socio-technical study are to investigate the Indian farmers’ biomass production capacities and their perceptions and willingness to supply their surplus biomass to fuel an envisioned biomass-based power plant in three selected Indian states: Maharashtra, Madhya Pradesh and Tamil Nadu. For doing so, 471 farmers (about one-third from each state) have been interviewed in the field with info-sheet filled in by the field investigators. The farmers from all of the states appeared very much willing to sell their surplus biomass directly to a power plant. The farmers seem to depreciate the involvement of a middleman in the biomass procurement process. The farmers, however, appeared to highly appreciate a community-based association to regulate the biomass prices, with varying perceptions regarding government intervention. The majority of the farmers perceived the establishment of a biomass-based power plant in their region with positive economic outcomes. The farmers identified several barriers to supply biomass to a power plant where transportation logistics appeared to be the main barrier. The study recommends considering biomass collection, storage and transportation logistics as a fundamental segment of any envisioned investment in a biomass-based power plant. Biomass processing, such as pelletization or briquetting is recommended for efficient transportation of biomass at longer distances to reduce the transportation costs. The study further encourages the establishment of a farmers’ association aimed at collecting and selling biomass in agriculture areas predominant for small land holdings.

Biotechnology is developing at an ever-increasing pace, and the progressive computerization of health care and research is making it increasingly easy to share data. One of the fastest growing areas is biobanking. However, even with the best equipment and the best trained staff, a biobank will be useless without donors. For this reason, we have decided to gauge Polish citizens' awareness and attitudes towards biobanking and their willingness to donate biological samples. For this purpose the survey was conducted among a nationwide group of 1052 Poles aged 18 and over where the totals for gender, age and place of residence were selected according to their representation in the total population of adult Poles. The survey was conducted using the Computer Assisted Web Interview (CAWI) technique. Approximately two thirds of respondents N = 701 (66.6%) indicated that they had heard of scientific studies in which samples of biological material such as blood, saliva or urine are collected. More than half of respondents ( N = 613, 58.3%) had a positive opinion regarding scientific research in which samples of biological material are taken. Only N = 220 (20.9%) of respondents had previously encountered the term biobanking. More than a half N = 687 (65.3%) of respondents would participate in a scientific study that biobanked biological material and health information. Almost half of the respondents (48.0%) would like specific consent to be used in biobanking. In our study we observed a negligible correlation between socio-demographic factors and a willingness to donate biological material to a biobank. Considering the results presented above, the level of knowledge and awareness of biobanks, and their role in scientific research and the health care system, among Polish citizens is low and requires education and information activities.