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This study examines the factors influencing COVID-19 vaccination intentions among Chinese residents over the age of 60, with a focus on the mediating roles of Health Beliefs and Cues to Vaccination Action in the relationship between vaccine knowledge and vaccination intentions. We conducted a cross-sectional online survey involving 1,305 participants from Southwest China. Multiple logistic regression analysis identified potential determinants of vaccination intention, including socioeconomic characteristics, knowledge, health beliefs, and cues to vaccination action. Furthermore, mediation analysis using the causal mediation analysis method explored the mediating effects within the knowledge-to-intention pathway. Vaccination intention and its related factors: among the 1212 elderly people included in the study, 92.9% expressed willingness to receive the COVID-19 vaccine. Main factors influencing their vaccination willingness included Residency (urban vs. rural, OR = 0.47, p < 0.01), Age (75 + vs. others, OR = 0.41, p < 0.05), Marital status (OR = 0.36, p < 0.01), Occupation (business/service vs. others, OR = 0.33, p < 0.05), Awareness of vaccine effectiveness (OR = 1.23, p < 0.01), Cues to vaccination action (OR = 1.31, p < 0.01) and COVID-19 related knowledge (OR = 1.06, p < 0.01). The analysis revealed two significant mediators—Health Beliefs and Cues to Vaccination Action. These mediators (p<0.05 for both natural indirect effect and natural direct effect) acted along two key pathways: (1) From Knowledge of COVID-19 to Health Beliefs to Vaccination Intention: Natural Direct Effects (NDE) ranged from 0.012 to 0.016, with Natural Indirect Effects (NIE) from 0.001 to 0.003, indicating that mediators accounted for 4% to 18% of the total effect. (2) From Knowledge of COVID-19 to Cues of Vaccination Action to Vaccination Intention: NDE ranged from 0.012 to 0.016 and NIE from 0.002 to 0.003, with mediators accounting for 9% to 20% of the effect. The intention to vaccinate against COVID-19 among older adults varies significantly based on socioeconomic and health belief factors. The study identifies health beliefs and cues to action not only as direct contributors but also as crucial mediators in the pathway from knowledge to vaccination intention among older individuals. These findings can extend our understanding of the impact of sociodemographic factors and health beliefs on the COVID-19 vaccination willingness among older adults. [ABSTRACT FROM AUTHOR]

Abstract This study examines the factors influencing COVID-19 vaccination intentions among Chinese residents over the age of 60, with a focus on the mediating roles of Health Beliefs and Cues to Vaccination Action in the relationship between vaccine knowledge and vaccination intentions. We conducted a cross-sectional online survey involving 1,305 participants from Southwest China. Multiple logistic regression analysis identified potential determinants of vaccination intention, including socioeconomic characteristics, knowledge, health beliefs, and cues to vaccination action. Furthermore, mediation analysis using the causal mediation analysis method explored the mediating effects within the knowledge-to-intention pathway. Vaccination intention and its related factors: among the 1212 elderly people included in the study, 92.9% expressed willingness to receive the COVID-19 vaccine. Main factors influencing their vaccination willingness included Residency (urban vs. rural, OR = 0.47, p

Abstract Background COVID-19 vaccination is crucial to reduce the incidence of severe forms of the disease in the population. However, people who use drugs (PWUD) face structural and individual barriers to vaccination, and little is known about vaccination intention and factors associated with that intention among PWUD. This study aimed to estimate vaccination intention in PWUD and associated factors in the early stage of vaccination campaigns. Methods We conducted cross-sectional study in France among PWUD, as part of the international EPIC program, a community-based research study coordinated by Coalition PLUS. It included 166 unvaccinated PWUD attending harm reduction centers. A questionnaire collected data on sociodemographic characteristics, COVID-19 related difficulties, and mental health, among other things. Multivariate logistic regression was used to identify factors associated with low vaccination intention. Results Only 19% of participants reported strong intention to get vaccinated against COVID-19. Factors independently associated with low vaccination intention were younger age (aOR = 0.90, 95%CI = 0.85–0.95), lower education level (aOR = 2.67, 95% CI = 0.95–7.55), and unstable housing (aOR = 6.44, 95% CI = 1.59–40.34). The most-cited reasons for low intention were mistrust in COVID-19 vaccines (66.1%), fear of side effects (48.7%), and non-belief in vaccinations in general (25.2%). Conclusions This study highlights the need for targeted COVID-19 information and interventions to increase vaccine uptake in PWUD, especially those living in precarity. Community-based interventions and targeted government assistance could play a crucial role in addressing vaccine hesitancy in this population, not only for COVID-19 but for future epidemics.

Abstract Background Vaccination is one of the most economic and effective strategies for preventing infectious diseases. However, public intention to be vaccinated is, to a certain degree, influenced by issues related to vaccine hesitancy, anti-vaccine movement, and public concerns about safety and adverse effects. Vaccine literacy is considered as a positive factor in improving vaccination intention, however, the correlation between vaccine literacy and vaccination intention has not been thoroughly investigated in mainland China. This study aims to (1) explore the correlation between vaccine literacy and vaccination intention among adults in mainland China; (2) investigate whether participants could seek out vaccine information on their own initiative and whether they knew basic information of common vaccines. Methods An online cross-sectional survey was conducted on 614 adult participants from 27 May to 8 June 2023 by a convenience sampling. Data were collected by using the questionnaire of demographic characteristics, vaccine literacy, vaccination intention, initiative of seeking out vaccine information, and basic vaccine quiz about common vaccines. Data were analyzed by using IBM SPSS version 24.0 at a significance level of 0.05. Results The mean scores of functional, and interactive-critical vaccine literacy were 2.97 ± 0.70 and 2.73 ± 0.66; the vaccination intentions of influenza, hepatitis B, COVID-19 and HPV were 58.5%, 80.0%, 71.3% and 62.9% respectively; interactive-critical vaccine literacy was significantly and positively associated with vaccination intention. The results also showed: 71.4% of the participants could seek out vaccine information on their own initiative, however, a certain proportion of the participants merely knew vaccine names and did not know basic information of common vaccines, especially influenza vaccine and hepatitis B vaccine. Conclusions There is still room for improvement in vaccine literacy, vaccination intention of influenza and HPV vaccines, and basic vaccine information. Based on the significantly positive correlation between interactive-critical vaccine literacy and vaccination intention, it is advisable to harness vaccine literacy to boost vaccination intention by communicating and learning basic information of common vaccines.

AbstractRespiratory Syncytial Virus (RSV) is a common respiratory pathogen with high morbidity and mortality, especially in children under two years of age. Severe RSV infection poses a significant threat to healthcare systems, making vaccination an utmost need. In August 2023, the U.S. FDA approved an RSV maternal vaccine to prevent lower respiratory tract disease (LRTD) in infants throughout their first six months of life. This cross-sectional survey was designed to evaluate pregnant women’s willingness to receive the vaccine during pregnancy. An anonymous survey was administered from April 2023 to December 2023 to pregnant women aged above 16 years old attending gynecology wards of randomly selected public and private hospitals in Crete. The primary outcome was the intention to receive the vaccine. Univariable and multivariable analyses were carried out to identify factors associated with the intention to get vaccinated. Questionnaires were distributed to a sample of 335 pregnant females who agreed to participate in this study. The intention to get vaccinated against RSV was positively associated with educational level, the presence of school-age children, RSV infection awareness, intention to get routine pregnancy vaccines according to the National Immunization Program (NIP), and previous vaccination against COVID-19. The majority of pregnant females were not familiar with the term RSV and the upcoming vaccine. An educational campaign regarding RSV infection and its vaccine is required to improve women’s perceptions and to support healthcare workers in promoting it upon its availability in Greece. [ABSTRACT FROM AUTHOR]

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Background: Vaccine hesitancy is a significant barrier to achieving high vaccination rates, particularly among men who have sex with men (MSM), a group at increased risk for Mpox. This study aimed to develop and validate a Mpox vaccine hesitancy scale specifically tailored for Chinese MSM, grounded in the protection motivation theory (PMT). Methods: An online survey through snowball sampling was conducted from October 2023 to March 2024, collecting 2403 valid responses across six representative regions in China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to evaluate the scale's construct validity, while reliability was assessed using Cronbach's α coefficient. The predictive validity of the scale was analyzed using Receiver Operating Characteristic (ROC) analysis. Results: EFA ultimately retained 22 items in the Mpox vaccination scale and identified four distinct dimensions: Maladaptive Rewards (seven items), Self-efficacy (seven items), Response Efficacy (four items), and Response Costs (four items). These dimensions were confirmed by CFA, which demonstrated satisfactory model fit indices (χ²/df = 4.382, RMSEA = 0.053, SRMR = 0.048, GFI = 0.935, CFI = 0.967, NFI = 0.958, TLI = 0.963, and IFI =0.967). All indices were within acceptable ranges. The scale exhibited good internal consistency, with a Cronbach's alpha of 0.906, and strong content validity, with an S-CVI/Ave of 0.952. The scale's predictive accuracy was evaluated using Receiver Operating Characteristic (ROC) analysis. When used to evaluate the scale's predictive accuracy, it yielded an area under the curve (AUC) of 0.854 after adjustments, indicating good predictive ability between high and low hesitancy. Conclusions: This scale provides a reliable and valid tool for assessing Mpox vaccine hesitancy among MSM and can be used to gauge Mpox vaccination intention within this group. [ABSTRACT FROM AUTHOR]

It has been established that vaccination is still one of the most effective ways to alleviate the sheer devastation of the COVID-19 pandemic. However, various communication and psychological factors influence people's willingness to get vaccinated. Anchored by the Extended Parallel Process Model (EPPM), this study analyzes a survey sample of 915 respondents from the United States and demonstrates that seeking COVID-19 news from social media was positively associated with perceived susceptibility, perceived severity, self-efficacy, and response efficacy. The increased self- and response efficacy were further positively tied to vaccination intention. Moreover, perceived susceptibility was positively associated with fear, while perceived severity was negatively related to fear, which in turn facilitated vaccination intention, constituting a serially mediating mechanism. Finally, people's ability to identify misinformation was a significant moderator for the main association and the mediating effects. Specifically, vaccination intention became greater among those with a stronger ability to identify misinformation on social media infosphere. Theoretical and practical implications are further discussed. [ABSTRACT FROM AUTHOR]

Background: Vaccination is one of the most economic and effective strategies for preventing infectious diseases. However, public intention to be vaccinated is, to a certain degree, influenced by issues related to vaccine hesitancy, anti-vaccine movement, and public concerns about safety and adverse effects. Vaccine literacy is considered as a positive factor in improving vaccination intention, however, the correlation between vaccine literacy and vaccination intention has not been thoroughly investigated in mainland China. This study aims to (1) explore the correlation between vaccine literacy and vaccination intention among adults in mainland China; (2) investigate whether participants could seek out vaccine information on their own initiative and whether they knew basic information of common vaccines. Methods: An online cross-sectional survey was conducted on 614 adult participants from 27 May to 8 June 2023 by a convenience sampling. Data were collected by using the questionnaire of demographic characteristics, vaccine literacy, vaccination intention, initiative of seeking out vaccine information, and basic vaccine quiz about common vaccines. Data were analyzed by using IBM SPSS version 24.0 at a significance level of 0.05. Results: The mean scores of functional, and interactive-critical vaccine literacy were 2.97 ± 0.70 and 2.73 ± 0.66; the vaccination intentions of influenza, hepatitis B, COVID-19 and HPV were 58.5%, 80.0%, 71.3% and 62.9% respectively; interactive-critical vaccine literacy was significantly and positively associated with vaccination intention. The results also showed: 71.4% of the participants could seek out vaccine information on their own initiative, however, a certain proportion of the participants merely knew vaccine names and did not know basic information of common vaccines, especially influenza vaccine and hepatitis B vaccine. Conclusions: There is still room for improvement in vaccine literacy, vaccination intention of influenza and HPV vaccines, and basic vaccine information. Based on the significantly positive correlation between interactive-critical vaccine literacy and vaccination intention, it is advisable to harness vaccine literacy to boost vaccination intention by communicating and learning basic information of common vaccines. [ABSTRACT FROM AUTHOR]

To investigate the change between 2017 and 2023 in caregiver-reported intention to vaccinate children aged 6 months-5 years against influenza and compare this to vaccine uptake in Australia, following the COVID-19 pandemic and the free influenza vaccine policy for young children by different states and territories since 2018 and nationally in 2020. Retrospective data analysis. A retrospective data analysis was conducted using the Royal Children's Hospital National Child Health Poll data. The data were collected through online cross-sectional surveys of Australian caregivers' intention to vaccinate their children against influenza in 2017 and 2023. The proportion of parents who intended to vaccinate their children against influenza was weighted to reflect Australia's population distribution. We compared this to National Centre for Immunisation Research Surveillance (NCIRS) data on the percentage (%) of children registered as actually having had the influenza vaccine in 2017 and 2023. In children aged five years and under, an increase in intention to vaccinate of 34.7 percentage points from 27.4% (weighted, n = 307/1050) in 2017 to 62.1% (weighted, n = 457/743) in 2023 was observed. We compared intention with the NCIRS influenza vaccine uptake data, which recorded an increased uptake for children under five years of 23.3 percentage points from 6.2% in 2017 to 28.2% in 2023. Between 2017 and 2023, there was a substantial increase in caregiver intention to vaccinate children against influenza, during which the national free influenza vaccine policy for young children was enacted and the COVID-19 pandemic began. There is a substantial gap between the intention to vaccinate and actual uptake of influenza vaccination, warranting further investigation into the barriers behind vaccination, beyond that of cost. [ABSTRACT FROM AUTHOR]

Abstract Objective To analyse the influencing factors of vaccine hesitancy on HPV vaccination willingness of female college students in order to promote the promotion of HPV vaccine in female college student population. Methods From September-October 2022, a convenience sampling method was used to conduct a questionnaire survey among freshman female students from four higher vocational colleges in Henan Province, China. The survey comprised a general information questionnaire, as well as inquiries regarding vaccine hesitancy and willingness to receive the human papillomavirus (HPV) vaccine. In PSM analyses, vaccine-hesitant students were matched with non-vaccine-hesitant students at a 1:1 ratio; subsequently, both univariate and multivariatble logistic regression analyses were applied to assess the impact of vaccine hesitancy on female university students’ willingness to receive the HPV vaccine. Results The results revealed a vaccine hesitancy rate of 44.75% among female university students, with 82.9% expressing willingness to receive the HPV vaccine. The results of the multivariable ordinal logistic regression analysis indicated vaccine hesitancy is a risk factor for HPV vaccination intentions among female university students [OR = 4.38, 95% CI (2.74, 6.99), P

Salah S Alshagrawi Saudi Electronic University, College of Health Sciences, Department of Public Health, Riyadh, Saudi ArabiaCorrespondence: Salah S Alshagrawi, Email s.alshagrawi@seu.edu.saIntroduction: The pandemic caused by COVID-19 has had a profound effect on global health. Due to its potential impact on the efficacy of pandemic control measures, vaccine hesitancy (VH) in relation to COVID-19 has emerged as a significant concern. The attainment of herd immunity is contingent on the rate of COVID-19 vaccine adoption. Despite this, there have been reports of reluctance toward the COVID-19 vaccine. This study seeks to investigate the effect of constructs that influence adults’ intentions to receive COVID-19 vaccination using the Health Belief Model (HBM).Methods: A cross-sectional study was conducted by recruiting Saudi Arabian adults as participants. Using Structural Equation Modeling (SEM), the proposed HBM model was evaluated. A total of 505 individuals replied to the survey.Results: The suggested HBM model explained 68% of the variation in intention to get COVID-19 immunization. I found all HBM variables namely perceived susceptibility, greater levels of perceived behavioral control, severity, benefits, and barriers to be significant predictors of vaccination intentions. Among demographic variables, only married status had a significant relationship with the intention to obtain COVID-19 immunization.Discussion: The findings of this study indicate that the HBM can be utilized effectively to obtain insight into the factors that influence COVID-19 prevention measure adherence. Understanding and recognizing individuals’ perceived health beliefs and practices is essential for the development of effective COVID-19 intervention strategies.Keywords: immunization, COVID-19, health belief model, vaccine hesitancy, structural equation modeling, Saudi Arabia

As a pharmaceutical intervention, vaccines remain a major public health strategy for mitigating the effects of COVID-19. Yet, vaccine intake has been affected by various cognitive and cultural factors. We examine how a selected set of factors (i.e., knowledge, concern, media, peer influence, and demographics) shaped COVID-19 vaccination intention in the early phase of the pandemic (Fall 2020). Using a survey conducted in three US states (Idaho, Texas, and Vermont) just prior to the rollout of the first vaccines against COVID-19, we find that COVID-19 concern was the primary driver of vaccination intention. Concern was shaped mainly by two factors: political ideology and media sources. Yet, ideology and media were much more important in affecting concern for those who leaned politically conservative, as opposed to those who leaned liberal or remained moderate. The results from our structural equation models affirm that the information politically conservative respondents were receiving reinforced the effects of their ideology, leading to a greater reduction in their concern. We discuss the potential implications of these findings for future pandemic preparedness.

This study focused on the role of Americans' communication about COVID-19 vaccines, and its potential associations with two significant vaccine determinants. Two studies informed by the Situational Theory of Problem Solving (STOPS) were conducted. In the first, the researchers incorporated the intention to receive vaccination against the COVID-19 pandemic and vaccine-specific knowledge into STOPS to examine the associations among these three key variables. The second study introduced a new variable, trust in science/scientists, as a potential conceptual variable that functions together with vaccine knowledge to explain why Americans' intentions to receive COVID-19 vaccines increased despite their imperfect knowledge about them. Two online surveys were distributed using Amazon Mechanical Turk (Study 1) and Qualtrics (Study 2). The first was administered from December 18 through 22 of 2020, and the second from December 18 through 29 of 2020. An enhanced level of communicative action with respect to COVID-19 vaccines decreased the accuracy of knowledge about the vaccines, which increased the intention to receive these vaccines (Study 1). A significant interaction was also found between COVID-19 vaccine knowledge and participants' levels of trust in science/scientists on study participants' future intention to receive COVID-19 vaccines (Study 2). Contrary to previous findings, Americans' increased activeness in COVID-19 vaccine-specific communication was associated negatively with vaccine knowledge, which in turn, increased COVID-19 vaccination intentions. This negative association reflects the complex and unique nature of information environments with respect to COVID-19 vaccines. Trust in science/scientists served as a significant missing conceptual variable that shed light on the paradoxical finding. Plain language summary: This study focused on the role of Americans' communication about COVID-19 vaccines, and its potential associations with two significant vaccine determinants. Two studies informed by the Situational Theory of Problem Solving (STOPS) were conducted. In the first, the researchers incorporated the intention to receive vaccination against the COVID-19 pandemic and vaccine-specific knowledge into STOPS to examine the associations among these three key variables. The second study introduced a new variable, trust in science/scientists, as a potential conceptual variable that functions together with vaccine knowledge to explain why Americans' intentions to receive COVID-19 vaccines increased despite their imperfect knowledge about them. An enhanced level of communicative action with respect to COVID-19 vaccines decreased the accuracy of knowledge about the vaccines, which increased the intention to receive these vaccines (Study 1). A significant interaction was also found between COVID-19 vaccine knowledge and participants' levels of trust in science/scientists on study participants' future intention to receive COVID-19 vaccines (Study 2). [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignResultsConclusionThis study examined the effects of emotional arousal, emotional competence, emotion regulation (ER), and compassion on COVID-19 and flu vaccination intentions (VI) among the French population.Data were collected online from October to December 2020. Altogether, 451 participants (Mage = 35.8, SD = 16.4) were allocated to four groups. High positive (n = 104) or negative (n = 103) emotional arousal were induced into two groups using pictures and music, and compared against a control group (flu group; n = 116) and a reference group (COVID-19 group; n = 114). All groups completed questionnaires on emotional arousal, ER, emotional competence, compassion, and VI.The findings indicated a significant effect of group on VI, h2=.023, 95% CI [–.002, .09]. The Group*Gender interaction on emotional arousal was non-significant, ηp2=.015, 95%CI [.000, .041]. However, emotional arousal was observed to have a significant main effect on VI, ηp2=.09, 95% CI [.043, .238]. The ER type*Emotional arousal*Gender interaction on ER use was trend, ηp2 = .002, 95% CI [.000, .005]. The emotional competence*ER type interaction on ER use was significant, ηp2 = .028, 95% CI [.011, .049]. Only experiential avoidance mediated the relationship between emotional arousal and VI, p < .018, 95% CI [.015, .18].Emotional arousal impacts VI. High emotional competence only reduces the use of dysfunctional ER strategies. [ABSTRACT FROM AUTHOR]

As a pharmaceutical intervention, vaccines remain a major public health strategy for mitigating the effects of COVID-19. Yet, vaccine intake has been affected by various cognitive and cultural factors. We examine how a selected set of factors (i.e., knowledge, concern, media, peer influence, and demographics) shaped COVID-19 vaccination intention in the early phase of the pandemic (Fall 2020). Using a survey conducted in three US states (Idaho, Texas, and Vermont) just prior to the rollout of the first vaccines against COVID-19, we find that COVID-19 concern was the primary driver of vaccination intention. Concern was shaped mainly by two factors: political ideology and media sources. Yet, ideology and media were much more important in affecting concern for those who leaned politically conservative, as opposed to those who leaned liberal or remained moderate. The results from our structural equation models affirm that the information politically conservative respondents were receiving reinforced the effects of their ideology, leading to a greater reduction in their concern. We discuss the potential implications of these findings for future pandemic preparedness. [ABSTRACT FROM AUTHOR]

Abstract Background Identifying predictors of vaccination intention is critical to developing appropriate programs and campaigns targeting groups reluctant to be vaccinated. This study aimed to identify the determinants of vaccination intention at the beginning of the COVID-19 pandemic in three Central and Eastern European (CEE) countries: Poland, Romania, and Slovenia. Methods In this cross-sectional study, a sample of unvaccinated 1723 Poles, Romanians, and Slovenians completed an online survey (April 2021). Questions included measures of vaccination intention, attitudes towards vaccines, conspiracy mindset, preference for a type of vaccine, and trust in information sources. Results The results showed that mistrust of vaccine benefits and concerns about commercial profiteering negatively predicted vaccination intention. Conversely, trust in information from medical professionals and scientists, official sources, and traditional media was positively related to vaccination intention, while trust in digital media was negatively related to vaccination intention. In addition, preference for mRNA vaccine type was a positive significant predictor of vaccination intention. The differences between countries are discussed. Conclusions The study results deliver suggestions for developing appropriate vaccine uptake programs and campaigns that should consider presenting the positive outcomes of vaccines via official sources and traditional media based on scientific evidence and medical professionals’ knowledge.

Vaccination plays a pivotal role in the control of infectious disease outbreaks. Hesitancy/refusal of the vaccine by immigrants poses a serious threat to their and society's health. We reviewed studies regarding COVID-19 vaccine uptake in Europe by first-generation immigrants. A systematic review (PROSPERO: CRD42023432142), conducted until 31 October 2023 using Web of Science, PubMed, and Scopus, identified 295 potential articles. Of these, 16 conducted on 2,009,820 immigrants in nine European countries met the eligibility criteria. Most studies were of medium/high quality according to the Newcastle–Ottawa Scale adapted for observational studies. Factors that affected the uptake or hesitancy/refusal to vaccinate, with particular regard to gender, age, and country of origin, were examined. The meta-analysis of eight studies revealed that the pooled estimated prevalence of COVID-19 vaccine uptake in first-generation immigrants was 71.3% (95% CI: 70.0–72.5%), corresponding to 13.3% less than the host country population (95% CI: 10.2–16.4%). Limitations of included studies and this review were deeply discussed, highlighting the need for further research on the effect of acculturation on second-generation immigrants. European governments need to ensure equal availability of COVID-19 and other health-saving vaccines to all immigrants in the future by overcoming cultural barriers, building trust in institutions, and improving communication. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy poses a significant threat to the health of individuals across all age groups, which has been exacerbated by the COVID-19 pandemic. In this cross-sectional study, an extension of the Theory of Planned Behavior (TPB) was applied to investigate psychosocial variables predicting intention to vaccinate children under 12 against COVID-19 in a sample of 420 Italian parents (Mean age = 40.4, SD = 5.9; Women = 78.1%). Hierarchical regression analysis revealed that, among the TPB variables, cognitive attitude, descriptive norms, and perceived behavioral control significantly predicted parents' vaccination intention. Furthermore, including trust in the institutions' ability to manage the vaccination campaign in the model significantly increased the explained variance in intention. These findings suggest that campaigns promoting childhood COVID-19 vaccination should not only emphasize the safety and effectiveness of vaccines for children but also focus on reducing barriers to vaccination. Additionally, attention should be given to enhancing the perception that this behavior is widespread among other parents, thus leveraging the power of social influence. Finally, and not less important, significant efforts should be directed toward building and reinforcing trust in the system of actors promoting and managing the COVID-19 vaccination campaign. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that parents demand for information on vaccinations is universal. Nonetheless, parental knowledge demonstrated mixed results in vaccination intention, attitude, uptake, or confidence. In contrast, risk perception is a consistent predictor of vaccination-related outcomes. Objective: This study aimed to establish risk perception as a mediator between vaccination knowledge and intention. Method: Using a multistage random sampling technique, a cross-sectional survey was conducted with expectant mothers from maternity and child health clinics in the districts of Petaling, Klang, Gombak, and Hulu Langat. 416 respondents answered the self-administered questionnaire. Data was analysed using SPSS version 27 for descriptive statistics and Amos version 27 with bootstrapping procedure for mediation analysis. Results: Vaccination knowledge predicted risk perception [std β = 0.743, p = 0.036], risk perception predicted vaccination intention [std β = 0.934, p = 0.006], and risk perception fully mediate the relationship between vaccination knowledge and intention [std β = 0.694, p = 0.016]. The mediation model showed satisfactory fit indices: χ2/df (2.898), comparative fit index 0.946, Tucker-Lewis index 0.939, and root mean squared error of approximation 0.061. Conclusion: The goal of educational interventions is to increase vaccination intention by addressing vaccine information that influences both subjective and objective risk perception.

COVID-19 vaccine boosters are recommended because the protection provided by previous doses eventually decreases, posing a threat to immunity. Some people, however, remain hesitant or unwilling to get vaccinated. The present study sought to investigate factors associated with the intention to receive the COVID-19 booster vaccine based on (1) the constructs of the Health Belief Model, and (2) trust in healthcare workers and science. A sample of 165 adults with two doses of the COVID-19 vaccine were recruited using convenience sampling. Data was collected using an online survey from November 2021 to January 2022. The survey included questions about participants' socio-demographic details, health beliefs, trust, history of COVID-19 vaccination, and the intention to receive a third dose of the COVID-19 vaccine. Ordinal logistic regression analysis showed that higher perceived benefits, severity, and trust in healthcare workers, and lower perceived barriers predicted higher willingness to get a third dose of the vaccine whereas perceived susceptibility and trust in science did not. Understanding the factors and health beliefs that underlie vaccine hesitancy are vital when developing effective interventions with the aim of increasing uptake of COVID-19 booster vaccines.

Abstract Background By mid 2023, European countries reached 75% of vaccine coverage for COVID-19 and although vaccination rates are quite high, many people are still hesitant. A plethora of studies have investigated factors associated with COVID-19 vaccine hesitancy, however, insufficient attention has been paid to the reasons why people get vaccinated against COVID-19. Our work aims to investigate the role of reasons in the decision to get vaccinated against COVID-19 in a representative sample of 1,689 adult Italians (March–April 2021) balanced in terms of age, gender, educational level and area of residence. Methods Through an online questionnaire, we asked participants to freely report up to three reasons for and against COVID-19 vaccination, and the weight each had in the decision to get vaccinated. We first investigated the role of emotional competence and COVID-19 risk perception in the generation of both reasons using regression models. Next, we studied the role that the different reasons had in the vaccination decision, considering both the intention to vaccinate (using a beta regression model) and the decision made by the participants who already had the opportunity to get vaccinated (using a logistic regression model). Finally, two different classification tree analyses were carried out to characterize profiles with a low or high willingness to get vaccinated or with a low or high probability to accept/book the vaccine. Results High emotional competence positively influences the generation of both reasons (ORs > 1.5), whereas high risk perception increases the generation of positive reasons (ORs > 1.4) while decreasing reasons against vaccination (OR = 0.64). As pro-reasons increase, vaccination acceptance increases, while the opposite happens as against-reasons increase (all p

Background: Vaccine hesitancy is a significant barrier to achieving high vaccination rates, particularly among men who have sex with men (MSM), a group at increased risk for Mpox. This study aimed to develop and validate a Mpox vaccine hesitancy scale specifically tailored for Chinese MSM, grounded in the protection motivation theory (PMT). Methods: An online survey through snowball sampling was conducted from October 2023 to March 2024, collecting 2403 valid responses across six representative regions in China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to evaluate the scale’s construct validity, while reliability was assessed using Cronbach’s α coefficient. The predictive validity of the scale was analyzed using Receiver Operating Characteristic (ROC) analysis. Results: EFA ultimately retained 22 items in the Mpox vaccination scale and identified four distinct dimensions: Maladaptive Rewards (seven items), Self-efficacy (seven items), Response Efficacy (four items), and Response Costs (four items). These dimensions were confirmed by CFA, which demonstrated satisfactory model fit indices (χ²/df = 4.382, RMSEA = 0.053, SRMR = 0.048, GFI = 0.935, CFI = 0.967, NFI = 0.958, TLI = 0.963, and IFI =0.967). All indices were within acceptable ranges. The scale exhibited good internal consistency, with a Cronbach’s alpha of 0.906, and strong content validity, with an S-CVI/Ave of 0.952. The scale’s predictive accuracy was evaluated using Receiver Operating Characteristic (ROC) analysis. When used to evaluate the scale’s predictive accuracy, it yielded an area under the curve (AUC) of 0.854 after adjustments, indicating good predictive ability between high and low hesitancy. Conclusions: This scale provides a reliable and valid tool for assessing Mpox vaccine hesitancy among MSM and can be used to gauge Mpox vaccination intention within this group.

ObjectiveTo construct a prediction model for the intention of accepting recombinant zoster vaccine(RZV) vaccination among community residents based on reasoned action approach for promoting RZV vaccination in the population. MethodsTotally 1 480 attendees of four community health service centers were recruited with accidental sampling in three districts of Shanghai city for an online survey conducted during October – November 2022. The vaccination intention scale developed by Vissor et al was translated into Chinese and modified to collect participants′ information relevant to accept RZV vaccination. Of the 1 471 individual data from eligible respondents, 981 and 490 were randomly assigned into a training set and a test set. Lasso regression analysis on the data of training set was performed to explore the determinants of RZV vaccination intention. A nomogram prediction model for RZV vaccination intention was constructed using multivariate logistic regression analysis on the data of training set and the performance of the established model was evaluated with the receiver operating characteristic curve (ROC). ResultsThe intention to have RZV vaccination within 6 months was reported by 8.36% (123) of the eligible respondents. The results of Lasso regression analysis screened out nine predictive factors of RZV vaccination intention, including perception ability (β = 0.149), perceived infection risk (β = 0.074), moral norm (β = 0.061), decisional uncertainty (β = – 0.060), general vaccination beliefs (β = – 0.007), never having herpes zoster infection (β = 0.812), perceived cost-benefit (β = – 0.014), social norm (β = 0.019), and attitude (β = 0.003) and the nine factors were used to construct the prediction model. Based on the nomogram of the established prediction model, the possibility to have RZV vaccination within next 6 months is 9.00% for the respondents never having herpes zoster infection and with following scale items′ scores: 7 for perception ability, 7 for perceived infection risk, 7 for moral norm, 7 for decisional uncertainty, 42 for general vaccination beliefs, 28 for perceived cost-benefit, 49 for social norm, and 42 for the attitude towards RZV vaccination. The results of internal and external validation analysis showed that the established model is of good differentiation and calibration（the area under the curve [AUC]training set = 0.717, AUCtest set = 0.689; χ2training set = 9.061, degree of freedom [df]training set = 8, p training set = 0.337, χ2test set = 12.024, dftest set = 8, ptest set = 0.150）. ConclusionPerception ability, perceived infection risk, moral norm, decisional uncertainty, general vaccination beliefs, whether or not having herpes zoster infection, perceived cost-benefit, social norm, and attitude towards RZV vaccination are main predictive factors for RZV vaccination intention among community residents of Shanghai city.

Abstract Background China’s current immunization program was revised in 2007. Some common childhood vaccines such as those for influenza, pediatric pneumonia, Haemophilus influenzae, varicella, and rotavirus have not been included in the National Immunization Program (NIP) and need to be purchased by children’s guardians at their own expense. Rural areas, constrained by economic development and vaccine awareness, have a low non-NIP vaccination rate and more family medical expenses and social burden. This study aims to examine the awareness and attitude of rural parents about non-NIP vaccines and relevant factors influencing their vaccination intention to provide strategic suggestions for expanding and improving the Chinese government’s NIP policy. Methods A qualitative method of in-depth interviews were conducted for this study. We interviewed 30 rural parents in a central Chinese village to investigate their awareness of non-NIP vaccines and their vaccination intention and behavior. All the interview data were analyzed through the Colaizzi seven-step data analysis method. Results This study summarized the individual and social level factors influencing the non-NIP vaccination intention of rural parents. The individual level factors include four themes: perceived severity with physical harm, treatment consumption (cost of the treatment of the subject diseases), psychological burden, and social consequences being subthemes; perceived vulnerability with age vulnerability, medical history, immune quality (children’s underlying immune status), and environmental vulnerability (sanitary condition of the rural environment) as subthemes; perceived efficacy with effect perception, psychological comfort, protective strength, and functional compensation (functions of non-NIP vaccines unreplaceable by NIP vaccines) being subthemes; and perceived cost consisting of two subthemes cost burden and adverse reaction. The social level influencing factors include the vaccination opinions in rural social networks, the accessibility of health services and vaccine products, and the guidance and promotion of vaccination policies. These factors act outside of individuals’ subjective awareness and influence decisions regarding non-NIP vaccination in rural areas. Conclusion Based on these influencing factors, this study constructs a structural model for non-NIP vaccination decision-making process in rural areas of China. The results play a guiding role in directing attention to children’s health, promoting non-NIP vaccination, facilitating the dissemination of vaccine knowledge in rural areas, and improving NIP policies and practices in China.

Background: Mass vaccination against Covid-19 has been recognised as the most effective strategy for overcoming the pandemic emergency and remains crucial in the ongoing efforts to mitigate the impact of the virus. The present study aimed to test the efficacy of an extended Theory of Planned Behaviour (TPB) model in predicting vaccination intention in three different phases of the pandemic. Understanding how psychological drivers of vaccine acceptance may have changed throughout the pandemic is essential for informing public health strategies and addressing vaccine hesitancy, even in the current post-pandemic context. Methods: Using a repeated cross-sectional survey, we tested the hypothesised extended TPB model (intention, attitude, subjective norms, perceived behavioural control, anticipated affective reactions, risk perception, trust in science, trust in institutions and religiosity) across three independent samples: before (T1: November–December 2020; N = 657), during (T2: March–May 2021; N = 818), and after (T3: February–March 2022; N = 605) the start of the vaccination campaign in Italy. Results: Results indicated significant differences between the time points in all investigated variables, pointing to a general trend of improvement in vaccine acceptability levels at T2 compared to T1, and a worsening at T3 compared to the other two time points. Interestingly, net of these differences, a multi-group Structural Equation Modeling analysis supported the invariance, across time, of the structural relationships examined within the extended TPB. Conclusion: Findings demonstrated the efficacy of the TPB in predicting Covid-19 vaccination intention at different stages of the pandemic, suggesting that the model, in its extended version, represents a valuable framework for designing interventions aimed at promoting vaccine acceptance.

BackgroundThis study aims to utilize the extended Theory of Planned Behavior (TPB) model to examine the intentions of clinical interns in China towards Human papillomaviruses (HPV) vaccination. It also fills a significant gap in the literature concerning vaccine acceptance in this specific population.MethodsThis cross-sectional study was carried out with clinical interns in Shandong Province, China, with a total of 1,619 participants. Data were collected through self-reported questionnaires, including demographic characteristics, TPB variables, and HPV-related health knowledge. Hierarchical regression analysis was employed to identify key factors influencing vaccination intentions, and Structural Equation Modeling (SEM) was used to analyze the interrelationships between these factors.ResultsThis study initially identified key predictors affecting clinical interns’ intentions to receive the HPV vaccine through hierarchical regression analysis. The preliminary model, which accounted for demographic factors, revealed foundational impacts of household income and HPV-related clinical experience on intentions. After integrating TPB variables—attitude, subjective norm, perceived behavioral control, and HPV-related health knowledge—the model’s explanatory power was enhanced to 37.30%. SEM analysis focused on the interplay among TPB constructs and extended variables, confirming their significance in forming vaccination intentions, with subjective norm having the most substantial impact (β = 0.375, p

The interrelatedness of social-structural aspects and psychological features with vaccination intention provides the context to explore personal psychological features related to vaccination. Specifically, we focused on general decision making and vaccine-related dispositions, and their contribution to the intention to vaccinate, within post-pandemic circumstances, after the imposed possibility of choosing a vaccine brand. Our study aimed to map the function (promotive, protective, risk, vulnerability) of a set of personal psychological aspects in the intention to vaccinate among people holding different social roles regarding the vaccination. We surveyed three samples of people: healthcare providers (HPs), parents, and laypeople, within the post-pandemic context. Negative vaccine attitudes lower intention to vaccinate in all regression models (all βs ranging from −0.128 to −0.983, all ps < 0.01). The main results indicate that, regardless of the sample/social role, there is a shared attitudinal core for positive vaccination intention. This core consists of [high] trust in large corporations, government, and healthcare systems, as well as perceived consensus on vaccine safety/efficacy and experience of freedom (protective factors), and [low] vaccination conspiracy beliefs, trust in social media, and choice overload (risk and vulnerability factors, respectively). There are no common promotive factors of intention to vaccinate: for parents, perceived consensus on vaccines, and trust in corporations and the healthcare system, play such roles; for HPs, the experience of freedom is obtained as a unique promotive factor. In contrast, for laypeople, no unique promotive factors were found. Our findings provide insights into the function of psychological factors of vaccination intention across different social roles, particularly healthcare providers, parents, and laypeople, and emphasize the need for tailored immunization interventions in the post-pandemic landscape. [ABSTRACT FROM AUTHOR]

Background: By mid 2023, European countries reached 75% of vaccine coverage for COVID-19 and although vaccination rates are quite high, many people are still hesitant. A plethora of studies have investigated factors associated with COVID-19 vaccine hesitancy, however, insufficient attention has been paid to the reasons why people get vaccinated against COVID-19. Our work aims to investigate the role of reasons in the decision to get vaccinated against COVID-19 in a representative sample of 1,689 adult Italians (March–April 2021) balanced in terms of age, gender, educational level and area of residence. Methods: Through an online questionnaire, we asked participants to freely report up to three reasons for and against COVID-19 vaccination, and the weight each had in the decision to get vaccinated. We first investigated the role of emotional competence and COVID-19 risk perception in the generation of both reasons using regression models. Next, we studied the role that the different reasons had in the vaccination decision, considering both the intention to vaccinate (using a beta regression model) and the decision made by the participants who already had the opportunity to get vaccinated (using a logistic regression model). Finally, two different classification tree analyses were carried out to characterize profiles with a low or high willingness to get vaccinated or with a low or high probability to accept/book the vaccine. Results: High emotional competence positively influences the generation of both reasons (ORs > 1.5), whereas high risk perception increases the generation of positive reasons (ORs > 1.4) while decreasing reasons against vaccination (OR = 0.64). As pro-reasons increase, vaccination acceptance increases, while the opposite happens as against-reasons increase (all p < 0.001). One strong reason in favor of vaccines is enough to unbalance the decision toward acceptance of vaccination, even when reasons against it are also present (p < 0.001). Protection and absence of distrust are the reasons that mostly drive willingness to be vaccinated and acceptance of an offered vaccine. Conclusions: Knowing the reasons that drive people's decision about such an important choice can suggest new communication insights to reduce possible negative reactions toward vaccination and people's hesitancy. Results are discussed considering results of other national and international studies. [ABSTRACT FROM AUTHOR]

The transmissibility of new COVID‐19 variants and decreasing efficacy of vaccines led authorities to recommend a booster and even an annual dose. However, people's willingness to accept new doses varied considerably. Using two independent longitudinal samples of 4596 (Mean age = 53.6) and 514 (Mean age = 55.9) vaccinated participants, we examined how people's (lack of) vaccination motivation for their first dose was associated with their intention to get a booster (Sample 1) and an annual dose (Sample 2) several months later (Aim 1). We also aimed to capture the impact of the motivational heterogeneity on these intentions by capitalizing on participants' different motivational profiles collected at baseline (Aim 2). Across both samples, autonomous motivation, controlled motivation, and distrust‐based amotivation were uniquely related to, respectively, higher, lower, and even lower booster and annual dose intentions. Further, a two‐step clustering procedure revealed five profiles, with the profiles characterized by higher autonomous motivation (i.e. Good Quality and High Quantity profiles) reporting the highest vaccination intentions and the profile characterized by the highest number of obstacles (i.e. Global Amotivated profile) yielding the lowest vaccination intentions. These results stress the critical need to support citizens' volitional endorsement of vaccination to harvest long‐term benefits with respect to COVID‐19. [ABSTRACT FROM AUTHOR]

Many studies identified factors associated with vaccination intention and hesitancy, but factors associated with vaccination promptness and the effect of vaccination intention on vaccination promptness are unknown. This study identified factors associated with COVID-19 vaccination promptness and evaluated the role of vaccination intention on vaccination promptness in 1223 participants in a community-based longitudinal cohort study (June 2020 to December 2021). Participants answered questions regarding COVID-19 vaccination intention, vaccination status, and reasons for not receiving a vaccine. The association of baseline vaccine hesitancy with vaccination was assessed by the Kaplan–Meier survival analysis. Follow-up analyses tested the importance of other variables predicting vaccination using the Cox proportional hazards model. Older age was associated with shorter time to vaccination (HR = 1.76 [1.37–2.25] 85-year-old versus 65-year-old). Lower education levels (HR = 0.80 [0.69–0.92]), household incomes (HR = 0.84 [0.72–0.98]), and baseline vaccination intention of 'No' (HR = 0.16 [0.11–0.23]) were associated with longer times to vaccination. The most common reasons for not being vaccinated (N = 58) were vaccine safety concerns (n = 33), side effects (n = 28), and vaccine effectiveness (n = 25). Vaccination campaigns that target populations prone to hesitancy and address vaccine safety and effectiveness could be helpful in future vaccination rollouts. [ABSTRACT FROM AUTHOR]

ABSTRACTUniversity students, who face an elevated risk of influenza due to close living quarters and frequent social interactions, often exhibit low vaccine uptake rates. This issue is particularly pronounced among Chinese students, who encounter unique barriers related to awareness and access, emphasizing the need for heightened attention to this problem within this demographic. This cross-sectional study conducted in May-June 2022 involved 1,006 participants (404 in the UK, 602 in Mainland China) and aimed to explore and compare the factors influencing influenza vaccine acceptance and intentions between Chinese university students residing in the UK (C-UK) and Mainland China (C-M). The study employed a self-administered questionnaire based on the Theoretical Domains Framework and Capability Opportunity Motivation-Behavior model. Results revealed that approximately 46.8% of C-UK students received the influenza vaccine in the past year, compared to 32.9% of C-M students. More than half in both groups (C-UK: 54.5%, C-M: 58.1%) had no plans for vaccination in the upcoming year. Knowledge, belief about consequences, and reinforcement significantly influenced previous vaccine acceptance and intention in both student groups. Barriers to vaccination behavior included insufficient knowledge about the influenza vaccine and its accessibility and the distance to the vaccine center. Enablers included the vaccination behavior of individuals within their social circles, motivation to protect others, and concerns regarding difficulties in accessing medical resources during the COVID-19 pandemic. The findings of this study offer valuable insights for evidence-based intervention design, providing evidence for healthcare professionals, policymakers, and educators working to enhance vaccination rates within this specific demographic.

Low COVID-19 vaccination adherence in deprived neighbourhoods is problematic since the prevalence of chronic diseases associated with mortality rates due to COVID-19 is higher in these populations. The aim of this study is to provide an insight about beliefs and considerations relating to vaccination intention among inhabitants of deprived neighbourhoods in the Netherlands. Cross-sectional survey. Easily accessible vaccination facilities at markets in deprived neighbourhoods in the Netherlands. Participants were recruited at three vaccination facilities that were set up at markets in deprived neighbourhoods in Rotterdam. A total of 124 surveys were retained for analysis. Intention to get vaccinated against COVID-19. The survey was filled out by 124 respondents; 62 % had - prior to visiting the easily accessible locations - intended to get a COVID-19 vaccine and 38 % were hesitant (22.3 % had doubts and 15.7 % did not plan to get vaccinated). Many people mentioned the convenience of an easily accessible location nearby. At the bivariate level, the influence of information from the family was associated with vaccination intention (p < 0.01). In a logistic regression model, both fear of vaccination and fear of side-effects were significantly associated with vaccination intention (ORs 0.56 (CI 0.35–0.89) and 0.47 (CI 0.30–0.73)). The accessibility of a vaccination facility, family influence and fear are relevant factors for the intention to get vaccinated against COVID-19 in people living in deprived neighbourhoods. Interventions should address these factors in order to increase vaccination uptake. [ABSTRACT FROM AUTHOR]

• Health messages with the goal to support informed decision making can arise psychological reactance. • An online experiment assessing freedom of choice and message sidedness was executed. • Results show the effectivity of freedom of choice to reduce psychological reactance. • Lower reactance was associated with ameliorated evaluations of the message and higher vaccination intentions. • Psychological reactance mediated the effects found in this study. Reducing the spread of infectious diseases through vaccination faces the challenge of vaccine hesitancy: referring to questions, concerns and doubts arising when making a vaccine-related decision. A motivational state often arising within people exposed to health messages supporting informed decision making is psychological reactance, functioning as a driver to behavior opposed to the one recommended through the health message. Hence, there is a pressing need for communication strategies effective in counteracting reactance to health messages. This study tested two communication strategies that can potentially reduce psychological reactance and ameliorate evaluations of the message and subsequent behavioral vaccination intentions in the context of COVID-19. These were: (1) explicitly reminding individuals of their freedom of choice (to either accept or refuse the vaccine) and (2) providing a two-sided message, including, apart from evidence-based information on the necessity of vaccines, a set of concerns, and questions (about the vaccines) which are refuted immediately. A total of 234 participants who indicated having concerns about the COVID-19 vaccine participated in a 2 (freedom of choice: no choice vs. choice) × 2 (message sidedness: one-sided vs. two-sided) between-subjects online experiment where they received an informational brochure about COVID-19 vaccination. The results show that emphasizing freedom of choice significantly increased perceived credibility of the message, perceived information utility, and ultimately, vaccination intentions. A decrease in psychological reactance mediated these effects. Message sidedness did only show a significant direct effect on perceived information utility. No interaction effect was found. These findings indicate the importance of freedom of choice in reducing psychological reactance, which in its turn can lead to an increase of positive message evaluations and vaccination intentions among individuals who express concerns. The opportunities of message sidedness as an efficacious vaccination communication strategy should be further investigated. [ABSTRACT FROM AUTHOR]

• People are most concerned about vaccines' efficacy and severe side-effects when choosing COVID-19 vaccines. • Cash incentives are not useful in enhancing vaccines' appeal. • Time preference of vaccination is shaped more by respondent characteristics than vaccine attributes. • Forced COVID testing might delay vaccination decision. How do citizens choose COVID-19 vaccines, and when do they wish to be vaccinated? A choice-based conjoint experiment was conducted in Hong Kong to examine factors that shape citizens' preference toward COVID-19 vaccines and their time preference to be vaccinated, which is overlooked in extant literature. Results suggest people are most concerned about vaccines' efficacy and severe side-effects, and that cash incentives are not useful in enhancing vaccine appeal. The majority of respondents show low intention for immediate vaccination, and many of them want to delay their vaccination. Further analysis shows that their time preference is shaped more by respondent characteristics than vaccine attributes. In particular, confidence in the vaccine, trust in government, and working in high-risk professions are associated with earlier timing for vaccine uptake. Meanwhile, forced COVID testing would delay vaccination. The findings offer a novel view in understanding how people decide whether and when to receive new vaccines, which have pivotal implications for a head start of any mass vaccination programs. [ABSTRACT FROM AUTHOR]

Vaccination-related information is important for the public to increase vaccine acceptance intention, while the guidance and persuasion effects of information are influenced by approaches to information presentation. Thus, this study has focused on news media, an important source of vaccination-related dissemination, and aimed to investigate how different presentations of news influence an individual's COVID-19 vaccine intention. Moreover, whether the cultural values individuals possess would influence the persuasive effects of news information was also considered in our study. A web-based experiment among 310 participants employing 2 (news framing: rights frame vs. obligation frame) × 2 (argument quality: high argument quality vs. low argument quality) × 2 (individual–collective orientation: individualism vs. collectivism) design was conducted in this study. Data were analyzed through a series of analyses of variance (ANOVAs) in SPSS 26. The results show that argument quality had a significant positive impact on individuals' psychological acceptance of the COVID-19 vaccine. The results also show that the rights framework was significantly more persuasive than the obligation framework. Furthermore, for individualistic individuals, news information with high argument quality and a rights frame was the most persuasive. These findings may help guide the writing of news, thereby improving vaccine uptake, enhancing the public's health literacy, and facilitating the implementation of vaccination policies during and after a pandemic. [ABSTRACT FROM AUTHOR]

This study aimed to investigate how pre-service teachers' intentions to vaccinate against COVID-19 were related to their perceptions of the causes of COVID-19, which are conspiracy thoughts, perceptions of environmental and faith factors, trust in scientists, and risk perceptions toward COVID-19 vaccines. In this study, a cross-sectional survey research method was used and an online questionnaire was administered to 434 Turkish pre-service teachers from 19 different universities in Türkiye. A multinomial logistic regression analysis was conducted to predict pre-service teachers' vaccination intentions and two multinomial logit models were evaluated. The results indicated that most pre-service teachers had a positive intention to vaccinate against COVID-19. Pre-service teachers with lower risk perceptions about COVID-19 vaccination and scores on conspiracy thoughts, and higher scores on perceptions of environmental factors about COVID-19 vaccination were more likely to have a positive intention of getting COVID-19 vaccination. However, trust in scientists and faith did not have significant relationships with the intention of getting COVID-19 vaccination. Based on our findings we suggest paying attention to increasing environmental perceptions of pre-service teachers, decreasing their beliefs in conspiracy theories and risk perceptions, and increasing trust in scientists, which are believed to contribute to the development of teacher education programs that would more likely equip teacher candidates with features necessary for dealing with global challenges in the world. [ABSTRACT FROM AUTHOR]

Despite the massive volume of scientific evidence on the benefits of immunisation, vaccine hesitancy is still a global health threat and represents an obstacle to controlling the spread of viruses such as SARS-CoV-2 and its associated COVID-19. Thus, the present study aimed to adapt and validate an Italian version of the Vaccination Attitudes Examination (VAX) scale. The Italian version of the scale (VAX-I), along with validation measures (general health perceptions, perceived sensitivity to medicines, intention to get the flu vaccine, and trust in health authorities) were administered to a sample of 534 Italian participants aged 18 to 87 (M = 32.41, SD = 15.35). The original version of the VAX scale was translated into Italian using a back-translation method. The parallel and confirmatory factor analyses showed that the scale's four-factor structure fits the data well, as in the original version. Reliability coefficients indicated that the VAX-I scale showed good internal consistency and measurement invariance results demonstrated that the VAX-I scale is stable across gender. Construct validity was supported by the significant negative correlation with general health perceptions, intentions to get the flu vaccine, and trust in health authorities, and the weak but significant and positive correlation with perceived sensitivity to medicines. Overall, the VAX-I scale appears to be a valid instrument to assess vaccine hesitancy in the Italian context. [ABSTRACT FROM AUTHOR]

Background: China's current immunization program was revised in 2007. Some common childhood vaccines such as those for influenza, pediatric pneumonia, Haemophilus influenzae, varicella, and rotavirus have not been included in the National Immunization Program (NIP) and need to be purchased by children's guardians at their own expense. Rural areas, constrained by economic development and vaccine awareness, have a low non-NIP vaccination rate and more family medical expenses and social burden. This study aims to examine the awareness and attitude of rural parents about non-NIP vaccines and relevant factors influencing their vaccination intention to provide strategic suggestions for expanding and improving the Chinese government's NIP policy. Methods: A qualitative method of in-depth interviews were conducted for this study. We interviewed 30 rural parents in a central Chinese village to investigate their awareness of non-NIP vaccines and their vaccination intention and behavior. All the interview data were analyzed through the Colaizzi seven-step data analysis method. Results: This study summarized the individual and social level factors influencing the non-NIP vaccination intention of rural parents. The individual level factors include four themes: perceived severity with physical harm, treatment consumption (cost of the treatment of the subject diseases), psychological burden, and social consequences being subthemes; perceived vulnerability with age vulnerability, medical history, immune quality (children's underlying immune status), and environmental vulnerability (sanitary condition of the rural environment) as subthemes; perceived efficacy with effect perception, psychological comfort, protective strength, and functional compensation (functions of non-NIP vaccines unreplaceable by NIP vaccines) being subthemes; and perceived cost consisting of two subthemes cost burden and adverse reaction. The social level influencing factors include the vaccination opinions in rural social networks, the accessibility of health services and vaccine products, and the guidance and promotion of vaccination policies. These factors act outside of individuals' subjective awareness and influence decisions regarding non-NIP vaccination in rural areas. Conclusion: Based on these influencing factors, this study constructs a structural model for non-NIP vaccination decision-making process in rural areas of China. The results play a guiding role in directing attention to children's health, promoting non-NIP vaccination, facilitating the dissemination of vaccine knowledge in rural areas, and improving NIP policies and practices in China. [ABSTRACT FROM AUTHOR]

The COVID-19 vaccine development timelines offered a unique opportunity to explore the public's vaccine intention in an unusual situation characterised by great uncertainty about the vaccine's features and the disease it intended to prevent. To advance our knowledge of vaccine intention mechanisms under these unusual circumstances, to plan effective vaccination strategies, and to better direct communication efforts in similar scenarios, this study explored i) COVID19-related information needs, information-seeking behaviours, and perceived trustworthiness of news media; ii) COVID-19 vaccination intention and its determinants, during the first wave of COVID-19 pandemic in Italy. In particular, it was investigated whether and to what extent the perception of severity and susceptibility to the infection, trust in authorities, and demographics shaped people's vaccine intention. Between April and May 2020 in a cross-sectional study, 1373 Italian participants completed an online survey measuring demographic features, perception of the disease severity, disease risk perception, COVID19-related worry, disease-related information needs and behaviours, vaccination intention, and level of trust in authorities and news media. The leading information needs were the COVID-19 incubation period and transmission modalities, with the majority of people actively looking for information from one to three times a day. Despite uncertainty around the details of a COVID-19 vaccination, 68% of participants reported intending to be vaccinated for COVID-19. Greater COVID-19 vaccination intention was associated with having a regular history of seasonal flu vaccine, a greater COVID19-related worry, a higher perception of disease severity, and a higher trust in the Government. These findings further our understanding of vaccine intention in a pandemic scenario where a vaccine is still hypothetical and provide valuable information on the public's representation of the infection and future acceptance of a vaccine to inform the development of communication interventions aiming to maximise adherence to vaccination programmes and to modify disease-related dysfunctional representations. [ABSTRACT FROM AUTHOR]

Objectives: This cross‐sectional study was to determine the coronavirus disease 2019 (COVID‐19) vaccination intention of clinical dental hygienists in South Korea and the factors that influence vaccination intention. Methods: COVID‐19 vaccination intention of the 500 participants was confirmed through a survey including the following options: 'I will vaccinate (VAC)', 'I will not vaccinate (NoVAC)' and 'I do not know if I should get vaccinated (UNK)'. A Chi‐square test was performed to determine whether there were differences in COVID‐19 vaccination intention according to the general characteristics of the participants, degree of infection control knowledge (Score‐K) and practice (Score‐P) in response to COVID‐19, fears over COVID‐19 (Fear‐C) and the level of anxiety before (GADBefore) and after (GADAfter) the COVID‐19 pandemic. Multiple logistic regression was performed to identify factors affecting VAC and NoVAC by setting the base category as UNK. The p‐values of <0.05 were considered statistically significant. Results: According to the analysis, 44.8%, 18.8% and 36.4% of participants selected VAC, NoVAC and UNK respectively. There were significant differences in vaccination intention according to age, monthly income, residential area, symptoms related to COVID‐19, Score‐K, Fear‐C and GADBefore. Compared to UNK, < $2000 monthly income, Score‐K and Fear‐C variables significantly influenced the opinion of VAC. Compared to the answer UNK, monthly incomes of $2000 to $2360 and $2360 to $2730 in residential areas significantly influenced the opinion of NoVAC. Conclusions: The variables influencing vaccination intention were monthly income, residential area, Score‐K and Fear‐C. [ABSTRACT FROM AUTHOR]

Aim: We conducted a systematic review and meta-analysis to analyse gender differences in COVID-19 vaccination intentions. Subject and methods: PubMed, Web of Science and PsycInfo were searched (November 2020 to January 2021) for studies reporting absolute frequencies of COVID-19 vaccination intentions by gender. Averaged odds ratios comparing vaccination intentions among men and women were computed. Descriptive analyses of the studies were reported. Results: Sixty studies were included in the review and data from 46 studies (n = 141,550) were available for meta-analysis. A majority (58%) of papers reported men to have higher intentions to get vaccinated against COVID-19. Meta-analytic calculations showed that significantly fewer women stated that they would get vaccinated than men, OR 1.41 (95% CI 1.28 to 1.55). This effect was evident in several countries, and the difference was bigger in samples of health care workers than in unspecified general population samples. Conclusion: This systematic review and meta-analysis found lower vaccination intentions among women than men. This difference is discussed in the light of recent data on actual vaccination rates in different countries. [ABSTRACT FROM AUTHOR]

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