Pub Date : 2024-11-13DOI: 10.1016/j.jvacx.2024.100583
Frédéric Debellut , George Bello , Mike Chisema , Rouden Mkisi , Moses Kamzati , Clint Pecenka , Emmanuel Mugisha
Malawi introduced typhoid conjugate vaccine (TCV) in 2023 through an integrated campaign delivering TCV alongside other vaccines and interventions (measles rubella vaccine (MRV), bivalent oral polio vaccine (OPV), and vitamin A Supplementation). The campaign sought to reach all children 9 months to younger than 14 years, representing more than 9 million individuals, and about half the country’s population. Following the campaign, TCV was incorporated into the routine immunization program for 9-month-old infants. We conducted a micro-costing study at 50 randomly selected health facilities, 10 districts, and at national level to retrospectively assess the financial and economic cost of the integrated campaign, as well as prospectively estimate the cost of delivering TCV in the routine immunization system. The financial and economic costs per dose for all interventions delivered in the campaign were $0.49 ($0.42;$0.57) and $0.84 ($0.67;$1.02), respectively. The main activities and cost types varied; human resources represented the main resource at health facility level, and per diem at district and national levels. The financial and economic cost to routinely deliver a dose of TCV were $0.44 ($0.17;$0.87), and $2.37 ($1.39;$3.53), respectively, with human resources as the main resource used by the routine program at all levels.
The cost per dose delivered in the integrated campaign in Malawi was comparable with other integrated campaigns and was lower than the reported cost to deliver TCV in single antigen campaigns in India and Zimbabwe. Integrated campaigns may represent an opportunity to introduce new vaccines such as TCV to lower the cost per dose delivered. Attention should be given to challenges coming with integration, such as the burden for healthcare workers.
Evidence produced by this study can be used in Malawi to inform financial sustainability of the TCV program and should inform decisions and strategies for implementation by other countries.
{"title":"Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi","authors":"Frédéric Debellut , George Bello , Mike Chisema , Rouden Mkisi , Moses Kamzati , Clint Pecenka , Emmanuel Mugisha","doi":"10.1016/j.jvacx.2024.100583","DOIUrl":"10.1016/j.jvacx.2024.100583","url":null,"abstract":"<div><div>Malawi introduced typhoid conjugate vaccine (TCV) in 2023 through an integrated campaign delivering TCV alongside other vaccines and interventions (measles rubella vaccine (MRV), bivalent oral polio vaccine (OPV), and vitamin A Supplementation). The campaign sought to reach all children 9 months to younger than 14 years, representing more than 9 million individuals, and about half the country’s population. Following the campaign, TCV was incorporated into the routine immunization program for 9-month-old infants. We conducted a micro-costing study at 50 randomly selected health facilities, 10 districts, and at national level to retrospectively assess the financial and economic cost of the integrated campaign, as well as prospectively estimate the cost of delivering TCV in the routine immunization system. The financial and economic costs per dose for all interventions delivered in the campaign were $0.49 ($0.42;$0.57) and $0.84 ($0.67;$1.02), respectively. The main activities and cost types varied; human resources represented the main resource at health facility level, and per diem at district and national levels. The financial and economic cost to routinely deliver a dose of TCV were $0.44 ($0.17;$0.87), and $2.37 ($1.39;$3.53), respectively, with human resources as the main resource used by the routine program at all levels.</div><div>The cost per dose delivered in the integrated campaign in Malawi was comparable with other integrated campaigns and was lower than the reported cost to deliver TCV in single antigen campaigns in India and Zimbabwe. Integrated campaigns may represent an opportunity to introduce new vaccines such as TCV to lower the cost per dose delivered. Attention should be given to challenges coming with integration, such as the burden for healthcare workers.</div><div>Evidence produced by this study can be used in Malawi to inform financial sustainability of the TCV program and should inform decisions and strategies for implementation by other countries.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"21 ","pages":"Article 100583"},"PeriodicalIF":2.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142655349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-08DOI: 10.1016/j.jvacx.2024.100580
T. Untung, R. Pandey, P. Johansson
Objectives
To prepare for future epidemics, the experiences from the vaccination programs in the COVID-19 pandemic need to be collated. This systematic review synthesizes health economic evidence of COVID-19 vaccination programs in European countries comparing the target groups children, adults, and elderly, to study whether the Swedish vaccination strategy was justified on cost-effectiveness grounds.
Method
A literature search using the PICOS (Population, Intervention, Control, Outcomes, Study design) convention was conducted in the databases Medline, Embase, PsycInfo, CINAHL, and Tuft CEA Registry, Cochrane and INAHTA in February 2023. The inclusion criteria were economic evaluations (S) comparing COVID-19 vaccination (I) in age-groups children, adult, and elderly European residents (P) with non-vaccinated European residents (C) in terms of cost per QALY, cost differences, and net monetary benefit (O). Hand-search was done on selected websites and in reference lists of included reports. Title/abstract screening, full-text screening, and quality assessment with the Swedish HTA agency checklist were performed by two researchers. The reporting follows the PRISMA 2020 recommendations.
Results
The database search resulted in 5,720 reports, title/abstract screening yielded 162 reports and after full-text screening, four reports remained. Two studies comparing vaccination of adults and elderly with high and moderate study quality were included. No study was found on the children population. The economic evidence indicated that COVID-19 vaccination of the elderly is cost-effective when compared with vaccination of the adult group, but the transferability to Swedish circumstances was inconclusive due to differences in outcome and cost data between Sweden and the included studies’ settings.
Conclusion
The common European COVID-19 vaccination policy that prioritized the elderly population was the cost-effective option in the reviewed studies. The lack of transferability to Sweden precludes a clear conclusion on the Swedish vaccination policy.
{"title":"The cost-effectiveness of COVID-19 vaccination program among age-groups children, adults, and elderly in Europe: A systematic review","authors":"T. Untung, R. Pandey, P. Johansson","doi":"10.1016/j.jvacx.2024.100580","DOIUrl":"10.1016/j.jvacx.2024.100580","url":null,"abstract":"<div><h3>Objectives</h3><div>To prepare for future epidemics, the experiences from the vaccination programs in the COVID-19 pandemic need to be collated. This systematic review synthesizes health economic evidence of COVID-19 vaccination programs in European countries comparing the target groups children, adults, and elderly, to study whether the Swedish vaccination strategy was justified on cost-effectiveness grounds.</div></div><div><h3>Method</h3><div>A literature search using the PICOS (Population, Intervention, Control, Outcomes, Study design) convention was conducted in the databases Medline, Embase, PsycInfo, CINAHL, and Tuft CEA Registry, Cochrane and INAHTA in February 2023. The inclusion criteria were economic evaluations (S) comparing COVID-19 vaccination (I) in age-groups children, adult, and elderly European residents (P) with non-vaccinated European residents (C) in terms of cost per QALY, cost differences, and net monetary benefit (O). Hand-search was done on selected websites and in reference lists of included reports. Title/abstract screening, full-text screening, and quality assessment with the Swedish HTA agency checklist were performed by two researchers. The reporting follows the PRISMA 2020 recommendations.</div></div><div><h3>Results</h3><div>The database search resulted in 5,720 reports, title/abstract screening yielded 162 reports and after full-text screening, four reports remained. Two studies comparing vaccination of adults and elderly with high and moderate study quality were included. No study was found on the children population. The economic evidence indicated that COVID-19 vaccination of the elderly is cost-effective when compared with vaccination of the adult group, but the transferability to Swedish circumstances was inconclusive due to differences in outcome and cost data between Sweden and the included studies’ settings.</div></div><div><h3>Conclusion</h3><div>The common European COVID-19 vaccination policy that prioritized the elderly population was the cost-effective option in the reviewed studies. The lack of transferability to Sweden precludes a clear conclusion on the Swedish vaccination policy.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"21 ","pages":"Article 100580"},"PeriodicalIF":2.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142655346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-07DOI: 10.1016/j.jvacx.2024.100582
Chulwoo Park, Pyramida Vagoyan Zabala
The Centers for Disease Control and Prevention recommends that children aged 6 months–5 years (children under 5) receive multiple doses of COVID-19 vaccine, including updated (bivalent) COVID-19 vaccine. However, since the updated vaccines became available for children under 5, there has been limited knowledge regarding hesitancy toward the original vaccine or boosters in vaccinating children. To address this gap, this study utilized data from the Household Pulse Survey conducted from March 1, 2023 to May 8, 2023 (Phase 3.8). The purpose of the study was to examine the proportion of children under 5 who had received at least one dose of COVID-19 vaccine and to assess the likelihood of vaccination, categorized as willingness to vaccinate, moderate hesitancy, and strong hesitancy. Additionally, we identified sociodemographic factors that may influence the level of vaccine hesitancy for children. Overall, 24.5 % (95 % CI: 22.2–26.8) of children under 5 had received at least one dose of the COVID-19 vaccine, with the highest percentage among non-Hispanic Asians (42.1 %, 95 % CI: 36.4–47.8). Respondents who had not received the vaccine showed a statistically significant decrease in their inclination to vaccinate children. There was a higher level of vaccine hesitancy among females compared to males regarding vaccinating children under 5. As household income and educational attainment decreased, there was an observed increase in the proportion of individuals showing strong vaccine hesitancy. Households without health insurance had significantly lower vaccine uptake and higher rates of strong vaccine hesitancy compared to those with health insurance. Parents, guardians, and healthcare providers play essential roles in vaccinating children under 5. Targeted interventions are needed to address vaccine hesitancy and promote the importance of booster doses in the vaccination of children.
{"title":"COVID-19 vaccine or booster uptake and hesitancy for children aged 6 months–5 years in the United States: A national descriptive study using the household pulse survey between March and May 2023","authors":"Chulwoo Park, Pyramida Vagoyan Zabala","doi":"10.1016/j.jvacx.2024.100582","DOIUrl":"10.1016/j.jvacx.2024.100582","url":null,"abstract":"<div><div>The Centers for Disease Control and Prevention recommends that children aged 6 months–5 years (children under 5) receive multiple doses of COVID-19 vaccine, including updated (bivalent) COVID-19 vaccine. However, since the updated vaccines became available for children under 5, there has been limited knowledge regarding hesitancy toward the original vaccine or boosters in vaccinating children. To address this gap, this study utilized data from the Household Pulse Survey conducted from March 1, 2023 to May 8, 2023 (Phase 3.8). The purpose of the study was to examine the proportion of children under 5 who had received at least one dose of COVID-19 vaccine and to assess the likelihood of vaccination, categorized as willingness to vaccinate, moderate hesitancy, and strong hesitancy. Additionally, we identified sociodemographic factors that may influence the level of vaccine hesitancy for children. Overall, 24.5 % (95 % CI: 22.2–26.8) of children under 5 had received at least one dose of the COVID-19 vaccine, with the highest percentage among non-Hispanic Asians (42.1 %, 95 % CI: 36.4–47.8). Respondents who had not received the vaccine showed a statistically significant decrease in their inclination to vaccinate children. There was a higher level of vaccine hesitancy among females compared to males regarding vaccinating children under 5. As household income and educational attainment decreased, there was an observed increase in the proportion of individuals showing strong vaccine hesitancy. Households without health insurance had significantly lower vaccine uptake and higher rates of strong vaccine hesitancy compared to those with health insurance. Parents, guardians, and healthcare providers play essential roles in vaccinating children under 5. Targeted interventions are needed to address vaccine hesitancy and promote the importance of booster doses in the vaccination of children.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"21 ","pages":"Article 100582"},"PeriodicalIF":2.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142655348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-04DOI: 10.1016/j.jvacx.2024.100579
Marciane Maria Rover , Fernando Luis Scolari , Geraldine Trott , Mariana Motta Dias da Silva , Denise de Souza , Rosa da Rosa Minho dos Santos , Raíne Fogliati De Carli Schardosim , Emelyn de Souza Roldão , Gabriel Pozza Estivalete , Gabriela Soares Rech , Duane Mocellin , Jennifer Menna Barreto de Souza , Aline Paula Miozzo , Carolina Rothmann Itaqui , Gabrielle Nunes da Silva , Juliana de Mesquita Neto , Hellen Jordan Martins Freitas , Catherine Vitória Pereira dos Santos , Alanys Santos da Silveira , Carla Moura D’Ávila , Regis Goulart Rosa
Background
While COVID-19 vaccination has been shown to reduce the risk of severe illness, its impact on the occurrence of persistent symptoms in patients with mild Omicron infection remains uncertain. Our objective was to investigate whether COVID-19 vaccination reduces the occurrence of persistent COVID-19-related symptoms 3 months after mild Omicron infection.
Methods
Multicenter prospective cohort study was conducted in Brazil between January 2022 and June 2023 when Omicron was predominant. Participants ≥ 18 years seeking outpatient care for symptomatic SARS-CoV-2 infection were enrolled. Complete vaccination included individuals who received the full primary series and any booster dose, while incomplete vaccination included those with incomplete primary series or no vaccination. The primary outcome was any persistent symptoms at 3 months. Secondary outcomes were organ system-specific persistent symptoms and the EQ-5D-3L utility score. All outcomes were assessed by means of structured telephone interviews 3 months after enrollment.
Results
1,067 patients were enrolled (median age, 39 years), of which 914 (871 completely vaccinated and 43 unvaccinated or incompletely vaccinated). Among the vaccinated participants the median time since the last vaccine dose was 145 (interquartile range, 106–251) days. A total of 388/1067 (36.9 %) had a prior infection at the time of study entry. The occurrence of overall persistent COVID-19-related symptoms at 3 months was 41.6 % (n = 362) among completely vaccinated and 44.2 % (n = 19) among unvaccinated or incompletely vaccinated patients (adjusted risk ratio [aRR], 0.87; 95 % confidence interval [CI], 0.61–1.23; p = 0.43). Complete vaccination was associated with lower occurrence of mental health symptoms (aRR, 0.44; 95 % CI, 0.24–0.81; p = 0.01). No differences were found in the occurrence of persistent symptoms in other specific domains, nor in EQ-5D-3L utility scores.
Conclusions
This study was not able to identify a statistically significant protection of complete COVID-19 vaccination against any overall persistent symptoms at 3 months. Nevertheless, complete vaccination was associated with a lower occurrence of persistent mental health symptoms.
{"title":"Association between vaccination and persistent COVID-19-related symptoms among patients with mild Omicron infection: A prospective cohort study","authors":"Marciane Maria Rover , Fernando Luis Scolari , Geraldine Trott , Mariana Motta Dias da Silva , Denise de Souza , Rosa da Rosa Minho dos Santos , Raíne Fogliati De Carli Schardosim , Emelyn de Souza Roldão , Gabriel Pozza Estivalete , Gabriela Soares Rech , Duane Mocellin , Jennifer Menna Barreto de Souza , Aline Paula Miozzo , Carolina Rothmann Itaqui , Gabrielle Nunes da Silva , Juliana de Mesquita Neto , Hellen Jordan Martins Freitas , Catherine Vitória Pereira dos Santos , Alanys Santos da Silveira , Carla Moura D’Ávila , Regis Goulart Rosa","doi":"10.1016/j.jvacx.2024.100579","DOIUrl":"10.1016/j.jvacx.2024.100579","url":null,"abstract":"<div><h3>Background</h3><div>While COVID-19 vaccination has been shown to reduce the risk of severe illness, its impact on the occurrence of persistent symptoms in patients with mild Omicron infection remains uncertain. Our objective was to investigate whether COVID-19 vaccination reduces the occurrence of persistent COVID-19-related symptoms 3 months after mild Omicron infection.</div></div><div><h3>Methods</h3><div>Multicenter prospective cohort study was conducted in Brazil between January 2022 and June 2023 when Omicron was predominant. Participants ≥ 18 years seeking outpatient care for symptomatic SARS-CoV-2 infection were enrolled. Complete vaccination included individuals who received the full primary series and any booster dose, while incomplete vaccination included those with incomplete primary series or no vaccination. The primary outcome was any persistent symptoms at 3 months. Secondary outcomes were organ system-specific persistent symptoms and the EQ-5D-3L utility score. All outcomes were assessed by means of structured telephone interviews 3 months after enrollment.</div></div><div><h3>Results</h3><div>1,067 patients were enrolled (median age, 39 years), of which 914 (871 completely vaccinated and 43 unvaccinated or incompletely vaccinated). Among the vaccinated participants the median time since the last vaccine dose was 145 (interquartile range, 106–251) days. A total of 388/1067 (36.9 %) had a prior infection at the time of study entry<em>.</em> The occurrence of overall persistent COVID-19-related symptoms at 3 months was 41.6 % (n = 362) among completely vaccinated and 44.2 % (n = 19) among unvaccinated or incompletely vaccinated patients (adjusted risk ratio [aRR], 0.87; 95 % confidence interval [CI], 0.61–1.23; <em>p</em> = 0.43). Complete vaccination was associated with lower occurrence of mental health symptoms (aRR, 0.44; 95 % CI, 0.24–0.81; <em>p</em> = 0.01). No differences were found in the occurrence of persistent symptoms in other specific domains, nor in EQ-5D-3L utility scores.</div></div><div><h3>Conclusions</h3><div>This study was not able to identify a statistically significant protection of complete COVID-19 vaccination against any overall persistent symptoms at 3 months. Nevertheless, complete vaccination was associated with a lower occurrence of persistent mental health symptoms.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"21 ","pages":"Article 100579"},"PeriodicalIF":2.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jvacx.2024.100578
Rhythm Hora , Arindam Ray , Imkongtemsu Longchar , G.R. Rio , Rashmi Mehra , Seema Singh Koshal , Amrita Kumari , Syed F. Quadri , Amanjot Kaur , Arup Deb Roy
Background
Worldwide, vaccine-preventable diseases have been a significant cause of mortality in the under-5 age group. To reduce the disease burden, new vaccines are being introduced in every country’s immunization programmes. For this to happen, high vaccination coverage is necessary. However, rapidly identifying the areas that fail to reach the expected coverage becomes cumbersome. During recent years, lot quality assurance sampling (LQAS) has been widely used in evaluating immunization coverage across the globe. The present study aims to pilot this approach for field monitoring of a new vaccine against routine concurrent field monitoring in one of the North-Eastern states of India.
Methodology
For LQAS, a community-based cross-sectional study was undertaken among 55 children aged 0–23 months in all 5 Primary health centres (lots) of Medziphema block, Dimapur, Nagaland. The total sample size for LQAS was calculated based on α = 5, β = 90 using Lemeshow and Taber-LQAS table with a target level of immunization defined as 90 % and the lower limit set to 55 %. For the concurrent field monitoring, a sample of 30 children in the same age group was selected through random sampling. Pre-designed, pre-tested questionnaire for the caregivers, scripted on a digital tool was employed with verification of immunization card and caregiver’s recall. Data was analyzed using SPSS software version 25.0.
Results
The study found a slight difference in the percentage of children age-appropriately vaccinated for PCV (as per the schedule) in concurrent field monitoring (93.3 %) and LQAS (90.9 %). However, no statistically significant difference was found in comparing the immunization coverage using both methodologies (p > 0.05).
Conclusion
The study findings encourage that LQAS can be considered for monitoring the immunization coverage of a newly introduced vaccine. It offers the added advantage of identifying poor/low-performing pockets that require focused attention.
{"title":"Lot quality assurance sampling for coverage evaluation of a new vaccine: A pilot study","authors":"Rhythm Hora , Arindam Ray , Imkongtemsu Longchar , G.R. Rio , Rashmi Mehra , Seema Singh Koshal , Amrita Kumari , Syed F. Quadri , Amanjot Kaur , Arup Deb Roy","doi":"10.1016/j.jvacx.2024.100578","DOIUrl":"10.1016/j.jvacx.2024.100578","url":null,"abstract":"<div><h3>Background</h3><div>Worldwide, vaccine-preventable diseases have been a significant cause of mortality in the under-5 age group. To reduce the disease burden, new vaccines are being introduced in every country’s immunization programmes. For this to happen, high vaccination coverage is necessary. However, rapidly identifying the areas that fail to reach the expected coverage becomes cumbersome. During recent years, lot quality assurance sampling (LQAS) has been widely used in evaluating immunization coverage across the globe. The present study aims to pilot this approach for field monitoring of a new vaccine against routine concurrent field monitoring in one of the North-Eastern states of India.</div></div><div><h3>Methodology</h3><div>For LQAS, a community-based cross-sectional study was undertaken among 55 children aged 0–23 months in all 5 Primary health centres (lots) of Medziphema block, Dimapur, Nagaland. The total sample size for LQAS was calculated based on α = 5, β = 90 using Lemeshow and Taber-LQAS table with a target level of immunization defined as 90 % and the lower limit set to 55 %. For the concurrent field monitoring, a sample of 30 children in the same age group was selected through random sampling. Pre-designed, pre-tested questionnaire for the caregivers, scripted on a digital tool was employed with verification of immunization card and caregiver’s recall. Data was analyzed using SPSS software version 25.0.</div></div><div><h3>Results</h3><div>The study found a slight difference in the percentage of children age-appropriately vaccinated for PCV (as per the schedule) in concurrent field monitoring (93.3 %) and LQAS (90.9 %). However, no statistically significant difference was found in comparing the immunization coverage using both methodologies (p > 0.05).</div></div><div><h3>Conclusion</h3><div>The study findings encourage that LQAS can be considered for monitoring the immunization coverage of a newly introduced vaccine. It offers the added advantage of identifying poor/low-performing pockets that require focused attention.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"21 ","pages":"Article 100578"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-29DOI: 10.1016/j.jvacx.2024.100576
Trenton M. White , Katarzyna Wyka , Kenneth Rabin , Ayman El-Mohandes
Objectives
To evaluate changes in public trust in the science behind COVID-19 vaccines in the United States (US) from 2021 to 2023, and to assess how loss of a family member or close friend to COVID-19, influences this trust and vaccine acceptance.
Methods
Using stratified random sampling for key demographic variables, including age, gender, race/ethnicity, region, and education level, the study analyzes data from a series of cross-sectional surveys conducted in 2021, 2022 and 2023. Descriptive statistics were employed to summarize the socio-demographic characteristics of the respondents and their levels of trust in science and vaccine acceptance. Weighted logistic regression models were applied to assess the relationships between trust in science, vaccine acceptance, and socio-demographic factors. These models controlled for potential confounding variables and allowed for the estimation of adjusted odds ratios (aOR) and 95% confidence intervals (CI), highlighting the key predictors of vaccine acceptance and willingness to receive future recommended boosters.
Results
The results indicate that trust in science remained relatively stable over the study period and continued to be a strong predictor of vaccine acceptance, which was higher among male respondents, those with university degrees, and those with higher than median income. Notably, the experience of personal loss was significantly related to an individual’s trust in science and vaccine acceptance.
Conclusions
Trust in the science behind COVID-19 vaccines appears to have been a crucial factor in US vaccine acceptance, with respondents who expressed higher trust being significantly more likely to accept the vaccine and express willingness to take future boosters. To maintain and enhance public trust in vaccination programs, trust in health communication from public sources, particularly the CDC, must be strengthened, as trust in the CDC was also found to be significantly correlated with both vaccine acceptance and future booster uptake. Personal experiences of loss due to COVID-19 were important predictors of trust in science and vaccine acceptance, highlighting the need for public health communications to be sensitive to the emotional impact of loss and grief along with the diverse socio-economic and educational backgrounds of the US population.
{"title":"Trust in the science behind COVID-19 vaccines as a driver of vaccine acceptance in the United States, 2021–2023","authors":"Trenton M. White , Katarzyna Wyka , Kenneth Rabin , Ayman El-Mohandes","doi":"10.1016/j.jvacx.2024.100576","DOIUrl":"10.1016/j.jvacx.2024.100576","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate changes in public trust in the science behind COVID-19 vaccines in the United States (US) from 2021 to 2023, and to assess how loss of a family member or close friend to COVID-19, influences this trust and vaccine acceptance.</div></div><div><h3>Methods</h3><div>Using stratified random sampling for key demographic variables, including age, gender, race/ethnicity, region, and education level, the study analyzes data from a series of cross-sectional surveys conducted in 2021, 2022 and 2023. Descriptive statistics were employed to summarize the socio-demographic characteristics of the respondents and their levels of trust in science and vaccine acceptance. Weighted logistic regression models were applied to assess the relationships between trust in science, vaccine acceptance, and socio-demographic factors. These models controlled for potential confounding variables and allowed for the estimation of adjusted odds ratios (aOR) and 95% confidence intervals (CI), highlighting the key predictors of vaccine acceptance and willingness to receive future recommended boosters.</div></div><div><h3>Results</h3><div>The results indicate that trust in science remained relatively stable over the study period and continued to be a strong predictor of vaccine acceptance, which was higher among male respondents, those with university degrees, and those with higher than median income. Notably, the experience of personal loss was significantly related to an individual’s trust in science and vaccine acceptance.</div></div><div><h3>Conclusions</h3><div>Trust in the science behind COVID-19 vaccines appears to have been a crucial factor in US vaccine acceptance, with respondents who expressed higher trust being significantly more likely to accept the vaccine and express willingness to take future boosters. To maintain and enhance public trust in vaccination programs, trust in health communication from public sources, particularly the CDC, must be strengthened, as trust in the CDC was also found to be significantly correlated with both vaccine acceptance and future booster uptake. Personal experiences of loss due to COVID-19 were important predictors of trust in science and vaccine acceptance, highlighting the need for public health communications to be sensitive to the emotional impact of loss and grief along with the diverse socio-economic and educational backgrounds of the US population.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"21 ","pages":"Article 100576"},"PeriodicalIF":2.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1016/j.jvacx.2024.100577
Aditya S. Khanna , Mollie A. Monnig , Samantha E. Clark , Peter M. Monti
Background
The link between individuals’ vaccine attitudes and their social networks has been widely studied, but less is known about how these networks impact broader health behaviors like precautionary measures during the COVID-19 pandemic.
Methods
Egocentric social network data were collected from June 7–21, 2021, via an online survey by researchers based at the Brown University School of Public Health. The sample (n = 173) was recruited through Amazon’s Mechanical Turk in Connecticut, Massachusetts, New Jersey, New York, and Rhode Island. Participants reported their COVID-19 precautionary behaviors and those of up to 5 of their closest social network contacts (SNCs, n = 851). The primary outcome was the mean of 13 CDC-recommended precautionary behaviors (PBS). Covariates included SNCs’ COVID-19 testing, hospitalization, vaccination, disease experiences, social distancing adherence, and encouragement of participants’ testing and vaccination. Associations between PBS and SNC attributes were assessed using chi-square tests, t-tests, and Generalized Estimating Equations (GEE).
Results
Eighty percent of participants had received at least one vaccine dose. The PBS ranged from 0.38 to 3.00 (M = 2.3) and was positively associated with SNCs’ adherence to social distancing guidelines (0.33, p < 0.001), encouragement of social distancing (0.33, p < 0.001), encouragement of vaccination (0.25, p = 0.001), mask-wearing behavior (0.20, p = 0.008), receiving the vaccine (0.20, p = 0.01), and encouragement of testing (0.17, p < 0.05).
Discussion
The clustering of precautionary behaviors in social networks highlights the potential of leveraging these networks to promote public health interventions. The identification of clusters of unprotected communities at risk underscores the need to address disparities and integrate interpersonal factors into future pandemic responses.
{"title":"Social network characteristics of COVID-19 vaccination and preventive health behaviors: Cross-sectional findings from the US northeast during the early COVID-19 pandemic","authors":"Aditya S. Khanna , Mollie A. Monnig , Samantha E. Clark , Peter M. Monti","doi":"10.1016/j.jvacx.2024.100577","DOIUrl":"10.1016/j.jvacx.2024.100577","url":null,"abstract":"<div><h3>Background</h3><div>The link between individuals’ vaccine attitudes and their social networks has been widely studied, but less is known about how these networks impact broader health behaviors like precautionary measures during the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>Egocentric social network data were collected from June 7–21, 2021, via an online survey by researchers based at the Brown University School of Public Health. The sample (n = 173) was recruited through Amazon’s Mechanical Turk in Connecticut, Massachusetts, New Jersey, New York, and Rhode Island. Participants reported their COVID-19 precautionary behaviors and those of up to 5 of their closest social network contacts (SNCs, n = 851). The primary outcome was the mean of 13 CDC-recommended precautionary behaviors (PBS). Covariates included SNCs’ COVID-19 testing, hospitalization, vaccination, disease experiences, social distancing adherence, and encouragement of participants’ testing and vaccination. Associations between PBS and SNC attributes were assessed using chi-square tests, t-tests, and Generalized Estimating Equations (GEE).</div></div><div><h3>Results</h3><div>Eighty percent of participants had received at least one vaccine dose. The PBS ranged from 0.38 to 3.00 (M = 2.3) and was positively associated with SNCs’ adherence to social distancing guidelines (0.33, p < 0.001), encouragement of social distancing (0.33, p < 0.001), encouragement of vaccination (0.25, p = 0.001), mask-wearing behavior (0.20, p = 0.008), receiving the vaccine (0.20, p = 0.01), and encouragement of testing (0.17, p < 0.05).</div></div><div><h3>Discussion</h3><div>The clustering of precautionary behaviors in social networks highlights the potential of leveraging these networks to promote public health interventions. The identification of clusters of unprotected communities at risk underscores the need to address disparities and integrate interpersonal factors into future pandemic responses.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"21 ","pages":"Article 100577"},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1016/j.jvacx.2024.100575
Su Hyun Lim , Mona Hersi , Ramya Krishnan , Joshua Montroy, Bonnie Rook, Kelly Farrah, Yung-En Chung, Adrienne Stevens, Joseline Zafack, Eva Wong, Nicole Forbes, April Killikelly, Kelsey Young, Matthew Tunis
Background
The COVID-19 pandemic resulted in a rapid accumulation of novel vaccine research evidence. As a means to monitor this evidence, the Public Health Agency of Canada (PHAC) created the Evidence eXtraction Team for Research Analysis (EXTRA), which contributed to situational awareness in Canada through a bibliographic repository used to support decision-making by the National Advisory Committee on Immunization. We describe the process by which this literature was identified and catalogued, and provide an overview of characteristics in the identified literature.
Methods
To expedite the process, PHAC leveraged an artificial intelligence (AI) tool to assist in the screening and selection of relevant articles. Literature search results were initially screened by AI, then manually reviewed for relevance. Relevant articles were tagged using controlled vocabulary and stored in a bibliographic repository. This repository was analyzed to identify trends in vaccine research over time according to several key characteristics.
Results
As of December 31, 2023, EXTRA’s repository contained 19,050 articles relevant to PHAC’s immunization mandate. The majority of these articles (63.9 %) were identified between August 2021 and January 2023, with an average of 20 relevant articles added daily during this period. Nearly 14,000 articles reported on mRNA vaccines. Safety outcomes were most frequently reported (n = 8,289), followed by immunogenicity (n = 7,269) and efficacy/effectiveness (n = 3,246). COVID-19 vaccine literature output started to decrease in mid-2023, two years after the initial dramatic increase in mid-2021.
Conclusions
This hybrid (AI and human) approach was critical for PHAC situational awareness and the development of timely vaccine guidance in Canada during the COVID-19 pandemic. Given the volume of data and analyses required, the AI-augmented processes made this massive undertaking manageable. Analysis of COVID-19 vaccine research patterns supports projections of research volume, type, and rate that will help predict resourcing and information needs to plan future emergency vaccine guidance activities.
{"title":"COVID-19 vaccine evidence monitoring assisted by artificial Intelligence: An emergency system implemented by the Public Health Agency of Canada to capture and describe the trajectory of evolving pandemic vaccine literature","authors":"Su Hyun Lim , Mona Hersi , Ramya Krishnan , Joshua Montroy, Bonnie Rook, Kelly Farrah, Yung-En Chung, Adrienne Stevens, Joseline Zafack, Eva Wong, Nicole Forbes, April Killikelly, Kelsey Young, Matthew Tunis","doi":"10.1016/j.jvacx.2024.100575","DOIUrl":"10.1016/j.jvacx.2024.100575","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic resulted in a rapid accumulation of novel vaccine research evidence. As a means to monitor this evidence, the Public Health Agency of Canada (PHAC) created the <strong>E</strong>vidence e<strong>X</strong>traction <strong>T</strong>eam for <strong>R</strong>esearch <strong>A</strong>nalysis (<strong>EXTRA</strong>), which contributed to situational awareness in Canada through a bibliographic repository used to support decision-making by the National Advisory Committee on Immunization. We describe the process by which this literature was identified and catalogued, and provide an overview of characteristics in the identified literature.</div></div><div><h3>Methods</h3><div>To expedite the process, PHAC leveraged an artificial intelligence (AI) tool to assist in the screening and selection of relevant articles. Literature search results were initially screened by AI, then manually reviewed for relevance. Relevant articles were tagged using controlled vocabulary and stored in a bibliographic repository. This repository was analyzed to identify trends in vaccine research over time according to several key characteristics.</div></div><div><h3>Results</h3><div>As of December 31, 2023, EXTRA’s repository contained 19,050 articles relevant to PHAC’s immunization mandate. The majority of these articles (63.9 %) were identified between August 2021 and January 2023, with an average of 20 relevant articles added daily during this period. Nearly 14,000 articles reported on mRNA vaccines. Safety outcomes were most frequently reported (n = 8,289), followed by immunogenicity (n = 7,269) and efficacy/effectiveness (n = 3,246). COVID-19 vaccine literature output started to decrease in mid-2023, two years after the initial dramatic increase in mid-2021.</div></div><div><h3>Conclusions</h3><div>This hybrid (AI and human) approach was critical for PHAC situational awareness and the development of timely vaccine guidance in Canada during the COVID-19 pandemic. Given the volume of data and analyses required, the AI-augmented processes made this massive undertaking manageable. Analysis of COVID-19 vaccine research patterns supports projections of research volume, type, and rate that will help predict resourcing and information needs to plan future emergency vaccine guidance activities.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"21 ","pages":"Article 100575"},"PeriodicalIF":2.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.1016/j.jvacx.2024.100571
Björn Zethelius , Sofia Attelind , Gabriel Westman , Rickard Ljung , Anders Sundström
Background
During the COVID-19 vaccination campaign in Sweden, pulmonary embolism (PE) was a frequently reported suspected serious adverse drug reaction. The aim was to estimate risk of PE following vaccination for COVID-19 in the Swedish population aged 18 to 84 years.
Methods
Population-based cohort study using the CoVacSafe-SE established platform including national registers. PE-case definition: Individuals discharged from inpatient-care or visiting specialized outpatient-care with a main diagnosis of PE occurring between 27-Dec-2020 and 31-Dec-2022 without simultaneous diagnosis of COVID-19 infection. Time-to-event analysis was performed using multi-variable Cox’ proportional hazard’s models. Hazard Ratios (HR) adjusted for age, sex and co-morbidities were modelled.
The vaccines were BNT162b2/Comirnaty®, mRNA1273/Spikevax® and ChAdOx1 nCoV-19/Vaxzevria® without regard to variants. Doses number one to five were studied.
Results
Eighty percent of the study-population (≈6.1 million people) received at least two doses of COVID-19 vaccine. A total of 12,456 cases of PE were identified. Twenty-eight days after vaccinations we observed 99 cases after 701,455 1st doses of ChAdOx1 nCoV-19, HRadj, 1.29 (95%-CI, 1.05–1.59). Corresponding for BNT162b2 was 361 cases after 4,708,284 1st doses of BNT162b2 HRadj of 1.19 (95%-CI, 1.06–1.34) driven by age group 65–84; HR adj, 1.24 (95%-CI, 1.07–1.44). No increased risks were observed for mRNA1273.
Conclusion
In this nation-wide study, no strong associations were found between COVID-19 vaccinations and pulmonary embolism. Small increases in relative risk for the earliest doses of vaccines may be associated with prioritizing the frailest groups of people in the vaccination campaign, thus selection bias or unmeasured residual confounding is possible.
{"title":"Pulmonary embolism after SARS-CoV-2 vaccination","authors":"Björn Zethelius , Sofia Attelind , Gabriel Westman , Rickard Ljung , Anders Sundström","doi":"10.1016/j.jvacx.2024.100571","DOIUrl":"10.1016/j.jvacx.2024.100571","url":null,"abstract":"<div><h3>Background</h3><div>During the COVID-19 vaccination campaign in Sweden, pulmonary embolism (PE) was a frequently reported suspected serious adverse drug reaction. The aim was to estimate risk of PE following vaccination for COVID-19 in the Swedish population aged 18 to 84 years.</div></div><div><h3>Methods</h3><div>Population-based cohort study using the CoVacSafe-SE established platform including national registers. PE-case definition: Individuals discharged from inpatient-care or visiting specialized outpatient-care with a main diagnosis of PE occurring between 27-Dec-2020 and 31-Dec-2022 without simultaneous diagnosis of COVID-19 infection. Time-to-event analysis was performed using multi-variable Cox’ proportional hazard’s models. Hazard Ratios (HR) adjusted for age, sex and co-morbidities were modelled.</div><div>The vaccines were BNT162b2/Comirnaty®, mRNA1273/Spikevax® and ChAdOx1 nCoV-19/Vaxzevria® without regard to variants. Doses number one to five were studied.</div></div><div><h3>Results</h3><div>Eighty percent of the study-population (≈6.1 million people) received at least two doses of COVID-19 vaccine. A total of 12,456 cases of PE were identified. Twenty-eight days after vaccinations we observed 99 cases after 701,455 1st doses of ChAdOx1 nCoV-19, HR<sub>adj</sub>, 1.29 (95%-CI, 1.05–1.59). Corresponding for BNT162b2 was 361 cases after 4,708,284 1st doses of BNT162b2 HR<sub>adj</sub> of 1.19 (95%-CI, 1.06–1.34) driven by age group 65–84; HR <sub>adj</sub>, 1.24 (95%-CI, 1.07–1.44). No increased risks were observed for mRNA1273.</div></div><div><h3>Conclusion</h3><div>In this nation-wide study, no strong associations were found between COVID-19 vaccinations and pulmonary embolism. Small increases in relative risk for the earliest doses of vaccines may be associated with prioritizing the frailest groups of people in the vaccination campaign, thus selection bias or unmeasured residual confounding is possible.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"21 ","pages":"Article 100571"},"PeriodicalIF":2.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.jvacx.2024.100566
Jessica Lu , Branka Vulesevic , Ann N. Burchell , Joel Singer , Judy Needham , Yanbo Yang , Hong Qian , Catharine Chambers , Hasina Samji , Ines Colmegna , Sugandhi del Canto , Guy-Henri Godin , Muluba Habanyama , Sze Shing Christian Hui , Abigail Kroch , Enrico Mandarino , Shari Margolese , Carrie Martin , Maureen Owino , Elisa Lau , Cecilia T. Costiniuk
<div><h3>Background</h3><div>Understanding the roots of vaccine confidence in vulnerable populations, such as persons living with HIV (PLWH), is important to facilitate vaccine uptake, thus mitigating infection and spread of vaccine-preventable infectious diseases. In an online survey of PLWH conducted in Canada during winter 2022 (<em>AIDS and Behav 2023</em>), we reported that the overall COVID-19 vaccination uptake rate in PLWH was similar by sex. Here, we examined attitudes and beliefs towards vaccination against COVID-19 based on sex.</div></div><div><h3>Methods</h3><div>Between February and May 2022, PLWH across Canada were recruited via social media and community-based organizations to complete an online survey consisting of a modified Vaccine Hesitancy Scale (VHS) questionnaire with items from the National Advisory Committee on Immunization Acceptability Matrix. Descriptive statistics were used to summarize participant characteristics and responses to the VHS questionnaire by sex. The effect of biological sex on total VHS score, two subscales (“lack of confidence” and “perceived risk”) was assessed separately by linear regression adjusting for other key baseline variables.</div></div><div><h3>Results</h3><div>Of 259 PLWH, 69 (27 %) were females and 189 (73 %) were males. Sixty-six (26 %) of participants self-identified as a woman, 163(63 %) as a man and 28(11 %) as trans/two-spirited/queer/non-binary/agender/other. The mean age (SD) was 47 ± 14 years. Females were less likely to believe that COVID-19 vaccination was: important for his/her own health (71 % vs. 86 %); a good way to protect themselves from infection (68 % vs. 86 %); that getting the COVID-19 vaccine was important for the health of others in his/her community (78 % vs. 91 %); believed recommendations by their doctor/health care provider about COVID-19 vaccines (78 % vs. 88 %); that information about COVID-19 vaccines from public health officials was reliable and trustworthy (56 % vs. 75 % vs); COVID-19 vaccines are effective in preventing COVID-19 infections (61 % vs. 82 %) and that all COVID-19 vaccines offered by government programs in their communities were important for good health (70 % vs. 87 %). Although more males than females felt that new vaccines generally carry more risks than older vaccines (19 % vs 16 %,), fewer males than females endorsed concern about serious side effects of COVID-19 vaccines (33 % vs 45 %).</div><div>The linear regression model showed females had a significantly higher VHS total score than males (adjusted mean difference 0.38; 95 % confidence interval (CI) 0.13–0.64; p = 0.004), indicating greater COVID-19 vaccine hesitancy among females. It was observed that females had a greater “lack of confidence in vaccines” score than males (adjusted mean difference 0.43; 95 % CI 0.14–0.73; p = 0.004). We did not observe a significant difference in “perceived risk in vaccines” between males and females (adjusted mean difference 0.20; 95 % CI −0.07–0.46;
{"title":"Sex differences in COVID-19 vaccine confidence in people living with HIV in Canada","authors":"Jessica Lu , Branka Vulesevic , Ann N. Burchell , Joel Singer , Judy Needham , Yanbo Yang , Hong Qian , Catharine Chambers , Hasina Samji , Ines Colmegna , Sugandhi del Canto , Guy-Henri Godin , Muluba Habanyama , Sze Shing Christian Hui , Abigail Kroch , Enrico Mandarino , Shari Margolese , Carrie Martin , Maureen Owino , Elisa Lau , Cecilia T. Costiniuk","doi":"10.1016/j.jvacx.2024.100566","DOIUrl":"10.1016/j.jvacx.2024.100566","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the roots of vaccine confidence in vulnerable populations, such as persons living with HIV (PLWH), is important to facilitate vaccine uptake, thus mitigating infection and spread of vaccine-preventable infectious diseases. In an online survey of PLWH conducted in Canada during winter 2022 (<em>AIDS and Behav 2023</em>), we reported that the overall COVID-19 vaccination uptake rate in PLWH was similar by sex. Here, we examined attitudes and beliefs towards vaccination against COVID-19 based on sex.</div></div><div><h3>Methods</h3><div>Between February and May 2022, PLWH across Canada were recruited via social media and community-based organizations to complete an online survey consisting of a modified Vaccine Hesitancy Scale (VHS) questionnaire with items from the National Advisory Committee on Immunization Acceptability Matrix. Descriptive statistics were used to summarize participant characteristics and responses to the VHS questionnaire by sex. The effect of biological sex on total VHS score, two subscales (“lack of confidence” and “perceived risk”) was assessed separately by linear regression adjusting for other key baseline variables.</div></div><div><h3>Results</h3><div>Of 259 PLWH, 69 (27 %) were females and 189 (73 %) were males. Sixty-six (26 %) of participants self-identified as a woman, 163(63 %) as a man and 28(11 %) as trans/two-spirited/queer/non-binary/agender/other. The mean age (SD) was 47 ± 14 years. Females were less likely to believe that COVID-19 vaccination was: important for his/her own health (71 % vs. 86 %); a good way to protect themselves from infection (68 % vs. 86 %); that getting the COVID-19 vaccine was important for the health of others in his/her community (78 % vs. 91 %); believed recommendations by their doctor/health care provider about COVID-19 vaccines (78 % vs. 88 %); that information about COVID-19 vaccines from public health officials was reliable and trustworthy (56 % vs. 75 % vs); COVID-19 vaccines are effective in preventing COVID-19 infections (61 % vs. 82 %) and that all COVID-19 vaccines offered by government programs in their communities were important for good health (70 % vs. 87 %). Although more males than females felt that new vaccines generally carry more risks than older vaccines (19 % vs 16 %,), fewer males than females endorsed concern about serious side effects of COVID-19 vaccines (33 % vs 45 %).</div><div>The linear regression model showed females had a significantly higher VHS total score than males (adjusted mean difference 0.38; 95 % confidence interval (CI) 0.13–0.64; p = 0.004), indicating greater COVID-19 vaccine hesitancy among females. It was observed that females had a greater “lack of confidence in vaccines” score than males (adjusted mean difference 0.43; 95 % CI 0.14–0.73; p = 0.004). We did not observe a significant difference in “perceived risk in vaccines” between males and females (adjusted mean difference 0.20; 95 % CI −0.07–0.46;","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"21 ","pages":"Article 100566"},"PeriodicalIF":2.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142655347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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