RESUMEN
Despite increased risk of severe acute respiratory syndrome coronavirus 2 infections and higher rates of COVID-19-related complications, racialized and Indigenous communities in Canada have lower immunization uptake compared to White individuals. However, there is woeful lack of data on predictors of COVID-19 vaccine mistrust (VM) that accounts for diverse social and cultural contexts within specific racialized and Indigenous communities. Therefore, we sought to characterize COVID-19 VM among Arab, Asian, Black, and Indigenous communities in Canada. An online survey was administered to a nationally representative, ethnically diverse panel of participants in October 2023. Arabic, Asian, Indigenous, and Black respondents were enriched in the sampling panel. Data were collected on demographics, COVID-19 VM, experience of racial discrimination, health literacy, and conspiracy beliefs. We used descriptive and regression analyses to determine the extent and predictors of COVID-19 VM among racialized and Indigenous individuals. All racialized respondents had higher VM score compared to White participants. Among 4220 respondents, we observed highest VM among Black individuals (12.18; ±4.24), followed by Arabic (12.12; ±4.60), Indigenous (11.84; ±5.18), Asian (10.61; ±4.28), and White (9.58; ±5.00) participants. In the hierarchical linear regression analyses, Black participants, women, everyday racial discrimination, and major experience of discrimination were positively associated with COVID-19 VM. Effects of racial discrimination were mediated by addition of conspiracy beliefs to the model. Racialized and Indigenous communities experience varying levels of COVID-19 VM and carry specific predictors and mediators to development of VM. This underscores the intricate interaction between race, gender, discrimination, and VM that need to be considered in future vaccination campaigns.
Asunto(s)
Árabes , Vacunas contra la COVID-19 , COVID-19 , Alfabetización en Salud , Pueblos Indígenas , Racismo , Humanos , Femenino , Masculino , Adulto , COVID-19/prevención & control , COVID-19/etnología , Canadá/epidemiología , Vacunas contra la COVID-19/administración & dosificación , Persona de Mediana Edad , Pueblos Indígenas/estadística & datos numéricos , Confianza , Adulto Joven , Encuestas y Cuestionarios , Conocimientos, Actitudes y Práctica en Salud , Anciano , Pueblo Asiatico , Población Negra/estadística & datos numéricos , Población Negra/psicología , SARS-CoV-2/inmunología , Vacunación/psicología , Vacunación/estadística & datos numéricos , Adolescente , EtnicidadRESUMEN
The COVID-19 pandemic disproportionately affected Black communities in Canada in terms of infection and mortality rates compared to the general population. Despite these facts, Black communities are among those with the highest level of COVID-19 vaccine mistrust (COVID-19 VM). We collected novel data to analyze the sociodemographic characteristics and factors associated with COVID-19 VM among Black communities in Canada. A survey was conducted among a representative sample of 2002 Black individuals (51.66% women) aged 14-94 years (M = 29.34; SD = 10.13) across Canada. Vaccine mistrust was assessed as the dependent variable and conspiracy theories, health literacy, major racial discrimination in healthcare settings, and sociodemographic characteristics of participants were assessed as independent variables. Those with a history of COVID-19 infection had higher COVID-19 VM score (M = 11.92, SD = 3.88) compared to those with no history of infection (M = 11.25, SD = 3.83), t (1999) = -3.85, p < 0.001. Participants who reported having experienced major racial discrimination in healthcare settings were more likely to report COVID-19 VM (M = 11.92, SD = 4.03) than those who were not (M = 11.36, SD = 3.77), t (1999) = -3.05, p = 0.002. Results also showed significant differences for age, education level, income, marital status, provinces, language, employment status, and religion. The final hierarchical linear regression showed that conspiracy beliefs (B = 0.69, p < 0.001) were positively associated with COVID-19 VM, while health literacy (B = -0.05, p = 0.002) was negatively associated with it. The mediated moderation model showed that conspiracy theories completely mediated the association between racial discrimination and vaccine mistrust (B = 1.71, p < 0.001). This association was also completely moderated by the interaction between racial discrimination and health literacy (B = 0.42, p = 0.008), indicating that despite having a high level of health literacy, those who experienced major racial discrimination in health services developed vaccine mistrust. This first study on COVID-19 VM exclusively among Black individuals in Canada provides data that can significantly impact the development of tools, trainings, strategies, and programs to make the health systems free of racism and increase their confidence in vaccination for COVID-19 and other infectious diseases.
Asunto(s)
COVID-19 , Alfabetización en Salud , Racismo , Vacunas , Humanos , Femenino , Masculino , Vacunas contra la COVID-19 , COVID-19/epidemiología , COVID-19/prevención & control , Pandemias , Conocimientos, Actitudes y Práctica en SaludRESUMEN
The COVID-19-related misinformation and vaccine hesitancy is a widespread global concern and a recognized public health problem in Pakistan. The current research sought to explore the beliefs and experiences with regard to COVID-19, including vaccine hesitancy and acceptance, in a slum of Karachi, Pakistan. This study used an interpretivist epistemological approach for data collection and employed in-depth interviews (IDIs) and focus group discussions (FGDs) to explore the themes of interest. IDIs and FDGs were conducted in the local language (Pashtu) and Urdu, using semi-structured interview guides. A hybrid thematic analysis approach (use of both inductive and deductive coding) was used to analyze the data. We identified two key themes: the first related to vaccine hesitancy and refusal and included the role of personal belief systems, vaccine mistrust and public perceptions in hesitancy; the second related to vaccine acceptance and included knowledge and awareness about the vaccine and trusted sources of information. Religious beliefs and cultural norms influenced attitudes toward COVID-19 and vaccination. This study also found that awareness about the COVID-19 vaccine in this sample was influenced by sex, educational status and socioeconomic status. Participants with good health literacy and those from healthcare backgrounds were more likely to share views that indicated vaccine acceptance. The findings of this study are being used to co-design a comprehensive intervention to dispel COVID-19 misinformation and vaccine hesitancy across a range of stakeholders such as youths, community leaders, family members, faith leaders, schools and community-based local organizations in Pakistan.
This study explored the beliefs and experiences of the COVID-19 vaccine, including hesitancy and acceptance toward vaccinations, in a slum of Karachi, Pakistan. The findings of this study highlight that hesitancy was linked to personal belief systems, vaccine mistrust and public perceptions. In contrast, vaccine acceptance was linked to knowledge and awareness about the vaccine and trusted sources of information. This research identifies a clear need for co-designed health communication for vaccines to design and deliver people-centered interventions to dispel the COVID-19 misconceptions and vaccine hesitancy.
Asunto(s)
COVID-19 , Vacunas , Adolescente , Humanos , Vacunas contra la COVID-19 , Áreas de Pobreza , Aceptación de la Atención de Salud , Conocimientos, Actitudes y Práctica en Salud , COVID-19/prevención & control , Vacilación a la Vacunación , Pakistán , VacunaciónRESUMEN
Background: The advent of an effective novel COVID-19 vaccine could extinguish the current devastating pandemic but the vaccine hesitancy is a hurdle for the public health system, so this study estimated the COVID-19 vaccination intention and hesitancy among the healthcare workers, the priority target group for the COVID-19 vaccination in India. Methods: A web-based cross-sectional survey was conducted among the healthcare workers in Chandigarh, a union territory in North India, using a Snowball sampling technique. A total of 403 healthcare workers participated in the study between 2nd and 25th January 2021. The primary data collected were the intention to get vaccinated against the available COVID-19 vaccine and the concerns regarding the new vaccines. The attitude towards novel COVID-19 vaccine was assessed using developed Vaccine attitude examination scale. These questionnaire, which were delivered via WhatsApp, was filled by the participants over Google forms. Results: Among the 403 respondents surveyed, the majority (54.6%) reported they were definitely intended to get vaccinated against COVID-19, however, 7% expressed a resistance for inoculation with COVID-19 vaccination. The perceived susceptibility (aOR = 0.511, CI 0.265-0.987) and severity of COVID-19 infection (aOR = 0.551 CI 0.196-0.704) and not being concerned about the efficacy of new COVID-19 vaccines (aOR = 0.702 CI 1.109-26.55) were found to have the highest significant odds of intention to take the COVID-19 vaccine. The majority (62%) were concerned about the safety of the vaccine, in terms of side-effects, quality control, and doubted efficacy of the vaccine. The mistrust of the benefits of the vaccine is a significant predictor for vaccine hesitancy among the healthcare workers (aOR = 5.205 CI 3.106-8.723). Conclusion: Therefore, strategic communication and vaccine-acceptance programs should be formulated in order to combat the prevailing mistrust on the vaccine safety and efficacy and attain effective coverage to gain herd immunity.
Asunto(s)
COVID-19 , Vacunas , COVID-19/prevención & control , Vacunas contra la COVID-19/uso terapéutico , Estudios Transversales , Personal de Salud , Humanos , Intención , Vacunación , Vacilación a la VacunaciónRESUMEN
AIM: This study aims to determine the causes of vaccine mistrust among family healthcare professionals (FHP) in the unit where they serve and vaccine hesitancy of families. METHOD: The study group consisted of 682 FHPs working in a primary health care institution. The data collection tools of the study included a sociodemographic data form and a vaccine hesitancy data form. Pearson's chi-square analysis and logistic regression analysis were performed to analyze the data. FINDINGS: To the question of "Do you trust the active ingredient in the vaccines?", only 2.1% of FHPs responded "I do not trust" and 18.9% answered "I am indecisive". 70.7% of FHPs said that at least one vaccine hesitant family was in the unit where they served. The most important reasons stated by FHPs on behalf of such families were vaccine mistrust (73.2%), the belief that they may be harmful for the child (58.7%), and the belief that vaccines cause autism (55.6%). In the univariate analysis, vaccine mistrust was significantly higher in FHPs who were measles-hesitant and responded "The decision to get vaccinated or not should belong to the family voluntarily". From logistic regression analysis, vaccine mistrust in FHPs increased 2.8-fold for those who did not think vaccination should be compulsory, 2.7-fold for those who did not think that vaccination refusal should be legally enforced, and 1.61-fold for those under age 35 years. CONCLUSION: It was observed that FHPs had high sensitivity and positive attitudes toward vaccination in general.