OBJECTIVE: In the setting of an active pandemic the impact of public vaccine hesitancy on healthcare workers has not yet been explored. There is currently a paucity of literature that examines how patient resistance to disease prevention in general impacts practitioners.
OBJECTIVE: The COVID-19 pandemic created unprecedented healthcare challenges with impacts on healthcare workers\' wellbeing. Vaccine hesitancy added complexity to providing care for unvaccinated patients. Our study qualitatively explored experiences of healthcare providers caring for unvaccinated patients with severe COVID-19 infection in the intensive care setting.
METHODS: We used interview-based constructivist grounded theory methodology to explore experiences of healthcare providers with critically ill unvaccinated COVID-19 patients.
METHODS: Healthcare providers who cared for unvaccinated patients with severe COVID-19 respiratory failure following availability of severe acute respiratory syndrome coronavirus 2 vaccines were recruited from seven ICUs located within two large academic centers and one community-based hospital. We interviewed 24 participants, consisting of eight attending physicians, seven registered nurses, six critical care fellows, one respiratory therapist, one physiotherapist, and one social worker between March 2022 and September 2022 (approximately 1.5 yr after the availability of COVID-19 vaccines in Canada).
METHODS: Interviews were recorded, transcribed, de-identified, and coded to identify emerging themes. The final data was analyzed to generate the thematic framework. Reflexivity was employed to reflect upon and discuss individual pre-conceptions and opinions that may impact collection and interpretation of the data.
RESULTS: Healthcare providers maintained dedication toward professionalism during provision of care, at the cost of suffering emotional turmoil from the pandemic and COVID-19 vaccine hesitancy. Evolving sources of stress associated with vaccine hesitancy included ongoing high volumes of critically ill patients, resource shortages, and visitation restrictions, which contributed to perceived emotional distress, empathy loss, and professional dissatisfaction. As a result, there were profound personal and professional consequences for healthcare professionals, with perceived impacts on patient care.
CONCLUSIONS: Our study highlights struggles of healthcare providers in fulfilling professional duties while navigating emotional stressors unique to vaccine hesitancy. System-based interventions should be explored to help providers navigate biases and moral distress, and to foster resilience for the next major healthcare system strain.

UNASSIGNED: People with disabilities are at increased risk for severe COVID-19 health outcomes and face barriers accessing COVID-19 vaccines. The aim of this study is to examine receipt of ≥ 1 dose of the COVID-19 vaccine, intention to vaccinate in the future, and reasons for not vaccinating among people with disabilities and functional limitations using a large, nationally representative dataset of adults in the United States.
UNASSIGNED: Data were analyzed from the Census Bureau\'s Household Pulse Survey (14-26 April 2021, n = 68,913). Separate logistic regression models were conducted to examine the association between each disability (vision, hearing, cognition and mobility), overall disability status, and functional status on ≥1 dose COVID-19 vaccination receipt and intention to vaccinate. Furthermore, reasons for not getting vaccinated were examined among those with disabilities or functional limitations.
UNASSIGNED: Approximately 13% of adults reported having a disability, and almost 60% reported having some or a lot of functional limitations. Over 65% of adults with disabilities had received ≥1 dose of COVID-19 vaccines, compared to 73% among adults without disabilities (adjusted prevalence ratio = 0.94). Among adults with disabilities, those who were younger, had lower educational attainment and income, did not have insurance and had a prior history of COVID-19 were less likely to get vaccinated or intend to get vaccinated than their respective counterparts. The main reasons for not getting vaccinated were concerns about possible side effects (52.1%), lack of trust in COVID-19 vaccines (45.4%) and lack of trust in the government (38.6%).
UNASSIGNED: Efforts to ensure high and equitable vaccination coverage include working with communities to strengthen the message that the vaccine is safe and effective, educating health professionals about the need to recommend and promote vaccines, and making vaccination sites more accessible for people who need additional accommodations.

UNASSIGNED: Pregnant individuals have an increased risk of severe illness from coronavirus disease 2019 (COVID-19) infection. Vaccination is an effective strategy to prevent severe illness and complications for pregnant individuals. Pregnant individuals are often excluded from research and remain hesitant to receive vaccination against COVID-19. It is pivotal to study factors related to vaccine uptake and hesitancy among pregnant individuals. We studied barriers and facilitators for pregnant individuals choice and motivation regarding vaccination against COVID-19 during pregnancy to aid future pregnant individuals in their decision to vaccinate against various infectious agents.
UNASSIGNED: In this qualitative study, pregnant individuals were interviewed between October 2021 and January 2022 using a semi-structured approach. A topic list was used to explore their feelings, perceptions and ideas regarding vaccination against COVID-19 during pregnancy. Interviews were transcribed verbatim and thematic analyses was performed using MAX QDA.
UNASSIGNED: After nine interviews, saturation was reached. Three main themes were identified that influenced pregnant individuals choice and motivation regarding vaccination: health consequences, ambiguity of information and societal motivation. Health consequences mainly concerned the effect for their offspring, and the unknown long-term effects of COVID-19 vaccination. The advice from the Dutch institute for Public Health and Environment changed from not vaccinating pregnant individuals after release of the developed vaccine, to routinely vaccinating all pregnant individuals after research data were available from the United States of America (USA). This change of policy fuelled doubt and confusion for vaccination. Arguments in favor of vaccination from the social perspective were specific behaviour rules and restrictions due to the pandemic. E.g. without vaccination people were unable to travel abroad and having to take a COVID-19 test every time entering a public place.
UNASSIGNED: Pregnant individuals need clear, unambiguous information concerning health consequences, short- and long-term, particularly for their offspring, in the decision-making process regarding COVID-19 vaccination. Additionally, the societal perspective needs to be addressed. Besides the aforementioned themes, general counselling should focus on misperceptions of vaccine safety and the role of misinformation which are also important in the non-pregnant population. This study underlines the importance of including pregnant individuals in research programs to obtain specific information targeted to their needs.

Vaccination is a cornerstone of public health, but vaccine hesitancy poses significant challenges as highlighted during the COVID-19 pandemic. Addressing the challenge requires healthcare professionals to effectively counter misinformation. They have a pivotal role in fostering trust and promoting evidence-based vaccine recommendations, with tailored communication strategies and community engagement initiatives. Legislation, policy interventions, research, innovation, and technology are needed to enhance vaccine uptake and ensure equitable access. Integration of vaccination into routine healthcare is paramount for public health protection against emerging infectious threats.

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OBJECTIVE: To describe vaccination coverage and hesitation for the basic children\'s schedule in Belo Horizonte and Sete Lagoas, Minas Gerais state, Brazil.
METHODS: Population-based epidemiological surveys performed from 2020 to 2022, which estimated vaccine coverage by type of immunobiological product and full schedule (valid and ministered doses), according to socioeconomic strata; and reasons for vaccination hesitancy.
RESULTS: Overall coverage with valid doses and vaccination hesitancy for at least one vaccine were, respectively, 50.2% (95%CI 44.1;56.2) and 1.6% (95%CI 0.9;2.7), in Belo Horizonte (n = 1,866), and 64.9% (95%CI 56.9;72.1) and 1.0% (95%CI 0.3;2.8), in Sete Lagoas (n = 451), with differences between socioeconomic strata. Fear of severe reactions was the main reason for vaccination hesitancy.
CONCLUSIONS: Coverage was identified as being below recommended levels for most vaccines. Disinformation should be combated in order to avoid vaccination hesitancy. There is a pressing need to recover coverages, considering public health service access and socioeconomic disparities.
RESULTS: Vaccination coverage of children up to 4 years old was 50.2% in Belo Horizonte, and 64.9% in Sete Lagoas. Fear of severe reactions and believing that vaccination against eradicated diseases is unnecessary were the main reasons for vaccination hesitancy.
UNASSIGNED: Recovery of high vaccination coverage among children, considering public health service access conditions and socioeconomic inequities. Acting on reasons for hesitancy that can assist in targeting actions.
CONCLUSIONS: The multifactorial context of vaccination hesitancy demands the development of health education strategies to raise awareness about child immunization.

OBJECTIVE: to investigate the factors influencing vaccine hesitancy against COVID-19 among Brazilians.
METHODS: this research employed an observational and analytical approach, utilizing a web-based survey. Data collection took place in 2020, and data analysis was conducted using structural equation modeling.
RESULTS: the prevalence of vaccine hesitancy was found to be 27.5% (1182 individuals). There is a negative correlation between belief in conspiracy theories and social influence. Among the various beliefs associated with vaccination intentions, only conspiracy beliefs exhibited significant predictive value. Thus, the findings suggest that personal beliefs significantly impact hesitancy towards vaccination, and also indicate that trust in governmental bodies is inversely related to hesitancy.
CONCLUSIONS: vaccine hesitancy emerges as a multifaceted phenomenon influenced by a complex array of factors, including personal beliefs, trust in governmental bodies, and healthcare systems.

UNASSIGNED: First Nations peoples face disproportionate vaccine-preventable risks due to social, economic, and healthcare disparities. Additionally, during the COVID-19 pandemic, there was also mistrust and hesitancy about the COVID-19 vaccines among First Nations peoples. These are rooted in factors such as colonial histories, discriminatory medical practices, and unreliable information.
UNASSIGNED: To examine strategies to address COVID-19 vaccine hesitancy among First Nations peoples globally.
UNASSIGNED: A systematic review was conducted. Searches were undertaken in OVID MEDLINE, OVID EMBASE, OVID PsycINFO, CINAHL, and Informit. Searches were date limited from 2020. Items included in this review provided primary data that discussed strategies used to address COVID-19 vaccine hesitancy in First Nations peoples.
UNASSIGNED: We identified several key strategies across four countries - Australia, the USA, Canada, and Guatemala in seventeen papers. These included understanding communities\' needs, collaborating with communities, tailored messaging, addressing underlying systemic traumas and social health gaps, and early logistics planning.
UNASSIGNED: The inclusion of First Nations-centred strategies to reduce COVID-19 vaccine hesitancy is essential to delivering an equitable pandemic response. Implementation of these strategies in the continued effort to vaccinate against COVID-19 and in future pandemics is integral to ensure that First Nations peoples are not disproportionately affected by disease.
Main findings In this review, we identified seventeen studies detailing five key strategies to reduce COVID-19 vaccine hesitancy among First Nations Peoples.Added knowledge First Nations-centred strategies to reduce COVID-19 vaccine hesitancy were: understanding communities’ needs, collaboration with communities, tailored messaging, logistics planning and addressing the underlying systemic trauma experienced by First Nations peoples when accessing healthcare.Global health impact for policy and action First Nations-centred strategies must be included in the continued effort to vaccinate against COVID-19 and other future outbreaks to ensure that First Nations peoples are not disproportionately affected.

UNASSIGNED: The coronavirus disease 2019 (COVID-19) continues to threaten human health, and health professionals, including nursing students, usually work in healthcare frontiers with a high risk of infection. Vaccination is currently one of the most effective preventive measures. This study aimed to explore the determinants of COVID-19 vaccine hesitancy in nursing students.
UNASSIGNED: In November 2022, a sample of undergraduate nursing students was recruited from several medical schools in Anhui Province, China, and an online cross-sectional survey was conducted using the questionnaire star platform (Wenjuanxin). A Chi-square test was used to explore vaccine hesitancy among nursing students with different social demographic characteristics and vaccine attitudes. Binary logistic regression analysis was then used to determine the influence factors of vaccine hesitancy among nursing students.
UNASSIGNED: A total of 1,090 valid samples were collected in this study. Of these, 27.06% (295) of nursing students reported COVID-19 vaccine hesitancy. The results showed \"the need to go out of town recently\" (OR = 0.670), \"very confident that the outbreak could be controlled sustainably\" (OR = 0.393), \"feeling at risk of infection\" (OR = 0.658), \"not being worried/being generally worried about the vaccine\'s safety\" (OR = 0.226 and OR = 0.686, respectively), and \"not being worried about the vaccine\'s effectiveness\" (OR = 0.411). These five factors are protective factors associated with COVID-19 vaccine hesitancy in nursing students. The factors \"considering the country completely safe from an outbreak\" (OR = 3.436), \"considering themselves safe because others are vaccinated\" (OR = 2.239), and \"Agreeing that other protective measures can be relaxed after vaccination with the COVID-19 vaccine\" (OR = 2.007) are risk factors associated with COVID-19 vaccine hesitancy among nursing students (P < 0.05).
UNASSIGNED: Overall, relatively few nursing students had COVID-19 vaccine hesitancy. Schools and relevant institutions still need to actively guide them to improve their confidence in the COVID-19 vaccine, strengthen the prevention and control measures of the epidemic, and improve their awareness of the crisis to improve the vaccination rate to reduce the COVID-19 vaccine hesitancy in nursing students.

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