COVID-19 vaccination is an effective intervention preventing individuals from contracting SARS-CoV-2 or transmitting the virus to others. However, in many countries, vaccine hesitancy has impeded the progress of mass vaccination to reach herd immunity. This study aimed to understand the similarities and differences in the determinants of COVID-19 vaccine hesitancy in Taiwan, the United States, the Netherlands, and Haiti. A qualitative study was conducted by face-to-face interviews with participants in Taiwan and remote online interviews with participants in the United States, the Netherlands, and Haiti. In total, 47 interviews were conducted. A reflective thematic analysis was employed to analyze the collected data. Distrust of COVID-19 vaccines was reported by the participants in all countries. A perception of a lack of necessity or urgency to be vaccinated was reported by the Taiwanese and Haitian participants. Lack of knowledge regarding COVID-19 vaccines was reported by the Taiwanese, U.S. and Haitian participants, contributing to hesitation or refusal to vaccination. Regarding misinformation and rumors, misinformation was found among a few Taiwanese and Dutch participants. Additionally, rumors concerning COVID-19 vaccines were mentioned by the Dutch and Haitian participants. Furthermore, a lack of verified information was reported by the participants in all four countries. Overall, the current study suggests that vaccine hesitancy exists among participants in Taiwan, the United States, the Netherlands, and Haiti. Building trust in the COVID-19 vaccine, cultivating vaccine literacy, clarifying misinformation and rumors concerning COVID-19 vaccines, and providing verified information are critical for increasing public acceptance of the COVID-19 vaccine.
Low-income countries, such as Haiti, are facing challenges in fighting the COVID-19 pandemic due to resource shortages and fragile healthcare systems. This study assessed the functional capacity and preparedness of the Haitian healthcare system regarding the COVID-19 pandemic. It employed a narrative review approach to analyze secondary data and used the Donabedian model and the global health security index as the theoretical frameworks to evaluate preparedness. The findings reveal that Haiti faces challenges in tackling the COVID-19 pandemic due to a lack of biosafety and biosecurity regulations, inadequate laboratory systems for COVID-19 testing, and shortages of human resources and personal protective equipment. Moreover, poverty remains widespread, and people lack access to clean water and sanitation services, resulting in a high risk of COVID-19 infection. Furthermore, a lack of communication, rumors, the circulation of fake news regarding COVID-19, and stigmatization cause distrust and reduce the number of people seeking healthcare services. Haiti faces challenges with respect to tackling the pandemic. The Haitian government can strengthen and improve the capacity of the healthcare system to fight against the COVID-19 pandemic and infectious diseases emerging in the future.
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