Trajectory of COVID-19 Vaccine Hesitancy Over Time and Association of Initial Vaccine Hesitancy With Subsequent Vaccination

Siegler, Aaron J; Luisi, Nicole; Hall, Eric W.; Bradley, Heather; Sanchez, Travis; Lopman, Benjamin A.; Sullivan, Patrick S.

doi:10.1001/jamanetworkopen.2021.26882

Cited by 84 publications

(86 citation statements)

References 3 publications

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“…The additional fact that a quarter (25.1%) of the unvaccinated group was willing to take the booster dose demonstrates the dynamic nature of vaccine hesitancy and the potential to change the minds of a proportion of the vaccine hesitant group. In a previous cohort study of individuals who were hesitant to the COVID-19 vaccine in late 2020, 32% reported receiving at least one dose, and another 37% would likely be vaccinated when re-assessed in early 2021 [45]. Perhaps, with a targeted vaccination campaign focused on those who are persuadable within hesitant groups, vaccination uptake (and eventual booster uptake) could be increased.…”

Section: Discussionmentioning

confidence: 99%

Assessing Acceptability of COVID-19 Vaccine Booster Dose among Adult Americans: A Cross-Sectional Study

et al. 2021

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Given the emergence of breakthrough infections, new variants, and concerns of waning immunity from the primary COVID-19 vaccines, booster shots emerged as a viable option to shore-up protection against COVID-19. Following the recent authorization of vaccine boosters among vulnerable Americans, this study aims to assess COVID-19 vaccine booster hesitancy and its associated factors in a nationally representative sample. A web-based 48-item psychometric valid survey was used to measure vaccine literacy, vaccine confidence, trust, and general attitudes towards vaccines. Data were analyzed through Chi-square (with a post hoc contingency table analysis) and independent-sample t-/Welch tests. Among 2138 participants, nearly 62% intended to take booster doses and the remaining were COVID-19 vaccine booster hesitant. The vaccine-booster-hesitant group was more likely to be unvaccinated (62.6% vs. 12.9%) and did not intend to have their children vaccinated (86.1% vs. 27.5%) compared to their non-hesitant counterparts. A significantly higher proportion of booster dose hesitant individuals had very little to no trust in the COVID-19 vaccine information given by public health/government agencies (55% vs. 12%) compared to non-hesitant ones. The mean scores of vaccine confidence index and vaccine literacy were lower among the hesitant group compared to the non-hesitant group. Compared to the non-hesitant group, vaccine hesitant participants were single or never married (41.8% vs. 28.7%), less educated, and living in a southern region of the nation (40.9% vs. 33.3%). These findings underscore the need of developing effective communication strategies emphasizing vaccine science in ways that are accessible to individuals with lower levels of education and vaccine literacy to increase vaccination uptake.

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Section: Discussionmentioning

confidence: 99%

Assessing Acceptability of COVID-19 Vaccine Booster Dose among Adult Americans: A Cross-Sectional Study

et al. 2021

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“…Last, self-reported information about a previous SARS-CoV-2 infection or vaccination could bias study outcome. However, recent studies have found a good correlation between self-reported and administrative records with 98% consistency for vaccination type and 95% for vaccination date or detection of SARS-CoV-2 antibodies with a positive predictive value of 98.2% and a negative predictive value of 97.3%, respectively ( 71 , 72 ). Additionally, our data on persistence and magnitude of vaccine-induced humoral responses is consistent with several other cohort-based studies ( 11 , 20 , 41 , 66 ) which did not rely on self-reported vaccination records, therefore stressing the validity of our approach.…”

Section: Discussionmentioning

confidence: 99%

Comparative Magnitude and Persistence of Humoral SARS-CoV-2 Vaccination Responses in the Adult Population in Germany

et al. 2022

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Recent increases in SARS-CoV-2 infections have led to questions about duration and quality of vaccine-induced immune protection. While numerous studies have been published on immune responses triggered by vaccination, these often focus on studying the impact of one or two immunisation schemes within subpopulations such as immunocompromised individuals or healthcare workers. To provide information on the duration and quality of vaccine-induced immune responses against SARS-CoV-2, we analyzed antibody titres against various SARS-CoV-2 antigens and ACE2 binding inhibition against SARS-CoV-2 wild-type and variants of concern in samples from a large German population-based seroprevalence study (MuSPAD) who had received all currently available immunisation schemes. We found that homologous mRNA-based or heterologous prime-boost vaccination produced significantly higher antibody responses than vector-based homologous vaccination. Ad26.CoV2S.2 performance was particularly concerning with reduced titres and 91.7% of samples classified as non-responsive for ACE2 binding inhibition, suggesting that recipients require a booster mRNA vaccination. While mRNA vaccination induced a higher ratio of RBD- and S1-targeting antibodies, vector-based vaccines resulted in an increased proportion of S2-targeting antibodies. Given the role of RBD- and S1-specific antibodies in neutralizing SARS-CoV-2, their relative over-representation after mRNA vaccination may explain why these vaccines have increased efficacy compared to vector-based formulations. Previously infected individuals had a robust immune response once vaccinated, regardless of which vaccine they received, which could aid future dose allocation should shortages arise for certain manufacturers. Overall, both titres and ACE2 binding inhibition peaked approximately 28 days post-second vaccination and then decreased.

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“…25 This shift has been precipitated by signi cant voluntary refusal of the vaccine as well as vaccine and mask mandates. 26,27 We believe much can be learned by replicating our study at a different time point within the pandemic to examine the shifts in medical student and physician attitudes resulting from the changing healthcare landscape.…”

Section: Future Directionsmentioning

confidence: 93%

A Qualitative Exploration of Medical Student Empathy During the COVID-19 Pandemic

Ellison

Pruzinsky

2021

Preprint

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BackgroundThere is evidence that medical student self-reported empathy may decline as one progresses through their clinical training. Due to the unprecedented changes to both patient care and medical education caused by COVID-19, it is reasonable to assume that medical student empathy may be impacted. The goal of this July 2020 study was to qualitatively explore how the COVID-19 pandemic might affect medical students’ reported experience of empathy.MethodUsing a semi-structured interview, the authors interviewed 12 medical students, 6 second-year and 6 fourth-year. They selected these groups because of the distinct differences in their clinical experience. ResultsData analysis identified 5 major themes: 1) Expanded Perspective (e.g., a feeling of “we’re in this together”, increased awareness of patient vulnerability) 2) Moral Dilemmas (e.g., difficult decisions faced by students as a result of the pandemic such as weighing educational vs. family responsibilities, students risking their own health to provide the best possible care) 3) Confirmation of Values (e.g., Feeling reaffirmed in decision to enter medicine, feeling the pandemic was “what we signed up for” by entering medical school) 4) Shaping Priorities (e.g., changes in medical specialty or populations of interest) 5) Barriers to Empathy and Adaptive Strategies (e.g., COVID-19 created many physical, psychological, and social barriers to empathy for students, students presented many strategies for ameliorating these barriers). Five students (42%) reported increased empathy with no students reporting a decrease in empathy due to experiences during the pandemic. Conclusions Participants did not report that their personal experience of empathy for patients was negatively influenced by the COVID-19 pandemic. Many reported that their empathy increased. The observed differences in responses by pre-clinical (second-year) and clinical (fourth-year) students suggests a possible shift in how empathy is experienced and practiced as one progresses through their medical education. The overwhelmingly positive responses to the semi-structured interview, emphasizing appreciation of the opportunity to discuss topics not previously openly discussed, underscores the importance of providing explicit opportunities for students to discuss their emotional/interpersonal experiences within medical education, particularly in difficult times such as the COVID-19 pandemic.

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Trajectory of COVID-19 Vaccine Hesitancy Over Time and Association of Initial Vaccine Hesitancy With Subsequent Vaccination

Cited by 84 publications

References 3 publications

Assessing Acceptability of COVID-19 Vaccine Booster Dose among Adult Americans: A Cross-Sectional Study

Assessing Acceptability of COVID-19 Vaccine Booster Dose among Adult Americans: A Cross-Sectional Study

Comparative Magnitude and Persistence of Humoral SARS-CoV-2 Vaccination Responses in the Adult Population in Germany

A Qualitative Exploration of Medical Student Empathy During the COVID-19 Pandemic

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