While vaccine hesitancy has become a salient issue, few studies have examined the influence of international collaboration and vaccine developments on people's attitudes towards vaccines. The international collaboration especially with China has been an integral part of the field of influenza. In recent years, attitudes towards vaccines and China are both heavily politicized in the USA with a deepening partisan divide. Republicans are more likely than Democrats to be vaccine hesitant, and they are also more likely to view China negatively. At the same time, the USA has economic, security, and medical collaboration with Japan and most Americans display a very positive view of the country. Thus, does a more international collaboration or more country-specific vaccine development have an influence on US vaccine hesitancy? This study conducts a survey-embedded question-wording experiment to assess the roles of US–China and US–Japan collaboration and partisanship in people's willingness to get the flu vaccine. Despite the previously successful and effective US–China collaboration, this study finds that respondents especially Republicans are much less likely to receive a US–China flu vaccine than a US–Japan or USA alone. Interestingly, both Democrats and Republicans are as willing to receive a US–Japan vaccine as USA alone. These results point to critical roles of partisanship and international relations.

Effective communication is essential for delivering public health messages and enabling behaviour change. Little is known about possible backfiring, or spillover effects, of COVID-19 vaccine messaging. In a study with n = 1,848 United Kingdom (UK) adults, we assess whether communication strategies that target vaccine hesitancy have any unintended, positive or negative, spillover effects on people's intention to engage in protective, compliance and prosocial behaviours. In June–July 2021, we conducted an online experiment to assess the potential spillover effects of three messages, emphasising (a) the medical benefits of COVID-19 vaccination, (b) the non-medical collective benefits of vaccination or (c) the non-medical individual benefits of holding a vaccination certificate. Exposure to different messages did not significantly affect people's intention to engage in protective, compliance, or prosocial behaviours. Instead, vaccination status (being vaccinated vs not) was positively associated with intentions to engage in protective, compliance and prosocial behaviours. Our results suggest that communication strategies that aim to increase vaccination uptake do not have any unintended effects on other health behaviours and vaccination campaigns can be tailored to specific populations to increase uptake and compliance.

There has been a lack of information on vaccine acceptance for Finnish adults. We conducted a secondary analysis of cross-sectional data collected through the Finnish Medicines Agency Medicine Barometer 2021 survey (response rate: 20.6%). We described and explained vaccine acceptance by investigating the associations between socio-demographic factors and statements using logistic regression and conducted a factor analysis. The majority of respondents (n = 2081) considered vaccines to be safe (93%), effective (97%), and important (95%). However, 20% and 14% felt they did not have enough information about vaccines and vaccine-preventable diseases (VPDs), respectively. Respondents aged 18–39 were 2.8 times more likely to disagree that they had enough information about VPDs compared to respondents aged 60–79 (p < 0.001), while respondents with poorer self-perceived health were 1.8 times more likely to declare not having enough information about vaccines (p < 0.001). We generated three-factor dimensions from the eight statements. They were related to ‘Confidence and attitudes towards vaccines’, ‘Access to information on vaccines and VPDs’, and ‘Debate on vaccine issues’, which may reflect the underlying thinking patterns. Access to and understanding of information about vaccines and VPDs need to be improved for Finnish adults to increase vaccine acceptance and uptake, thus preventing the spread of VPDs.

The Malaysian Government has initiated the National COVID-19 Immunisation Programme, known as PICK, to be a national strategy for addressing the spread of the coronavirus disease (COVID-19) pandemic across the country. Although the government intensified public awareness to increase program registration, the total number that registered in the state of Sabah, located in East Malaysia, was relatively low during August 2021, accounting for only 42.9% as compared to that of Peninsular Malaysia. Therefore, this paper examines the public perception toward the PICK program in Sabah based on 4 main components: safety, communication, psychology, and milieu. This study is based on the empirical findings drawn from 1024 respondents across Sabah using online Google Form surveys. This study adopts 5 methodologies for data analysis by using K-means clustering, mean score, Mann–Whitney U test, spatial analysis, and frequency analysis. It has been revealed that the percentage of respondents (categorized as Cluster 1) who have a negative perception toward the vaccination program is higher (55.9%) than those who have a positive perception (44.1%). This study further discovered that Cluster 1 has shown high skepticism regarding the vaccination program, which can be explained through the communication component (M = 3.33, SD = 0.588), especially Co2, Co3, Co1, and Co4. Following the communication factor, a chain of negative perceptions also affects other components such as safety, psychology, and milieu among Cluster 1, all of which contribute to poor participation in the PICK program. The study outcomes are extremely useful for informing local authorities to establish policies related to public interests, primarily in the areas of public health. Understanding the community’s perspectives and their obstacles in participating in such programs may assist local authorities in developing or implementing public policies and campaigns that ensure such related public programs can be conducted more effectively in the future.

This systematic review and meta-analysis aims to estimate the prevalence of coronavirus disease 2019 (COVID-19) vaccine hesitancy in Turkey, which can aid future health policies and strategies. A comprehensive search was conducted on various databases using keywords related to COVID-19 vaccine hesitancy in Turkey. Quality assessment was performed using Joanna Briggs Institute (JBI) checklist for prevalence studies. Data extraction was conducted. The random effect model (DerSimonian and Laird method) was used in pooled prevalence data analysis (95% confidence interval [CI]). A total of 1,072 articles were identified. After removing duplicates and excluding articles, 61 articles remained for bias assessment. Among these, 19 articles with low risk of bias were included in the review and meta-analysis. Total population included in the analysis was 15,164, vaccine hesitancy was 30.5% (95% Cl: 24.3–36.8%). Prevalence of the vaccine hesitancy was found to be 39.8% (95% Cl: 31.4–48.2%) in studies conducted before the initiation of vaccination, while in studies conducted after the commencement of vaccination, hesitancy was 20.4% (95% Cl: 12.9–28%). We suggest conducting high-quality studies in different populations to understand the level of vaccine hesitancy, as many of the previous studies have mainly focused on healthcare workers and students, and rest were community-based studies, which have generally shown high bias. Also, we suggest that early vaccination can reduce vaccine hesitancy.

Some vaccine-hesitant people lack epistemic trust in the COVID-19 vaccine recommendation that because vaccines have been shown to be medically safe and effective, one ought to get vaccinated. Citing what I call exception information, they claim that whatever the general safety and efficacy of vaccines, the vaccines may not be safe and effective for them. Examples include parents citing information about their children's health, pregnant women's concerns about the potential adverse effects of treatment on pregnant women, young people citing their relative invulnerability to extreme COVID-19 symptoms, or members of vulnerable racial groups citing epistemic injustice, such as a lack of representation in COVID-19 vaccine trials. This paper examines the extent to which a lack of epistemic trust in vaccine recommendations, based on such exemption information, is rational.

A new COVID-19 vaccine was introduced in a remarkably short period of time. Public and healthcare workers (HCWs) were concerned about the safety of the vaccine, especially in light of the use of new technologies. A review regarding attitudes towards COVID-19 vaccination found a 22.5% hesitancy rate among HCWs. Online anonymous questionnaires were delivered using a web-based surveying platform to community HCWs in a central district in Israel from 3 to 19 January 2021. The real COVID-19 vaccination data were collected between the beginning of the vaccination rollout and the end of the month after the survey as well as the real vaccination rate among the general population. Of the 3,172 HCWs, 549 (17%) responded to the questionnaire. The highest positive attitude towards the vaccine was among physicians (95%), while nurses showed the highest level of hesitation (14%) for a specific sector (P < 0.05). However, the real vaccination rates were similar among physicians (63%) and nurses (62%). Surprisingly, the total vaccination rate of HCWs was substantially lower (52%) than that of the general population (71%). The main vaccination motivators were the social and economic effects of the COVID-19 epidemic. Focused strategies to reduce the level of hesitancy among HCWs are needed.

This study investigated determinants of the willingness to get vaccinated in India and examined the relationship between engagement in preventive behaviours and vaccine uptake intent. A large-scale online survey covering aspects of COVID-19 preventive behaviours, vaccination status, moral emotions, trust in others, role models, and socio-demographics was used. A total of 953 Indians participated in the survey between May and June 2021, of which 770 contained valid data on vaccination status. Past preventive health behaviours (PHBs) such as avoiding social gatherings, higher interpersonal trust, and moral emotions were robustly associated with the willingness to take a COVID-19 vaccine. Results also showed that unvaccinated individuals were less likely to follow other PHBs, like wearing a mask; past COVID-19 infection status was associated with similar lower adherence to PHBs. Given the strong associations between positive moral emotions, like gratitude, and vaccine uptake intent (especially in the unvaccinated subsample), targeted communication interventions can boost uptake intent, and subsequently vaccine uptake, in jurisdictions with low vaccination rates.

This study investigated Coronavirus disease 2019 (COVID-19) vaccine acceptance, and compared the potential factors influencing vaccine acceptance and hesitancy between public university (PuU) and private university (PrU) students in Bangladesh. An anonymous, self-administered questionnaire was sent to 640 PuU and 660 PrU students in Google Form between 25th September and 22nd November 2021, which resulted in the participation of 1034 (461 PuU vs. 573 PrU) respondents (response rate: 72.03% vs. 86.81%). The pooled vaccine acceptance rates among PuU and PrU students were almost similar (88.1%, 95% confidence interval (CI) 85.1–91.1 vs. 87.6%, 95% CI 84.6–90.6). Employing binary logistic regression to assess the association between various potential factors and vaccine acceptance, the study revealed that out of 10 predictors, ‘safety’ and ‘efficacy’ had highly significant positive associations with vaccine acceptance in both cohorts (P = 0.000, P = 0.005). ‘Political roles’ was found to have varied effects– a significant (P = 0.02) negative and a significant positive (P = 0.002) association with vaccine acceptance in PuU and PrU students, respectively. Additionally, ‘communication’ (P = 0.003) and ‘trust’ (P = 0.01) were found to have significant positive associations in PrU students while ‘rumours’ (P = 0.03) had negative association in PuU students. The odds of accepting the COVID-19 vaccine were 1.5 vs. 0.9 in PuU and PrU students. Although chi-square analysis did not show any significant association between gender and vaccine acceptance, discrepancies were found in the factors that potentially affect vaccine uptake decision between PuU and PrU students. COVID-19 vaccine uptake may be improved if vaccine-related information becomes available and is communicated to large numbers of people effectively. The implementation of multidisciplinary interventional educational programmes may also be considered as a preferred approach to improve student's engagement in pandemic awareness and vaccine readiness.

Public distrust in the US pandemic response has significantly hindered its effectiveness. In this community-based participatory research mixed-methods study, based on two datasets, we examined how distrust in COVID-19 vaccines relates to institutional distrust. We found that the Johnson & Johnson vaccine pause undermined trust in COVID-19 vaccines in general. Findings also suggest that vaccine distrust developed after participating in a study on COVID-19 testing. Increased distrust may be an unintended consequence of how healthcare and public health activities are presented and delivered, and research participation is structured. Both will continue without proactively addressing the root causes of distrust.