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Perception, attitude and intention towards COVID-19 vaccination
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To overcome the situation due to pandemic (COVID-19), vaccination became essential. So, it was important to understand the overall perception, attitude and intention of respondents towards vaccination. This study aimed to investigate the combined effect of usefulness and trust on attitude towards COVID-19 vaccination and to understand the perception of vaccinated and unvaccinated people towards vaccination. Self administered questionnaire was used to collect the data. In the descriptive research design, Structural Equation Modeling was used to test the combined effect of usefulness and trust on attitude towards COVID-19 vaccination and one-way ANOVA was used to test the difference in perception of vaccinated and unvaccinated people. Simple random sampling was used in this study. The questionnaire based data were collected from 400 respondents of Haryana from April 24, 2021 to May 13, 2021. As per results, more than 70% were not vaccinated, around 16% received their first dose of vaccine and less than 15% received both doses of vaccine. Usefulness and trust had an impact on the attitude towards vaccination. There was significant difference between those who didn’t receive any dose of the vaccine i.e either Covishield (viral vector vaccine) or Covaxin (inactivated viral vaccine) and those who received both doses of the vaccine. The results reveal that attitude is strengthened by positive relation between trust and usefulness. Even though there were large number of people who were not vaccinated at the time of the survey, these people had positive perception towards the vaccine. So, they were most likely to get vaccinated in the future. It was also found that vaccine history of the respondents played an important role in future vaccination. Awareness programmes become important as people need to be well informed about the benefits of vaccination.

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Impact of COVID-19 on Influenza Virus Vaccination Coverage
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INTRODUCTION: Influenza vaccination is pivotal in alleviating healthcare burdens and possibly curbing COVID-19 infections due to symptom overlap. Despite previous suboptimal vaccination rates, the exceptional circumstances of the pandemic may have impacted Influenza vaccine coverage in 2020 and 2021. This study examines Influenza vaccination adherence from 2019 to 2021 at a private vaccination clinic in Belo Horizonte, Brazil, while considering demographic variables.

METHODS: Quantitative analytical study of a cross-sectional nature. Participants remained anonymous, identified solely by registration numbers to prevent data duplication. The sample comprised 36,478 individuals who sought the quadrivalent influenza vaccine at a private vaccination clinic in Belo Horizonte, Brazil, between January and December 2019 to 2021. Data, including vaccination date (month and year), age, and gender of participants, were collected and analyzed directly from the company's database, and correlations with the epidemiological variation of COVID-19 in the country during the period were established.

RESULTS AND DISCUSSION: Over the study period, vaccination adherence showed a steady 20.69% increase, with a noteworthy peak in vaccinations occurring in April (41.9%). The 40 to 59-year-old age group (33.4%) emerged as the most prominent, comprising a substantial portion of the workforce, putting them at considerable risk of severe COVID-19 cases. Notably, our analysis unveiled a valuable correlation between influenza vaccination and COVID-19 case notifications, indicating heightened demand for immunization during the pandemic. These findings significantly contribute to our comprehension of vaccination patterns during health crises.

CONCLUSION: This study demonstrates a notable rise in Influenza vaccination coverage during the COVID-19 pandemic. Socio-educational measures and government vaccination incentives seem to have played a significant role in this increase. Nonetheless, the substantial surge observed between 2019 and 2020 is likely linked to the population's heightened COVID-19-related apprehensions.

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Challenges faced by states and the WHO in regulating efficiently the use of mRNA vaccines

According to the World Health Organization (WHO), there is no formal regulatory guidance specifically for mRNA-based vaccines[1]. However, WHO provides information and regulatory considerations regarding key aspects of the manufacture and quality control, and nonclinical and clinical evaluation, of preventive mRNA vaccines against infectious disease for human use[2]. The global research and development of mRNA vaccines have been prodigious over the past decade, and the work in this field has been stimulated by the urgent need for rapid development of vaccines in response to an emergent disease such as the current COVID-19 pandemic[3]. In the EU no regulatory guidelines presently exist that specifically address mRNA-based vaccines. The existing regulatory framework, however, clearly defines that mRNA-based vaccines in most cases have to be centrally approved[4]. In the UK, both mRNA vaccines were granted temporary regulatory authorization under Regulation 174 of the Human Medicine Regulations 2012[5]. The potential of mRNA vaccine as a technology to rapidly respond to public health emergencies of infectious diseases, in addition to application for prophylactic vaccines for additional infectious diseases, have underscored the need for international regulatory convergence for RNA vaccines[6]. The challenges faced by states in the use of mRNA vaccines include not only regulatory gaps and but also technical issues such as the need for cold storage and transportation.

[1] Evaluation of the quality, safety and efficacy of RNA-based prophylactic vaccines for infectious diseases: regulatory considerations

[2] Messenger RNA vaccines - World Health Organization (WHO).

[3] Development of mRNA Vaccines: Scientific and Regulatory Issues.

[4] The European Regulatory Environment of RNA-Based Vaccines.

[5] Spotlight On MRNA – Regulation of MRNA Vaccines and Therapies - Life ....

[6] See: Messenger RNA vaccines - World Health Organization (WHO).; Evaluation of the quality, safety and efficacy of RNA-based ....; Development of mRNA Vaccines: Scientific and Regulatory Issues.

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Factors driving the attitudes and hesitancy of Albanian parents toward Covid-19 vaccination of children.
Published: 01 December 2023 by MDPI in The 1st International Electronic Conference on Vaccines session Vaccines and Society


The “3Cs” model of hesitancy claims that vaccine hesitancy is influenced by three factors such as complacency, convenience, and confidence which drive the acceptance or refusal of vaccines. Vaccine hesitancy is context-, time-, place- and vaccine-specific. This study aims to analyze different factors influencing perceptions and attitudes of Albanian parents toward covid-19 vaccination of children. The Anti-Covid-19 vaccine remains unapproved for children younger than 12 in Albania.


A validated questionnaire composed of 33 elements was used for the purpose of this study. The study was conducted on a sample of parents/caregivers of children aged 0 months to 18 years. There first section of the questionnaire is composed of demographic questions. The other sections aimed to collect data about economic level, political status of the country where they live, policies toward vaccination, parent’s perceptions and beliefs about covid-19 vaccines in children and access to immunization settings. The survey tool was composed of questions aimed to measure the complacency, convenience and confidence of the respondents toward Covid-2.

The data collected from the questionnaire were first coded and then studied using statistical software STATA13 and SPSS21. The data analysis was done based on 3 domains.

  1. The association of socio-demographic characteristics of parents with their perceptions regarding the safety of children's vaccines in general.
  2. The association of the experience of parents with COVID-19 disease with their perception of the safety of the Anti-Covid-19 vaccine
  3. The association of parental perceptions on COVID -19 infection with their perceptions of the safety of the Anti-Covid-19 vaccine in children

For each of these sub-divisions (sections), descriptive statistics (frequencies and percentages) and assessment of the association of different variables (socio-demographic; experience with COVID; parental perceptions on COVID) with the basic variable which is "perception of safety of the ANTI COVID 19 vaccine in children" through Pearson's chi-square test was conducted.

Then, using the multinomial regression method, the factors that influence the concrete administration of vaccination among children were analyzed. For this purpose, the following are considered as independent variables: age; the country where Albanians live; schooling; vaccination obligation in the respective state; the child's experience with COVID-19; the perceived safety of the COVID-19 vaccine (categorized in: do not agree at all; partially agree; completely agree).

Data were analyzed using the SPSS statistic program and R-project.


A total of 600 parents/caregivers responded to the questionnaire. The parents/caregivers that responded to the questionnaire were categorized in 3 groups: Albanian parents living in Albania, Albanian parents living in diaspore, Albanian parents living in Kosovo. The three groups were confronted between them in terms of perceptions and attitudes toward vaccination of children aged 0-18 years old with the SARS Cov-19 vaccine.

94.5% of the respondents were represented by mother. 52% of the respondents had a University degree and 33.1% of them had a post-graduate degree such as Doctoral studies, Master or Specialization diploma. 58% of the respondents declared to have a middle income. The age of the children in 39% of the cases was 0-2 years old, 16% of the respondents were parents of children aged 12-18 years old. 76% of the respondents declared that they would not vaccinate their child with the Covid-19 vaccine. 50% of them did not consider important the administration of covid-19 vaccine to their children.

From the regression analysis the following results were obtained

  • Parents living in Kosovo and Diaspora were more sceptic about the safety of Anti-Covid vaccines compared to parents living in Albania.
  • Parents of children aged 0-5 years old were more sceptic about the safety of Anti-Covid vaccines compared to parents of children aged more than 5 years old.
  • The possibility of getting the children vaccinated vs not getting the vaccination increases by 2.3 times if the vaccination is mandatory
  • The hesitancy of administering the vaccination to children compared to the total refusal increase es by 3 times if the vaccination is perceived as safe


From the results of this study several factors seem to influence the perceptions of parents toward Covid-19 vaccination of their children. The negative perceptions toward vaccination of their child were linked to mild form of the disease passed by their children and fear of adverse events. While access to immunization settings and economic level seemed to not influence the attitudes of parents toward vaccination. The perceived safety of the Anti-Covid-19 vaccine had a real impact on the implementation of vaccination in children: the positive perception of the safety of the Anti-Covid-19 vaccine was related to decreased refusal to administer the vaccination to children.

The negative perceptions of parents toward covid-19 vaccine seems to influence their attitude toward other childhood vaccinations, delaying the immunization time of their child which could by itself result in an increase of incidence of vaccine preventable diseases.

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Community Level Correlates of COVID-19 Booster Vaccine Hesitancy in the United States: A Cross-Sectional Analysis
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The COVID-19 vaccine was the first mRNA vaccine to receive full FDA approval. It has been shown that the novelty of mRNA vaccines significantly increases vaccine hesitancy, possibly due to the spread of misinformation on this technology. Additionally, previous research has indicated that individual-level socio-demographic factors contribute to vaccine hesitancy. However, it is unknown how community-level factors affect COVID-19 booster dose hesitancy. The current study aims to fill this knowledge gap by comparing data from a nation-wide survey on COVID-19 vaccine hesitancy with a community-level indicator i.e. Distressed Communities Index (DCI).


This cross-sectional study utilized a 48-item, psychometrically valid and reliable tool to measure attitudes toward vaccinations, vaccine literacy, COVID-19 vaccine confidence index, and trust in July 2021. A total of 2,138 survey participants residing in the United States were divided into quintiles of varying community distress levels (ranging from 1=prosperous to 5=distressed) based on their zip codes using the DCI. Data were analyzed through Chi-square, one-way ANOVA, and post-hoc analysis with Tukey’s test.


A significantly larger proportion of participants from the distressed communities had lower trust as opposed to their prosperous counterparts (26.6% vs. 37.6%, p<0.001). On the contrary, participants from the prosperous communities had the significantly higher mean scores of the vaccine confidence index as opposed to those who were living in distressed communities (2.22±1.13 vs. 1.70±1.01, p<0.001).


These findings affirm the importance of developing community-level interventions in these more vulnerable groups to promote trust in COVID-19 vaccinations, thereby increasing COVID-19 booster dose uptake. From these results, future studies can examine the efficacy of various community-level interventions in promoting vaccine confidence in communities with higher rates of vaccine hesitancy.

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Trajectory of COVID-19 Vaccine Hesitancy Post-Vaccination and Public’s Intention to Take Booster Vaccines: A Cross-Sectional Analysis

Background: Vaccine hesitancy (VH) is not a new phenomenon in Pakistan and is regarded as one of the primary causes of unsatisfactory vaccination campaigns. This study determined post-vaccination COVID-19 VH, factors influencing COVID-19 vaccine uptake, and public's intent to receive booster vaccinations.

Methods: A cross-sectional study was conducted among adult population of Lahore, Pakistan. Participants were recruited via convenience sampling between March and May 2022. SPSS version 22 was used for the data analysis.

Results: A total of 650 participants were included in the study (age = 28.1 ± 9.7 years; male-to-female ratio nearly 1: 1). The majority of participants received Sinopharm followed by Sinovac vaccine. The top three reasons of vaccine uptake were "only vaccinated individuals are allowed at the workplace, and educational institutes" (Relative importance index (RII) = 0.749), "only vaccinated people are allowed to go to markets, malls and other public places" (RII = 0.746), and "protect myself from the infection" (RII = 0.742). The mean COVID-19 VH score was 24.5 ± 6.2 (95% CI 23.9-24.9), with not being pro-vaccines and poor economic status were the significant predictors of COVID-19 vaccine hesitancy among immunized individuals (p < .05). Acceptance of booster vaccines was negatively associated with younger age and a lower level of education. Furthermore, being pro-vaccine was associated with a greater likelihood of accepting booster vaccines (p = .001).

Conclusions: The Pakistani public continues to express VH toward COVID-19 vaccines. Therefore, aggressive measures must be taken to combat the community factors that contribute to it.