Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Vaccine. 2024 Nov 14;42 Suppl 5:126034. doi: 10.1016/j.vaccine.2024.06.002. Epub 2024 Jun 10.
BACKGROUND: Strategies to increase COVID-19 vaccine coverage require an understanding of the extent and drivers of vaccine hesitancy and trust in government related to COVID-19 vaccine programs, especially in low-resource communities. METHODS: We conducted a cross-sectional household survey post-COVID-19 vaccine introduction among adults (n = 362) in four municipalities in Sarlahi District, Nepal from August to December 2022. The survey included modules on participant demographics and socioeconomic factors and vaccine hesitancy, information seeking, and trust in authorities related to COVID-19 vaccination. RESULTS: Of the study participants, 38.4 % expressed hesitancy related to COVID-19 vaccination. The adjusted odds of being "vaccine hesitant" were significantly lower among the older adults (51+ years) relative to younger (<30 years) (aOR: 0.49, CI: 0.24-0.97) and among males relative to females (aOR: 0.51, CI: 0.26, 0.95). The study population highly trusted the government's handling of the COVID-19 pandemic. While for most, self-reported access to vaccination opportunities was high (88.4 %), 70.4 % of participants did not know if vaccines were in stock at their local vaccination facility. Commonly reported statements of misinformation include the vaccine being developed in a rush or too fast (21.5 %), COVID-19 infection can be effectively treated with ayurvedic medicine(16.3 %) and obtaining immunity from natural infection is better than through vaccination (19.9 %). The primary sources of information on COVID-19 programs were family and friends (98.6 %), healthcare professionals (67.7 %), Female Community Health Volunteers (FCHVs) (61.9 %), television (56.4 %), and radio (43.1 %). CONCLUSION: Although many respondents expressed concerns about COVID-19 effectiveness and safety, a high proportion trusted COVID-19 information provided by healthcare workers and approved of the government's response to the pandemic. This study highlights an opportunity to design new evidence-based communication strategies to improve vaccine confidence delivered through frontline government healthcare workers. Approaches could be targeted to certain communities in the region shown to have higher vaccine hesitancy, including younger people and women.
背景：为了提高 COVID-19 疫苗的接种率，需要了解与 COVID-19 疫苗接种项目相关的疫苗犹豫和对政府信任的程度和驱动因素，尤其是在资源匮乏的社区。
方法：我们在 2022 年 8 月至 12 月期间，在尼泊尔萨拉斯瓦蒂地区的四个城市对成年人（n=362）进行了 COVID-19 疫苗接种后横断面家庭调查。调查包括参与者人口统计学和社会经济因素以及与 COVID-19 疫苗接种相关的疫苗犹豫、信息寻求和对当局信任的模块。
结果：在研究参与者中，38.4%表示对 COVID-19 疫苗接种犹豫不决。与年轻人（<30 岁）相比，年龄较大的成年人（51 岁及以上）（调整后的优势比：0.49，95%置信区间：0.24-0.97）和男性（调整后的优势比：0.51，95%置信区间：0.26-0.95）接种疫苗的可能性显著降低。研究人群非常信任政府对 COVID-19 大流行的处理。虽然大多数人表示他们能够获得接种疫苗的机会（88.4%），但 70.4%的参与者不知道他们当地的接种点是否有疫苗库存。常见的错误信息包括疫苗仓促或过快开发（21.5%）、阿育吠陀药物可以有效治疗 COVID-19 感染（16.3%）以及从自然感染中获得的免疫力比通过疫苗接种更好（19.9%）。关于 COVID-19 项目的主要信息来源是家庭和朋友（98.6%）、医疗保健专业人员（67.7%）、女性社区卫生志愿者（61.9%）、电视（56.4%）和广播（43.1%）。
结论：尽管许多受访者对 COVID-19 的有效性和安全性表示担忧，但很大一部分人信任医疗保健工作者提供的 COVID-19 信息，并认可政府对大流行的应对。这项研究强调了有机会设计新的基于证据的沟通策略，通过一线政府医疗保健工作者来提高疫苗信心。可以针对该地区显示出更高疫苗犹豫率的某些社区（包括年轻人和妇女）来实施这些方法。
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