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      Impact of prior SARS-CoV-2 infection on college students’ hesitancy to receive additional COVID-19 vaccine booster doses: A study from Taizhou, China

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          Highlights

          • Students were more hesitant to receive additional booster doses of the COVID-19 vaccine after secondary SARS-CoV-2 infection.

          • Males, undergraduates, non-medical majors, sophomores, and younger people were more hesitant to receive additional booster vaccinations against COVID-19 after experiencing a secondary infection.

          • Increased student hesitancy in China regarding the COVID-19 vaccine compared with before the classification of COVID-19 as a Category B for immunization.

          Abstract

          Purpose

          This study aimed to examine the impact of a history of SARS-CoV-2 infection on the hesitancy of college students to receive additional COVID-19 vaccine booster doses.

          Methods

          A population-based self-administered online survey was conducted in July 2024 in Taizhou, China. A total of 792 respondents were included in this study. Logistic regression was conducted to identify factors associated with college students’ hesitation to receive booster doses of the COVID-19 vaccine.

          Results

          Of 792 respondents, 32.2 % hesitated to receive additional doses of the COVID-19 vaccine booster. Furthermore, 23.5 % of the respondents reported an increase in hesitancy to receiving additional COVID-19 vaccine booster doses compared to before they were infected with SARS-CoV-2. In the regression analyses, college students who had a secondary infection were more hesitant to receive additional COVID-19 vaccine booster doses (OR = 0.481, 95 % CI: (0.299–0.774), P = 0.003). Moreover, students with secondary infections who were male (OR = 0.417, 95 % CI: 0.221–0.784, P = 0.007), with lower than a bachelor’s degree (OR = 0.471, 95 % CI: 0.272–0.815, P = 0.007), in non-medical majors (OR = 0.460, 95 % CI: 0.248–0.856, P = 0.014), and sophomores or below (OR = 0.483, 95 % CI: 0.286–0.817, P = 0.007) were more hesitant to receive additional COVID-19 vaccine booster doses.

          Conclusion

          A history of SARS-CoV-2 infection affects college students’ hesitation to receive additional COVID-19 vaccine booster doses, which was higher in those who experienced secondary infections.

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          Most cited references72

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          From Intentions to Actions: A Theory of Planned Behavior

          Icek Ajzen (1985)
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              Attitudes towards vaccines and intention to vaccinate against COVID-19: Implications for public health communications

              Background Negative attitudes towards vaccines and an uncertainty or unwillingness to receive vaccinations are major barriers to managing the COVID-19 pandemic in the long-term. We estimate predictors of four domains of negative attitudes towards vaccines and identify groups most at risk of uncertainty and unwillingness to receive a COVID-19 vaccine in a large sample of UK adults. Methods Data were cross-sectional and from 32,361 adults in the UCL COVID-19 Social Study. Ordinary least squares regression analyses examined the impact of socio-demographic and COVID-19 related factors on four types of negative vaccine attitudes: mistrust of vaccine benefit, worries about unforeseen effects, concerns about commercial profiteering, and preference for natural immunity. Multinomial regression examined the impact of socio-demographic and COVID-19 related factors, negative vaccine attitudes, and prior vaccine behaviour on uncertainty and unwillingness to be vaccinated for COVID-19. Findings 16% of respondents displayed high levels of mistrust about vaccines across one or more domains. Distrustful attitudes towards vaccination were higher amongst individuals from ethnic minority backgrounds, with lower levels of education, lower annual income, poor knowledge of COVID-19, and poor compliance with government COVID-19 guidelines. Overall, 14% of respondents reported unwillingness to receive a vaccine for COVID-19, whilst 23% were unsure. The largest predictors of both COVID-19 vaccine uncertainty and refusal were low-income groups (< £16,000, a year), having not received a flu vaccine last year, poor adherence to COVID-19 government guidelines, female gender, and living with children. Amongst vaccine attitudes, intermediate to high levels of mistrust of vaccine benefit and concerns about future unforeseen side effects were the most important determinants of both uncertainty and unwillingness to vaccinate against COVID-19. Interpretation Negative attitudes towards vaccines are a major public health concern in the UK. General mistrust in vaccines and concerns about future side effects in particular will be barriers to achieving population immunity to COVID-19 through vaccination. Public health messaging should be tailored to address these concerns and specifically to women, ethnic minorities, and people with lower levels of education and incomes. Funding The Nuffield Foundation [WEL/FR-000022583], the MARCH Mental Health Network funded by the Cross-Disciplinary Mental Health Network Plus initiative supported by UK Research and Innovation [ES/S002588/1], and the Wellcome Trust [221400/Z/20/Z and 205407/Z/16/Z].
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                Author and article information

                Contributors
                Journal
                Prev Med Rep
                Preventive Medicine Reports
                2211-3355
                29 March 2024
                May 2024
                29 March 2024
                : 41
                : 102709
                Affiliations
                [a ]Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
                [b ]Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
                [c ]School of Medicine, Taizhou University, 1139 Shifu Road, Jiaojiang District, Taizhou, Zhejiang 318000, China
                [d ]Enze Nursing College, Taizhou Vocational and Technical College, Taizhou, Zhejiang 318000, China
                Author notes
                [* ]Corresponding authors at: Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, 150 Ximen Street, Linhai 317000, Zhejiang Province, China (J.-S. Zhu). Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University,150 Ximen Street, Linhai 317000, Zhejiang Province, China (T.-H. Tung). ch2876@ 123456yeah.net zhuis@ 123456enzemed.com
                Article
                S2211-3355(24)00124-4 102709
                10.1016/j.pmedr.2024.102709
                10992892
                38576514
                e53c70ce-4ffd-490e-b937-6b568adc27c8
                © 2024 Published by Elsevier Inc.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 26 October 2023
                : 27 March 2024
                : 28 March 2024
                Categories
                Infectious Disease

                covid-19,vaccine hesitancy,sars-cov-2 infection,additional booster doses,college students

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