The goal of this study is to explore predictors of COVID-19 vaccine hesitancy, including socio-demographic factors, comorbidity, risk perception, and experience of discrimination, in a sample of the U.S. population. We used a cross-sectional online survey study design, implemented between 13–23 December 2020. The survey was limited to respondents residing in the USA, belonging to priority groups for vaccine distribution. Responses were received from 2650 individuals (response rate 84%) from all 50 states and Puerto Rico, American Samoa, and Guam. The five most represented states were California (13%), New York (10%), Texas (7%), Florida (6%), and Pennsylvania (4%). The majority of respondents were in the age category 25–44 years (66%), male (53%), and working in the healthcare sector (61%). Most were White and non-Hispanic (66%), followed by Black and non-Hispanic (14%) and Hispanic (8%) respondents. Experience with racial discrimination was a predictor of vaccine hesitancy. Those reporting racial discrimination had 21% increased odds of being at a higher level of hesitancy compared to those who did not report such experience (OR = 1.21, 95% C.I. 1.01–1.45). Communication and logistical aspects during the COVID-19 vaccination campaign need to be sensitive to individuals’ past-experience of racial discrimination in order to increase vaccine coverage.

ImportanceImmunization programs are only successful when there are high rates of acceptance and coverage. While delivering billions of COVID 19 doses globally addressing vaccine hesitancy will be one of the most significant public health communication efforts ever undertaken.ObjectiveThe goal of this study is to explore predictors of COVID 19 vaccine hesitancy, including sociodemographic factors, comorbidity, risk perception, and experience of discrimination, in a sample of the U.S. population.DesignWe used a cross sectional online survey study design. The survey was implemented between Dec 13 and 23, 2020.SettingThe survey was limited to respondents over 18 years of age residing in the USA.ParticipantsRespondents were individuals belonging to priority groups for vaccine distribution.Main Outcome(s) and Measure(s)Respondents were asked how likely they would be to take a COVID 19 vaccine if offered at no cost within two months. Vaccine hesitancy was measured using a scale ranging from 1 (low hesitancy) to 6 (high hesitancy).ResultsResponses were received from 2,650 respondents (response rate 84%) from all 50 states and Puerto Rico, American Samoa, and Guam. The majority were in the age category between 25 and 44 years (66%), male (53%), and working in the healthcare sector (61%). Most were White and non-Hispanic (66%) respondents followed by Black non-Hispanic (14%) and Hispanic (8%) respondents. Experience with racial discrimination was a predictor of vaccine hesitancy. Those reporting racial discrimination having 21% increased odds of being at a higher level of hesitancy compared to those who did not report such experience (OR=1.21, 95% C.I. 1.01-1.45).Conclusions and RelevanceCommunication and logistical aspects during the COVID 19 vaccination campaign need to be sensitive to individuals past-experience of discrimination by identifying appropriate channels of communication and sites for vaccine distribution to reach those who may have sentiments of mistrust in the vaccination campaign.

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Despite the availability of effective vaccines that lower mortality and morbidity associated with COVID-19, many countries including Italy have adopted strict vaccination policies and mandates to increase the uptake of the COVID-19 vaccine. Such mandates have sparked debates on the freedom to choose whether or not to get vaccinated. In this study, we examined the people’s belief in vaccine choice as a predictor of willingness to get vaccinated among a sample of unvaccinated individuals in Italy. An online cross-sectional survey was conducted in Italy in May 2021. The survey collected data on respondents’ demographics and region of residence, socioeconomic factors, belief in the freedom to choose to be vaccinated or not, risk perception of contracting and transmitting the disease, previous vaccine refusal, opinion on adequacy of government measures to address the pandemic, experience in requesting and being denied government aid during the pandemic, and intent to accept COVID-19 vaccination. The analysis employed binary logistic regression models using a hierarchical model building approach to assess the association between intent to accept vaccination and belief in the freedom to choose to vaccinate, while adjusting for other variables of interest. 984 unvaccinated individuals were included in the study. Respondents who agreed that people should be free to decide whether or not to vaccinate with no restrictions on their personal life had 85% lower odds of vaccine acceptance (OR = 0.15; 95% CI, 0.09,0.23) after adjusting for demographic and socioeconomic factors and their risk perception of contracting and transmitting COVID-19. Belief in the freedom to choose whether or not to accept vaccinations was a major predictor of COVID-19 vaccine acceptance among a sample of unvaccinated individuals in Italy in May 2021. This understanding of how individuals prioritize personal freedoms and the perceived benefits and risks of vaccines, when making health care decisions can inform the development of public health outreach, educational programs, and messaging.

In the field of counter-terrorism (CT) and countering violent extremism (CVE), policymakers are in constant need of accurate data to make informed decisions to support existing programs and develop new approaches to prevent radicalization to violence. The goal of the comparative analysis in this presentation is to identify the types of data needed to assess the impact of CT and CVE programs based on each country’s policy goals. A comparative analysis of the five countries’ specific CT/CVE policies was conducted to identify common themes and data needs. The first most widely discussed theme is the need to maintain and expand collaborations and information sharing across countries—all five policies strongly emphasize the importance of such collaborative efforts. All policies address the need for strengthening collaborations at the local level, considering the important role civil society plays in the frontline response to violent extremism. In particular, the North Macedonian policy recognizes the need to fully engage in multidisciplinary interagency efforts that include civil society in the process for reconciliation of ethnic and cultural divides, educate and promote democratic values in schools and faith based communities. According to the policy documents, it can be found that there is a need for a better understanding of what types of collaborative efforts and partnerships are needed to establish effective CT and CVE programs. All policies stress the need to address a range of extremist ideologies including Jihadist, Far Left, and Far Right groups to address radicalization in the online space as well as through in-person interventions. In terms of interventions, there is a need to understand what type of training is most effective to equip frontline professionals with the knowledge and skills to intervene when individuals engaged in VE come to their attention. The United States policy is innovative with respect to the others because it introduces the concept of targeted violence. By doing so, it recognizes the importance of including situations where ideology is not a motivating factor or the motivations are unknown behind the acts of violence. The Swedish policy is distinguished by its detailed legislation supporting the prevention of terrorist acts. The UK policy emphasizes the need to contrast ideologies and views that are not aligned with UK values. All policies recognize the need for evidence on strategic efficacy and recognize the fact that programs and policies have been widely implemented without scientific proof of their effectiveness. In particular, the Canadian policy points to the need for identifying best practices that can be transferred from case to case or country to country. As an area of policy improvement across countries, there is certainly a lack of clarity on the roles and responsibilities of the many agencies that may be potentially involved in prevention efforts, still leaving a nebulous space in terms of when and how security intercepts social work and public health.