Changes in COVID-19 vaccine acceptance rate among recovered critically Ill patients: A 12-month follow-up study

Abstract

Introduction We surveyed a cohort of patients who recovered from severe SARS-CoV-2 infection to determine the COVID-19 vaccination rate. We also compared the willingness to accept the vaccine before and after its availability to assess changes in perception and attitude towards vaccination. Materials and Methods Recovered patients with severe hypoxemic respiratory failure from SARS-CoV-2 infection treated in the ICU at Grady Memorial Hospital, Atlanta, Georgia between April 1, 2020, and June 30, 2020 were followed up over a 1-year period to assess vaccine acceptability and acceptance rates, and changes in perception towards COVID-19 vaccination before and after vaccine availability. Results A total of 98 and 93 patients completed the initial and follow up surveys respectively. During the initial survey , 41% of the patients intended to receive vaccination, 46% responded they would not accept a vaccine against COVID-19 even if it were proven to be ‘safe and effective ‘and 13% undecided. During the follow up survey, 44% of the study cohort had received at least one dose of a COVID-19 vaccine. Major reasons provided by respondents for not accepting COVID-19 vaccine were lack of trust in the effectiveness of the vaccine, pharmaceutical companies, government, vaccine technology, fear of side effects and perceived immunity against COVID-19. Respondents were more likely to be vaccinated if recommended by their physicians (OR 6.4, 95% CI 2.8 – 8.3), employers (OR 2.5, 95% CI 1.9 – 5.8), and family and friends (OR 1.6, 95% CI 1.1 – 4.5) Conclusion We found a suboptimal COVID-19 vaccination rate in a cohort of patients who recovered from severe infection. COVID-19 vaccine information and recommendation by healthcare providers, employers and family and friends may improve vaccination uptake.

Factors associated with reversals of COVID-19 vaccination willingness: Results from two longitudinal, national surveys in Japan 2021-2022

“…23 Those with annual influenza vaccine routines may have stronger faith in the benefits of vaccines, predisposing them to remain vaccine willing in the face of misinformation and mass reporting of adverse effects. Among those who have recovered from severe COVID-19 infection, the belief that one was now immune to reinfection was associated with reversal of vaccine willingness, 21 consistent with our findings. Notably, a history of having been tested and engagement in preventive measures against COVID-19 were not identified as significant predictors of vaccine hesitancy in the first round of this survey.…”

“…Our findings suggest that the higher the proportion of those in one's vicinity who are vaccinated, the lower the likelihood of becoming vaccine hesitant by the time of follow-up, which is consistent with other studies that have found reversals of vaccine hesitancy to be associated with knowing friends and family members who have been vaccinated and did not experience adverse effects. 21 Prior investigations of the determinants of vaccine hesitancy in Japan have found that a sense of collective responsibility and adherence to subjective norms were associated with a lower likelihood of being unsure or unwilling to receive a vaccine, 7,30 consistent with a culture that places a high premium on conformity. Those who were initially willing to receive vaccination despite believing there to be many disadvantages or few advantages were more easily swayed to hesitancy, suggesting that their initial willingness may have been tenuous.…”

“…Notably, there has been a dearth of data regarding the characteristics of individuals who have reversals of vaccine intention even though this population constitutes a prime target for public health messaging. In addition to a handful of other studies assessing limited population such as health care workers, 16−18 the elderly, 19 refugees, 20 COVID-19 recovered patients, 21 and people living with multiple sclerosis, 22,23 only two studies have attempted to assess vaccine changes of heart using actual vaccination as the primary outcome. Szilagyi et al (2021) assessed vaccination outcomes using longitudinal surveys in April/May and June/July 2021 and found that 17¢0% of those initially desiring vaccination became unsure or unwilling while 14¢5% of those initially unsure or unwilling became willing or already received vaccination.…”

Assessment of Attitudes, Main Concerns and Sources of Knowledge Regarding COVID-19 Vaccination in Poland in the Unvaccinated Individuals—A Nationwide Survey

“…Results from other studies on key factors are consistent with the findings we obtained. A history of influenza vaccination (which is a recommended vaccination in Poland) is a key factor that affects those willing to vaccinate against COVID-19, while concern about vaccine adverse events or lack of confidence in vaccine efficacy remain the primary factors associated with a lower willingness to vaccinate [ 62 , 63 , 64 ].…”

Characterising reasons for reversals of COVID-19 vaccination hesitancy among Japanese people: One-year follow-up survey

“….4% of those who were undecided, changed their minds and received the vaccine within a year thereafter. 15 Huang et al also found that among people with multiple sclerosis in the United Kingdom, 24.7% and 28.6% of those who responded that they would definitely not and probably not get a COVID-19 vaccine, respectively, received the vaccine within a few months thereafter. 14 On the other hand, a study by Evans et al conducted on healthcare workers in the United States demonstrated that 59.7% of those who previously reported no intention of getting vaccinated against COVID-19 and 90.6% of those who had previously been unsure were vaccinated by follow-up six months later.…”