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      The public’s role in COVID-19 vaccination: human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States

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          Highlights

          • A thoughtful vaccination campaign is critical to ensure COVID-19 vaccine uptake.

          • Social, behavioral, and communication science is essential to such a campaign.

          • Meaningful messages from trusted spokespersons can crowd out misinformation.

          • COVID-19 vaccines must be available at familiar, convenient locations that feel safe.

          • Transparent decisions and public oversight mechanisms strengthen vaccine confidence.

          Abstract

          Given the social and economic upheavals caused by the COVID-19 pandemic, political leaders, health officials, and members of the public are eager for solutions. One of the most promising, if they can be successfully developed, is vaccines. While the technological development of such countermeasures is currently underway, a key social gap remains. Past experience in routine and crisis contexts demonstrates that uptake of vaccines is more complicated than simply making the technology available. Vaccine uptake, and especially the widespread acceptance of vaccines, is a social endeavor that requires consideration of human factors. To provide a starting place for this critical component of a future COVID-19 vaccination campaign in the United States, the 23-person Working Group on Readying Populations for COVID-19 Vaccines was formed. One outcome of this group is a synthesis of the major challenges and opportunities associated with a future COVID-19 vaccination campaign and empirically-informed recommendations to advance public understanding of, access to, and acceptance of vaccines that protect against SARS-CoV-2. While not inclusive of all possible steps than could or should be done to facilitate COVID-19 vaccination, the working group believes that the recommendations provided are essential for a successful vaccination program.

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          Most cited references37

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          Is Open Access

          Vaccine hesitancy: Definition, scope and determinants.

          The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.
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            Fair Allocation of Scarce Medical Resources in the Time of Covid-19

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              Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012.

              Vaccine "hesitancy" is an emerging term in the literature and discourse on vaccine decision-making and determinants of vaccine acceptance. It recognizes a continuum between the domains of vaccine acceptance and vaccine refusal and de-polarizes previous characterization of individuals and groups as either anti-vaccine or pro-vaccine. The primary aims of this systematic review are to: 1) identify research on vaccine hesitancy; 2) identify determinants of vaccine hesitancy in different settings including its context-specific causes, its expression and its impact; and 3) inform the development of a model for assessing determinants of vaccine hesitancy in different settings as proposed by the Strategic Advisory Group of Experts Working Group (SAGE WG) for dealing with vaccine hesitancy. A broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy around vaccines, was applied across multiple databases. Peer-reviewed studies were selected for inclusion if they focused on childhood vaccines [≤ 7 years of age], used multivariate analyses, and were published between January 2007 and November 2012. Our results show a variety of factors as being associated with vaccine hesitancy but they do not allow for a complete classification and confirmation of their independent and relative strength of influence. Determinants of vaccine hesitancy are complex and context-specific - varying across time, place and vaccines. Copyright © 2014 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Vaccine
                Vaccine
                Vaccine
                Published by Elsevier Ltd.
                0264-410X
                1873-2518
                29 October 2020
                29 October 2020
                Affiliations
                [a ]Johns Hopkins Center for Health Security, Baltimore, MD, USA
                [b ]Department of Anthropology, Texas State University, San Marcos, TX, USA
                [c ]Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
                [d ]In-Q-Tel, Arlington, VA, USA
                [e ]Center for Sustainable Health Care Quality and Equity, Washington, DC, USA
                [f ]Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA
                [g ]Department of Women’s and Gender Studies, University of Michigan, Ann Arbor, MI, USA
                [h ]Health Preparedness Partners, Atlanta, GA, USA
                [i ]Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
                [j ]Department of Communication, University of Maryland, College Park, MD, USA
                [k ]Yale Institute for Global Health, New Haven, CT, USA
                [l ]Yale School of Medicine, New Haven, CT, USA
                [m ]Yale School of Public Health, New Haven, CT, USA
                [n ]Emory Vaccine Center, Atlanta, GA, USA
                [o ]Emory School of Medicine, Atlanta, GA, USA
                [p ]Rollins School of Public Health, Emory University, Atlanta, GA, USA
                [q ]Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, USA
                [r ]International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
                [s ]University of Maryland, School of Public Health, College Park, MD, USA
                [t ]Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
                [u ]Department of The History of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
                [v ]Center for Medical Humanities and Social Medicine, Johns Hopkins University, Baltimore, MD, USA
                Author notes
                [* ]Corresponding author.
                Article
                S0264-410X(20)31368-2
                10.1016/j.vaccine.2020.10.059
                7598529
                33160755
                01dc3b88-4689-4949-b822-acce5cef280c
                © 2020 Published by Elsevier Ltd.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 17 August 2020
                : 16 October 2020
                : 20 October 2020
                Categories
                Article

                Infectious disease & Microbiology
                covid-19,sars-cov-2,vaccine uptake,vaccine confidence,community engagement,epidemic management/response

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