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Studies related to the COVID-19 vaccine hesitancy are scanty in Bangladesh, despite the growing necessity of understanding the population behavior related to vaccination. Thus, the present study was conducted to assess the prevalence of the COVID-19 vaccine hesitancy and its associated factors in Bangladesh to fill the knowledge gap. This study adopted a cross-sectional design to collect data from 1497 respondents using online (Google forms) and face-to-face interviews from eight administrative divisions of Bangladesh between 1-7 February 2021. We employed descriptive statistics and multiple logistic regression analysis. The prevalence of vaccine hesitancy was 46.2%. The Muslims (aOR = 1.80, p ≤ 0.01) and the respondents living in the city corporation areas (aOR = 2.14, p ≤0.001) had more hesitancy. There was significant variation in vaccine hesitancy by administrative divisions (geographic regions). Compared to the Sylhet division, the participants from Khulna (aOR = 1.31, p ≤0.001) had higher hesitancy. The vaccine hesitancy tended to decrease with increasing knowledge about the vaccine (aOR = 0.88, p≤0.001) and the vaccination process (aOR = 0.91, p ≤ 0.01). On the other hand, hesitancy increased with the increased negative attitudes towards the vaccine (aOR = 1.17, p≤0.001) and conspiracy beliefs towards the COVID-19 vaccine (aOR = 1.04, p≤0.01). The perceived benefits of COVID-19 vaccination (aOR = 0.85, p≤0.001) were negatively associated with hesitancy, while perceived barriers (aOR = 1.16, p ≤0.001) were positively associated. The participants were more hesitant to accept the vaccine from a specific country of origin (India, USA, Europe). Our findings warrant that a vigorous behavior change communication campaign should be designed and implemented to demystify negative public attitudes and conspiracy beliefs regarding the COVID-19 Vaccine in Bangladesh. The policymakers should also think about revisiting the policy of the online registration process to receive the COVID-19 vaccine, as online registration is a key structural barrier for many due to the persistent digital divide in the country. Finally, the government should consider the population's preference regarding vaccines' country of manufacture to reduce the COVID-19 vaccine hesitancy.

COVID-19 has disproportionately affected Black individuals in the US; however, vaccination rates among Black individuals trail those among other racial groups. This disparity is often attributed to a high level of vaccine hesitancy among Black individuals, but few studies have examined changes in vaccine hesitancy over time. To compare changes in vaccine hesitancy between Black and White individuals in the US and to examine mechanisms that might help explain the observed differences. This survey study used 7 waves of data collected using a panel design. A total of 1200 English-speaking adults in the US were recruited from a nonprobability online panel to construct a census-matched sample. Participants were contacted monthly between December 9, 2020, and June 16, 2021. The main outcome of interest was self-reported vaccination intention, measured on a 6-point scale (where 1 indicates extremely unlikely and 6 indicates extremely likely). Beliefs about the safety, effectiveness, and necessity of COVID-19 vaccines were measured on a 5-point Likert scale, with higher scores denoting greater agreement. The baseline data included 1200 participants (693 women [52.0%; weighted]; 921 White individuals [64.0%; weighted], 107 Black individuals [12.2%; weighted]; weighted mean [SD] age, 49.5 [17.6] years). The survey participation rate was 57.0% (1264 of 2218). Black and White individuals had comparable vaccination intentions in December 2020, but Black individuals experienced larger increases in vaccination intention than White individuals relative to baseline in March 2021 (b = 0.666; P < .001), April 2021 (b = 0.890; P < .001), May 2021 (b = 0.695; P < .001), and June 2021 (b = 0.709; P < .001). The belief that the vaccines are necessary for protection also increased more among Black than White individuals in March 2021 (b = 0.221; P = .01) and April 2021 (b = 0.187; P = .04). Beliefs that the vaccines are safe and effective (b = 0.125; P < .001) and necessary (b = 0.405; P < .001) were positively associated with vaccination intention. There was no evidence that these associations varied by race. This survey study suggests that the intention of Black individuals to be vaccinated was initially comparable to that of White individuals but increased more rapidly. There is some evidence that this increase is associated with changes in beliefs about the vaccine. Vaccination rates continue to be lower among Black individuals than White individuals, but these results suggest that this might be less likely the result of vaccine hesitancy than other factors.

The state of Arizona has experienced one of the highest novel coronavirus disease 2019 (COVID-19) positivity test rates in the United States with disproportionally higher case rates and deaths among African-American/Black (AA/B), American Indian/Alaska Native (Native), and Hispanic/Latinx (HLX) individuals. To reduce disparities and promote health equity, researchers from Arizona State University, Mayo Clinic in Arizona, Northern Arizona University, and the University of Arizona formed a partnership with community organizations to conduct state-wide community-engaged research and outreach. This report describes results from 34 virtually-held focus groups and supplemental survey responses conducted with 153 AA/B, HLX, and Native community members across Arizona to understand factors associated with COVID-19 vaccine hesitancy and confidence. Focus groups revealed common themes of vaccine hesitancy stemming from past experiences of research abuses (e.g., Tuskegee syphilis experiment) as well as group-specific factors. Across all focus groups, participants strongly recommended the use of brief, narrative vaccination testimonials from local officials, community members, and faith leaders to increase trust in science, vaccine confidence and to promote uptake.

Understanding factors associated with hesitancy about pediatric COVID-19 vaccination is important for identifying strategies to improve vaccination rates. Our objective was to describe beliefs about COVID-19 vaccination among caregivers who had not yet vaccinated their children against COVID-19. From July 2022 to February 2023, caregivers of children unvaccinated for COVID-19 across 15 states within the IDeA States Pediatrics Clinical Trial Network were recruited into a randomized, controlled trial of a COVID-19 vaccine communication phone app. Recruitment sites served high numbers of children from rural areas or of backgrounds other than non-Hispanic White. At baseline, caregivers answered questions from the SAGE Vaccine Hesitancy Scale (VHS), and questions about trusted sources of information about COVID-19. We compared responses by rurality, race, and ethnicity using chi-square tests, and used multivariable modeling of a composite outcome of summed VHS scores to identify factors associated with vaccine hesitancy. A total of 725 caregivers were randomized; 512 completed the baseline survey. Many caregivers lived in a rural area (34.9 %) and nearly half were of non-White race (47.3 %). Over 80 % somewhat or strongly agreed that vaccines are important, that childhood vaccines are effective, and that vaccination is a good way to protect children from disease. Rural caregivers were more likely than non-rural caregivers to state that they generally do what their doctor recommends with regard to childhood vaccines (46.93 % vs. 37.00 %, p < .0021). In the multivariable model, the combined group of Asian, Native Hawaiian, Other Pacific Islander or multiracial caregivers, and Black or African American caregivers, had a higher vaccine hesitancy compared to White caregivers (25.25, 25.91, 22.50 respectively) (p < .0001). As we navigate work to build vaccine confidence, this study provides support for additional directions of study to better understand particular populations and could be further reproduced to look at intentions with other vaccines.

Parental vaccine hesitancy is a global public health issue that leads to lower immunization coverage among children. While vaccine mistrust is increased among racialized adults, whether parental vaccine hesitancy differs by ethnicity in the era of COVID-19 is unknown. Addressing these gaps in the literature, this study explores the factors influencing vaccine hesitancy among a racially diverse and representative sample of Canadian parents of children aged 0 to 12, comparing perspectives across different racial groups. An online survey was administered to a nationally representative sample of Arab, Asian, Black, Indigenous, White, and Mixed-race parents from October to November 2023. Data were collected on demographics, COVID-19 vaccine hesitancy, experience of major racial discrimination, conspiracy beliefs and health literacy. A total of 2528 parents (57.52 % women, 42.29 % men, and 0.20 % identified as non-binary gender) completed the survey. Significant mean differences in vaccine hesitancy were observed among racialized groups, F(7, 2520) = 3.89, p < .001, with Arab parents (M = 23.73, SD = 7.46) reporting higher hesitancy than White parents (M = 21.28, SD = 8.59). Younger participants (14–24 years) showed greater hesitancy (M = 23.98, SD = 8.22) than those aged 55+ (M = 20.26, SD = 7.83), F(4, 2523) = 2.84, p = .023. Regression analyses indicated that conspiracy beliefs (β = 0.48, p < .001) and racial discrimination (β = 0.09, p = .012) are key predictors of vaccine hesitancy. A significant interaction between conspiracy beliefs and discrimination was found among racialized groups (β = 0.24, p < .001). Based on these results, addressing vaccine hesitancy requires nuanced, participatory approaches that foster trust, counter misinformation, and acknowledge systemic racial inequities. As, health literacy, conspiracy beliefs, and racial discrimination significantly shape parental decisions, future policies must integrate culturally and racially tailored strategies to promote vaccination, ensuring that every child in Canada is protected.

From the beginning of the COVID-19 pandemic, the potential impact on Indigenous (First Nations, Métis and Inuit) communities in Canada was a major concern. Evidence from previous pandemics, particularly H1N1, suggested that more cases and poorer outcomes among Indigenous Peoples was likely and that there might be barriers to Indigenous Peoples' vaccination. In this short report we consider the non-vaccination decisions of a sample of unvaccinated Métis Nation of Ontario citizens. A small sample of six Métis individuals who had chosen not to receive the COVID-19 vaccine was recruited using referral and interviewed online. Participants expressed low confidence in COVID-19 vaccines, and cited safety concerns as the primary reason. Low confidence was in government and media was a major concern, and respondents referred to historical treatment of Indigenous peoples as reasons for suspicion. We discuss this continuing mistrust and its implications for future pandemic response.

Background People with HIV (PWH) from racial and ethnic minority groups in the United States (US) face a high risk for severe COVID-19 outcomes and have low uptake of the COVID-19 vaccine primary series and booster doses. This study aims to provide insights into barriers and facilitators to vaccination and identify strategies to increase vaccine trust and uptake in these populations. Methods Between November and December 2022, we conducted qualitative interviews with 24 vaccinated and unvaccinated adult PWH who self-identified as Hispanic/Latinx, Black/African American, or Haitian, and were clients of the Miami-Dade County Ryan White HIV/AIDS Program in Florida, US. Data were analyzed using deductive thematic analysis. Results Main barriers to vaccine uptake reported by participants included low or no perception of COVID-19 risk, concerns about safety and efficacy related to HIV status, mistrust of COVID-19 vaccines, general vaccine hesitancy, negative experiences and advice against vaccination within social networks, lack of provider recommendation, and exposure to negative messaging and misinformation about vaccines. Facilitators included perceived risk, awareness of the vaccines’ protective benefits for HIV-immunocompromised individuals and reducing transmission, encouragement and role modeling within social networks, provider recommendation, and exposure to accurate information from reputable sources. Some recommended strategies to increase uptake and trust in vaccines included incorporating vaccination into routine HIV care, leveraging peers with HIV, tailoring vaccine information and messaging, and partnering with trusted individuals for outreach. Conclusion Vaccination efforts for PWH should prioritize addressing specific barriers and concerns related to their HIV status and tailoring strategies to meet their needs.

Previous research has revealed lower vaccination rates among Black communities relative to other racial-ethnic communities in North America. However, there remains a gap in understanding the motivational barriers contributing to these persistent disparities. Grounded in Self-Determination Theory, the current research aimed to examine the effects of different motivations for vaccine acceptance across population groups (autonomous, controlled, and amotivation). The current investigation involved two survey studies conducted in the United States and Canada during the second year of the COVID-19 pandemic. Study 1 was cross-sectional and included 623 Americans (60.4 % female). Study 2 was a prospective longitudinal study of 413 Canadians (54 % female; Mage = 47.6, SD = 17.9). In both studies, Black adults reported significantly lower levels of vaccination (MBlack = 1.15 vs. MNon-Black = 1.48 in Study 1; MBlack = 2.25 vs. MNon-Black = 2.63 in Study 2), lower autonomous motivation, and higher distrust-based amotivation compared to individuals from other population groups. In the cross-sectional study, autonomous motivation (β = 0.45, p < .001) was positively associated with vaccine uptake while distrust-based amotivation (β = −0.23, p < .001) was negatively associated with vaccine uptake. In the longitudinal study, distrust-based amotivation (β = −0.11, p < .01) was associated with vaccination uptake for all groups, while lower autonomous motivation (b = 0.17, p < .01) and higher controlled motivation (b = −0.14, p < .05) were associated with lower vaccine uptake among Black individuals. These findings suggest that while addressing distrust-based amotivation at the institutional and systemic level to promote utilization of vaccination services is essential across all population groups, tailored public health interventions and policies that foster a sense of autonomy over one's healthcare decisions may play a particularly significant role for Black adults in supporting vaccine acceptance and uptake.

Vaccine hesitancy is a complex issue influenced by many interacting factors. While literature on its contributing causes continues to expand, there is limited research on the contextual and cultural dynamics that shape vaccine hesitancy among African-born individuals in Canada. Identifying and understanding these factors is critical in developing targeted health interventions that address specific barriers to vaccination within this community. The study aims to explore the unique socio-cultural and context-specific elements of vaccine hesitancy among African community members living in Canada. The study will use a mixed-methods approach to investigate vaccine hesitancy among African community members living in Southwestern Ontario. In the qualitative study, we will conduct semi-structured interviews and participatory focus groups within each of the selected study areas: London, Windsor and Chatham-Kent. The qualitative data will be collected, transcribed and then analyzed thematically using NVivo 12. For the quantitative study, we will provide participants with surveys to accurately assess the predictors of vaccine hesitancy. The quantitative data will be analyzed using logistic regression to explore how socio-cultural influences, trust, and accessible information impact vaccine hesitancy. This study addresses a significant gap in existing literature by providing cultural and contextual insights on the drivers of vaccine hesitancy among African-born individuals. Using a mix-method design, the study offers a rich understanding of the influences shaping vaccine decision-making. The findings will support the development of health policies and interventions aimed at improving overall health outcomes for African communities within Canada.

While disparities in COVID-19 vaccine confidence, mistrust, hesitancy, and uptake are well documented, the perception of vaccine efficacy remains understudied in Canada. This study investigates racial differences in COVID-19 vaccine efficacy perception and examines associated factors across Arab, Asian, Black, Indigenous, and White populations. A representative sample of 4220 participants (2358 women) aged 16 and older completed measures assessing perception of COVID-19 vaccine efficacy, conspiracy beliefs, health literacy, and racial discrimination in healthcare settings. Data were collected through a randomly selected online panel in October 2023. The overall mean vaccine efficacy perception score was 17.1 (SD = 4.5), with significant variation across racial groups (F(6, 4213) = 8.0, p < .001). Asian participants (M = 18.4; SD = 3.1) reported higher scores compared to Arab (M = 17.0; SD = 4.3), Black (M = 17.2; SD = 4.3), Indigenous (M = 16.4; SD = 5.2), and White (M = 17.1; SD = 4.4) participants. The most important factors associated with vaccine efficacy perception were conspiracy beliefs (β = −0.32, p < .001), health literacy (β = 0.07, p < .001), and the number of vaccine doses in White individuals. Conspiracy beliefs (β = −0.19, p < .001), higher education (β = 0.28, p < .001), health literacy (β = 0.16, p < .001), more vaccine doses (β = 1.61, p < .001), and experiences of racial discrimination in healthcare prior to accounting for conspiracy beliefs (β = −0.10, p < .05) were the most important factors for racialized individuals. This study highlights significant differences in COVID-19 vaccine efficacy perceptions across racial groups. The findings underscore the impact of factors such as conspiracy beliefs, health literacy, education level, age, and racial discrimination in healthcare on vaccine efficacy perceptions. Public health strategies should address misinformation, prioritize health literacy, and promote anti-racist practices in healthcare to improve vaccine confidence and acceptance.