Table_1_COVID-19 Vaccine Hesitancy Associated With Vaccine Inequity Among Healthcare Workers in a Low-Income Fragile Nation.pdf

ObjectivesPreventing severe disease and acquiring population immunity to COVID-19 requires global immunization coverage through mass vaccination. While high-income countries are battling vaccine hesitancy, low-income and fragile nations are facing the double dilemma of vaccine hesitancy and lack of access to vaccines. There is inadequate information on any correlation between vaccine hesitancy and access to vaccines. Our study in a low-income nation aimed to fill this gap.
MethodsIn the backdrop of a severe shortage of COVID-19 vaccines in Yemen, a low-income fragile nation, we conducted a nation-wide cross-sectional survey among its healthcare workers (HCWs), between 6 July and 10 August 2021. We evaluated factors influencing agreement to accept a COVID-19 vaccine and any potential correlation between vaccine acceptance and lack of access to vaccines.
ResultsOverall, 61.7% (n = 975) of the 1,581 HCWs agreed to accept a COVID-19 vaccine. Only 45.4% of the participants agreed to have access to a COVID-19 vaccine, with no sex dependent variations. Although several determinants of vaccine acceptance were identified, including, having a systemic disease, following the updates about COVID-19 vaccines, complying with preventive guidelines, having greater anxiety about contracting COVID-19, previous infection with COVID-19, believing COVID-19 to be a severe disease, and lower concern about the side effects of COVID-19, the strongest was access to vaccines (OR: 3.18; 95% CI: 2.5–4.03; p-value: 0.001).
ConclusionThe immediate and more dangerous threat in Yemen toward achieving population immunity is the severe shortage and lack of access to vaccines, rather than vaccine hesitancy, meaning, improving access to vaccines could lead to greater acceptance.

研究目标：预防新型冠状病毒肺炎（COVID-19）重症、实现人群免疫，需通过大规模疫苗接种达成全球免疫接种覆盖率。当前高收入国家正面临疫苗犹豫（vaccine hesitancy）困境，而低收入脆弱国家则同时陷入疫苗犹豫与疫苗可及性不足的双重难题。目前针对疫苗犹豫与疫苗可及性之间相关性的研究数据仍较为匮乏，本研究于低收入国家开展，旨在填补这一研究空白。
研究方法：针对低收入脆弱国家也门的新冠疫苗严重短缺现状，本研究于2021年7月6日至8月10日期间，针对该国医护人员（healthcare workers, HCWs）开展了一项全国性横断面调查，评估影响新冠疫苗接种意愿的相关因素，以及疫苗接种意愿与疫苗可及性不足之间的潜在相关性。
研究结果：整体而言，1581名受访医护人员中共有61.7%（n=975）表示愿意接种新冠疫苗；仅有45.4%的受访者表示可获取新冠疫苗，且该情况无性别差异。本研究共识别出多项影响疫苗接种意愿的因素，包括：患有全身性疾病、关注新冠疫苗最新动态、遵守防疫指南、对感染新冠的焦虑程度更高、既往感染过新冠、认为新冠为重症疾病，以及对新冠疫苗不良反应的担忧程度更低；其中影响强度最高的因素为疫苗可及性（OR=3.18；95% CI：2.5~4.03；P值=0.001）。
研究结论：在也门实现人群免疫的进程中，当前更具威胁的阻碍并非疫苗犹豫，而是新冠疫苗的严重短缺与可及性不足，这意味着提升疫苗可及性可有效提高疫苗接种意愿。