Background: In 2019, the World Health Organization declared the reluctance to vaccinate despite the availability of vaccination services as one of the top 10 threats to global health. In early 2021, self-reported reluctance to vaccinate among military personnel might have been considered a significant threat to national security. Having a choice architecture that made COVID-19 vaccination optional rather than required for military personnel could have inadvertently undermined military readiness if vaccination uptake did not reach an acceptable threshold.
Objective: The purpose of this observational study was to examine Marines' self-reported reasons for planning to decline the COVID-19 vaccine to understand their barriers to vaccination.
Methods: As the vaccination became available to 1 company of Fleet Antiterrorism Security Team (FAST) Marines in early 2021, company command required those planning to decline vaccination to write an essay with up to 5 reasons for their choice. These essays provided the data for this study. Qualitative descriptive analysis with elements from grounded theory was used to thematically categorize FAST Marines' written reasons for planning to decline the COVID-19 vaccine into a codebook describing 8 key behavioral determinants. Interrater agreement among 2 qualitatively trained researchers was very good (κ=0.81).
Results: A troop of 47 Marines provided 235 reasons why they planned to decline the COVID-19 vaccine. The most frequent reasons were difficulty understanding health information (105/235, 45%), low estimates of risk (33/235, 14%), and fear of physical discomfort (29/235, 12%). Resulting interventions directly targeted Marines' self-reported reasons by reducing barriers (eg, normalized getting the vaccine), increasing vaccine benefits (eg, improved access to base gyms and recreational facilities), and increasing nonvaccine friction (eg, required in writing 5 reasons for declining the vaccine).
Conclusions: Understanding the barriers military personnel experience toward COVID-19 vaccination remains critical as vaccine acquisition and availability continue to protect military personnel. Insights from subpopulations like FAST Marines can enhance our ability to identify barriers and appropriate intervention techniques to influence COVID-19 vaccination behaviors.
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http://dx.doi.org/10.2196/50181 | DOI Listing |
JMIR Form Res
January 2025
Vaccine Study Center, Northern California Division of Research, Kaiser Permanente, Oakland, CA, United States.
Background: Real-world COVID-19 vaccine effectiveness (VE) studies are investigating exposures of increasing complexity accounting for time since vaccination. These studies require methods that adjust for the confounding that arises when morbidities and demographics are associated with vaccination and the risk of outcome events. Methods based on propensity scores (PS) are well-suited to this when the exposure is dichotomous, but present challenges when the exposure is multinomial.
View Article and Find Full Text PDFJ Med Internet Res
January 2025
Unitat de Recerca i Innovació, Gerència d'Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain.
Background: The COVID-19 pandemic reshaped social dynamics, fostering reliance on social media for information, connection, and collective sense-making. Understanding how citizens navigate a global health crisis in varying cultural and economic contexts is crucial for effective crisis communication.
Objective: This study examines the evolution of citizen collective sense-making during the COVID-19 pandemic by analyzing social media discourse across Italy, the United Kingdom, and Egypt, representing diverse economic and cultural contexts.
PLoS One
January 2025
Department of Obstetrics and Gynecology, Nahdi Care Clinics, Jeddah, Saudi Arabia.
Introduction: Although COVID-19 vaccines have been recommended for children and adolescents since 2021, suboptimal vaccination uptake has been documented. No previous systematic review/meta-analysis (SRMA) investigated parents' willingness to administer COVID-19 vaccines for their children in Saudi Arabia. Accordingly, this SRMA aimed to estimate parents' willingness to immunize their children with COVID-19 vaccines in Saudi Arabia and to identify reasons and determinants influencing parents' decisions.
View Article and Find Full Text PDFVet Med Sci
March 2025
Department of Veterinary Medicine, National Chiayi University, Chiayi City, Taiwan.
This case report highlights a potential vaccine safety concern associated with the Pseudorabies virus (PRV) live vaccine, which warrants further investigation for comprehensive understanding. Vaccine-induced immune thrombotic thrombocytopenia (VITT), a novel syndrome of adverse events following adenovirus vector COVID-19 vaccines, was observed after vaccination with Zoetis PR-VAC PLUS. This led to a 100% morbidity and high mortality among PRV-free Danish purebred pigs from Danish Genetics Co.
View Article and Find Full Text PDFJAMA Intern Med
January 2025
Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington.
Importance: SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) contribute to many hospitalizations and deaths each year. Understanding relative disease severity can help to inform vaccination guidance.
Objective: To compare disease severity of COVID-19, influenza, and RSV among US veterans.
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