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  • Published: 14 May 2021

Public attitudes toward COVID-19 vaccination: The role of vaccine attributes, incentives, and misinformation

  • Sarah Kreps 1 ,
  • Nabarun Dasgupta 2 ,
  • John S. Brownstein 3 , 4 ,
  • Yulin Hswen 5 &
  • Douglas L. Kriner   ORCID: orcid.org/0000-0002-9353-2334 1  

npj Vaccines volume  6 , Article number:  73 ( 2021 ) Cite this article

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While efficacious vaccines have been developed to inoculate against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; also known as COVID-19), public vaccine hesitancy could still undermine efforts to combat the pandemic. Employing a survey of 1096 adult Americans recruited via the Lucid platform, we examined the relationships between vaccine attributes, proposed policy interventions such as financial incentives, and misinformation on public vaccination preferences. Higher degrees of vaccine efficacy significantly increased individuals’ willingness to receive a COVID-19 vaccine, while a high incidence of minor side effects, a co-pay, and Emergency Use Authorization to fast-track the vaccine decreased willingness. The vaccine manufacturer had no influence on public willingness to vaccinate. We also found no evidence that belief in misinformation about COVID-19 treatments was positively associated with vaccine hesitancy. The findings have implications for public health strategies intending to increase levels of community vaccination.

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Introduction.

In less than a year, an array of vaccines was developed to bring an end to the SARS-CoV-2 pandemic. As impressive as the speed of development was the efficacy of vaccines such as Moderna and Pfizer, which are over 90%. Despite the growing availability and efficacy, however, vaccine hesitancy remains a potential impediment to widespread community uptake. While previous surveys indicate that overall levels of vaccine acceptance may be around 70% in the United States 1 , the case of Israel may offer a cautionary tale about self-reported preferences and vaccination in practice. Prospective studies 2 of vaccine acceptance in Israel showed that about 75% of the Israeli population would vaccinate, but Israel’s initial vaccination surge stalled around 42%. The government, which then augmented its vaccination efforts with incentive programs, attributed unexpected resistance to online misinformation 3 .

Research on vaccine hesitancy in the context of viruses such as influenza and measles, mumps, and rubella, suggests that misinformation surrounding vaccines is prevalent 4 , 5 . Emerging research on COVID-19 vaccine preferences, however, points to vaccine attributes as dominant determinants of attitudes toward vaccination. Higher efficacy is associated with greater likelihood of vaccinating 6 , 7 , whereas an FDA Emergency Use Authorization 6 or politicized approval timing 8 is associated with more hesitancy. Whether COVID-19 misinformation contributes to vaccine preferences or whether these attributes or policy interventions such as incentives play a larger role has not been studied. Further, while previous research has focused on a set of attributes that was relevant at one particular point in time, the evidence and context about the available vaccines has continued to shift in ways that could shape public willingness to accept the vaccine. For example, governments, employers, and economists have begun to think about or even devise ways to incentivize monetarily COVID-19 vaccine uptake, but researchers have not yet studied whether paying people to receive the COVID-19 vaccine would actually affect likely behavior. As supply problems wane and hesitancy becomes a limiting factor, understanding whether financial incentives can overcome hesitancy becomes a crucial question for public health. Further, as new vaccines such as Johnson and Johnson are authorized, knowing whether the vaccine manufacturer name elicits or deters interest in individuals is also important, as are the corresponding efficacy rates of different vaccines and the extent to which those affect vaccine preferences. The purpose of this study is to examine how information about vaccine attributes such as efficacy rates, the incidence of side effects, the nature of the governmental approval process, identity of the manufacturers, and policy interventions, including economic incentives, affect intention to vaccinate, and to examine the association between belief in an important category of misinformation—false claims concerning COVID-19 treatments—and willingness to vaccinate.

General characteristics of study population

Table 1 presents sample demographics, which largely reflect those of the US population as a whole. Of the 1335 US adults recruited for the study, a convenience sample of 1100 participants consented to begin the survey, and 1096 completed the full questionnaire. The sample was 51% female; 75% white; and had a median age of 43 with an interquartile range of 31–58. Comparisons of the sample demographics to those of other prominent social science surveys and U.S. Census figures are shown in Supplementary Table 1 .

Vaccination preferences

Each subject was asked to evaluate a series of seven hypothetical vaccines. For each hypothetical vaccine, our conjoint experiment randomly assigned values of five different vaccine attributes—efficacy, the incidence of minor side effects, government approval process, manufacturer, and cost/financial inducement. Descriptions of each attribute and the specific levels used in the experiment are summarized in Table 2 . After seeing the profile of each vaccine, the subject was asked whether she would choose to receive the vaccine described, or whether she would choose not to be vaccinated. Finally, subjects were asked to indicate how likely they would be to take the vaccine on a seven-point likert scale.

Across all choice sets, in 4419 cases (58%) subjects said they would choose the vaccine described in the profile rather than not being vaccinated. As shown in Fig. 1 , several characteristics of the vaccine significantly influenced willingness to vaccinate.

figure 1

Circles present the estimated effect of each attribute level on the probability of a subject accepting vaccination from the attribute’s baseline level. Horizontal lines through points indicate 95% confidence intervals. Points without error bars denote the baseline value for each attribute. The average marginal component effects (AMCEs) are the regression coefficients reported in model 1 of Table 3 .

Efficacy had the largest effect on individual vaccine preferences. An efficacy rate of 90% increased uptake by about 20% relative to the baseline at 50% efficacy. Even a high incidence of minor side effects (1 in 2) had only a modest negative effect (about 5%) on willingness to vaccinate. Whether the vaccine went through full FDA approval or received an Emergency Use Authorization (EUA), an authority that allows the Food and Drug Administration mechanisms to accelerate the availability and use of treatments or medicines during medical emergencies 9 , significantly influenced willingness to vaccinate. An EUA decreased the likelihood of vaccination by 7% compared to a full FDA authorization; such a decline would translate into about 23 million Americans. While a $20 co-pay reduced the likelihood of vaccination relative to a no-cost baseline, financial incentives did not increase willingness to vaccinate. Lastly, the manufacturer had no effect on vaccination attitudes, despite the public pause of the AstraZeneca trial and prominence of Johnson & Johnson as a household name (our experiment was fielded before the pause in the administration of the Johnson & Johnson shot in the United States).

Model 2 of Table 3 presents an expanded model specification to investigate the association between misinformation and willingness to vaccinate. The primary additional independent variable of interest is a misinformation index that captures the extent to which each subject believes or rejects eight claims (five false; three true) about COVID-19 treatments. Additional analyses using alternate operationalizations of the misinformation index yield substantively similar results (Supplementary Table 4 ). This model also includes a number of demographic control variables, including indicators for political partisanship, gender, educational attainment, age, and race/ethnicity, all of which are also associated with belief in misinformation about the vaccine (Supplementary Table 2 ). Finally, the model also controls for subjects’ health insurance status, past experience vaccinating against seasonal influenza, attitudes toward the pharmaceutical industry, and beliefs about vaccine safety generally.

Greater levels of belief in misinformation about COVID-19 treatments were not associated with greater vaccine hesitancy. Instead, the relevant coefficient is positive and statistically significant, indicating that, all else being equal, individuals who scored higher on our index of misinformation about COVID-19 treatments were more willing to vaccinate than those who were less susceptible to believing false claims.

Strong beliefs that vaccines are safe generally was positively associated with willingness to accept a COVID-19 vaccine, as were past histories of frequent influenza vaccination and favorable attitudes toward the pharmaceutical industry. Women and older subjects were significantly less likely to report willingness to vaccinate than men and younger subjects, all else equal. Education was positively associated with willingness to vaccinate.

This research offers a comprehensive examination of attitudes toward COVID-19 vaccination, particularly the role of vaccine attributes, potential policy interventions, and misinformation. Several previous studies have analyzed the effects of vaccine characteristics on willingness to vaccinate, but the modal approach is to gauge willingness to accept a generic COVID-19 vaccine 10 , 11 . Large volumes of research show, however, that vaccine preferences hinge on specific vaccine attributes. Recent research considering the influence of attributes such as efficacy, side effects, and country of origin take a step toward understanding how properties affect individuals’ intentions to vaccinate 6 , 7 , 8 , 12 , 13 , but evidence about the attributes of actual vaccines, debates about how to promote vaccination within the population, and questions about the influence of misinformation have moved quickly 14 .

Our conjoint experiment therefore examined the influence of five vaccine attributes on vaccination willingness. The first category of attributes involved aspects of the vaccine itself. Since efficacy is one of the most common determinants of vaccine acceptance, we considered different levels of efficacy, 50%, 70%, and 90%, levels that are common in the literature 7 , 15 . Evidence from Phase III trials suggests that even the 90% efficacy level in our design, which is well above the 50% threshold from the FDA Guidance for minimal effectiveness for Emergency Use Authorization 16 , has been exceeded by both Pfizer’s and Moderna’s vaccines 17 , 18 . The 70% efficacy threshold is closer to the initial reports of the efficacy of the Johnson & Johnson vaccine, whose efficacy varied across regions 19 . Our analysis suggests that efficacy levels associated with recent mRNA vaccine trials increases public vaccine uptake by 20% over a baseline of a vaccine with 50% efficacy. A 70% efficacy rate increases public willingness to vaccinate by 13% over a baseline vaccine with 50% efficacy.

An additional set of epidemiological attributes consisted of the frequency of minor side effects. While severe side effects were plausible going into early clinical trials, evidence clearly suggests that minor side effects are more common, ranging from 10% to 100% of people vaccinated depending on the number of doses and the dose group (25–250 mcg) 20 . Since the 100 mcg dose was supported in Phase III trials 21 , we include the highest adverse event probability—approximating 60% as 1 in 2—and 1 in 10 as the lowest likelihood, approximating the number of people who experienced mild arthralgia 20 . Our findings suggest that a the prevalence of minor side effects associated with recent trials (i.e. a 1 in 2 chance), intention to vaccinate decreased by about 5% versus a 1 in 10 chance of minor side effects baseline. However, at a 25% rate of minor side effects, respondents did not indicate any lower likelihood of vaccination compared to the 10% baseline. Public communications about how to reduce well-known side effects, such as pain at the injection site, could contribute to improved acceptance of the vaccine, as it is unlikely that development of vaccine-related minor side effects will change.

We then considered the effect of EUA versus full FDA approval. The influenza H1N1 virus brought the process of EUA into public discourse 22 , and the COVID-19 virus has again raised the debate about whether and how to use EUA. Compared to recent studies also employing conjoint experimental designs that showed just a 3% decline in support conditional on EUA 6 , we found decreases in support of more than twice that with an EUA compared to full FDA approval. Statements made by the Trump administration promising an intensely rapid roll-out or isolated adverse events from vaccination in the UK may have exacerbated concerns about EUA versus full approval 8 , 23 , 24 , 25 . This negative effect is even greater among some subsets of the population. As shown in additional analyses reported in the Supplementary Information (Supplementary Fig. 5 ), the negative effects are greatest among those who believe vaccines are generally safe. Among those who believe vaccines generally are extremely safe, the EUA decreased willingness to vaccinate by 11%, all else equal. This suggests that outreach campaigns seeking to assure those troubled by the authorization process used for currently available vaccines should target their efforts on those who are generally predisposed to believe vaccines are safe.

Next, we compared receptiveness as a function of the manufacturer: Moderna, Pfizer, Johnson and Johnson, and AstraZeneca, all firms at advanced stages of vaccine development. Vaccine manufacturers in the US have not yet attempted to use trade names to differentiate their vaccines, instead relying on the association with manufacturer reputation. In other countries, vaccine brand names have been more intentionally publicized, such as Bharat Biotech’s Covaxin in India and Gamaleya Research Institute of Epidemiology and Microbiology Sputnik V in Russia. We found that manufacturer names had no impact on willingness to vaccinate. As with hepatitis and H. influenzae vaccines 26 , 27 , interchangeability has been an active topic of debate with coronavirus mRNA vaccines which require a second shot for full immunity. Our research suggests that at least as far as public receptiveness goes, interchangeability would not introduce concerns. We found no significant differences in vaccination uptake across any of the manufacturer treatments. Future research should investigate if a manufacturer preference develops as new evidence about efficacy and side effects becomes available, particularly depending on whether future booster shots, if needed, are deemed interchangeable with the initial vaccination.

Taking up the question of how cost and financial incentives shape behavior, we looked at paying and being paid to vaccinate. While existing research suggests that individuals are often willing to pay for vaccines 28 , 29 , some economists have proposed that the government pay individuals up to $1,000 to take the COVID-19 vaccine 30 . However, because a cost of $300 billion to vaccinate the population may be prohibitive, we posed a more modest $100 incentive. We also compared this with a $10 incentive, which previous studies suggest is sufficient for actions that do not require individuals to change behavior on a sustained basis 31 . While having to pay a $20 co-pay for the vaccine did deter individuals, the additional economic incentives had no positive effect although they did not discourage vaccination 32 . Consistent with past research 31 , 33 , further analysis shows that the negative effect of the $20 co-pay was concentrated among low-income earners (Supplementary Fig. 7 ). Financial incentives failed to increase vaccination willingness across income levels.

Our study also yields important insights into the relationship between one prominent category of COVID-19 misinformation and vaccination preferences. We find that susceptibility to misinformation about COVID-19 treatments—based on whether individuals can distinguish between factual and false information about efforts to combat COVID-19—is considerable. A quarter of subjects scored no higher on our misinformation index than random guessing or uniform abstention/unsure responses (for the full distribution, see Supplementary Fig. 2 ). However, subjects who scored higher on our misinformation index did not exhibit greater vaccination hesitancy. These subjects actually were more likely to believe in vaccine safety more generally and to accept a COVID-19 vaccine, all else being equal. These results run counter to recent findings of public opinion in France where greater conspiracy beliefs were negatively correlated with willingness to vaccinate against COVID-19 34 and in Korea where greater misinformation exposure and belief were negatively correlated with taking preventative actions 35 . Nevertheless, the results are robust to alternate operationalizations of belief in misinformation (i.e., constructing the index only using false claims, or measuring misinformation beliefs as the number of false claims believed: see Supplementary Table 4 ).

We recommend further study to understand the observed positive relationship between beliefs in COVID-19 misinformation about fake treatments and willingness to receive the COVID-19 vaccine. To be clear, we do not posit a causal relationship between the two. Rather, we suspect that belief in misinformation may be correlated with an omitted factor related to concerns about contracting COVID-19. For example, those who believe COVID-19 misinformation may have a higher perception of risk of COVID-19, and therefore be more willing to take a vaccine, all else equal 36 . Additional analyses reported in the Supplementary Information (Supplementary Fig. 6 ) show that the negative effect of an EUA on willingness to vaccinate was concentrated among those who scored low on the misinformation index. An EUA had little effect on the vaccination preferences of subjects most susceptible to misinformation. This pattern is consistent with the possibility that these subjects were more concerned with the disease and therefore more likely to vaccinate, regardless of the process through which the vaccine was brought to market.

We also observe that skepticism toward vaccines in general does not correlate perfectly with skepticism toward the COVID-19 vaccine. Therefore, it is important not to conflate people who are wary of the COVID-19 vaccine and those who are anti-vaccination, as even medically informed individuals may be hesitant because of the speed at which the COVID-19 vaccine was developed. For example, older people are more likely to believe vaccines are safe but less willing to receive the COVID-19 vaccine in our survey, perhaps following the high rates of vaccine skepticism among medical staff expressing concerns regarding the safety of a rapidly-developed vaccine 2 . This inverse relationship between age and willingness to vaccinate is also surprising. Most opinion surveys find older adults are more likely to vaccinate than younger adults 37 . However, most of these survey questions ask about willingness to take a generic vaccine. Two prior studies, both recruiting subjects from the Lucid platform and employing conjoint experiments to examine the effects of vaccine attributes on public willingness to vaccinate, also find greater vaccine hesitancy among older Americans 6 , 7 . Future research could explore whether these divergent results are a product of the characteristics of the sample or of the methodological design in which subjects have much more information about the vaccines when indicating their vaccination preferences.

An important limitation of our study is that it necessarily offers a snapshot in time, specifically prior to both the election and vaccine roll-out. We recommend further study to understand more how vaccine perceptions evolve both in terms of the perceived political ownership of the vaccine—now that President Biden is in office—and as evidence has emerged from the millions of people who have been vaccinated. Similarly, researchers should consider analyzing vaccine preferences in the context of online vaccine controversies that have been framed in terms of patient autonomy and right to refuse 38 , 39 . Vaccination mandates may evoke feelings of powerlessness, which may be exacerbated by misinformation about the vaccines themselves. Further, researchers should more fully consider how individual attributes such as political ideology and race intersect with vaccine preferences. Our study registered increased vaccine hesitancy among Blacks, but did not find that skepticism was directly related to misinformation. Perceptions and realities of race-based maltreatment could also be moderating factors worth exploring in future analyses 40 , 41 .

Overall, we found that the most important factor influencing vaccine preferences is vaccine efficacy, consistent with a number of previous studies about attitudes toward a range of vaccines 6 , 42 , 43 . Other attributes offer potential cautionary flags and opportunities for public outreach. The prospect of a 50% likelihood of mild side effects, consistent with the evidence about current COVID-19 vaccines being employed, dampens likelihood of uptake. Public health officials should reinforce the relatively mild nature of the side effects—pain at the injection site and fatigue being the most common 44 —and especially the temporary nature of these effects to assuage public concerns. Additionally, in considering policy interventions, public health authorities should recognize that a $20 co-pay will likely discourage uptake while financial incentives are unlikely to have a significant positive effect. Lastly, belief in misinformation about COVID-19 does not appear to be a strong predictor of vaccine hesitancy; belief in misinformation and willingness to vaccinate were positively correlated in our data. Future research should explore the possibility that exposure to and belief in misinformation is correlated with other factors associated with vaccine preferences.

Survey sample and procedures

This study was approved by the Cornell Institutional Review Board for Human Participant Research (protocol ID 2004009569). We conducted the study on October 29–30, 2020, prior to vaccine approval, which means we captured sentiments prospectively rather than based on information emerging from an ongoing vaccination campaign. We recruited a sample of 1096 adult Americans via the Lucid platform, which uses quota sampling to produce samples matched to the demographics of the U.S. population on age, gender, ethnicity, and geographic region. Research has shown that experimental effects observed in Lucid samples largely mirror those found using probability-based samples 45 . Supplementary Table 1 presents the demographics of our sample and comparisons to both the U.S. Census American Community Survey and the demographics of prominent social science surveys.

After providing informed consent on the first screen of the online survey, participants turned to a choice-based conjoint experiment that varied five attributes of the COVID-19 vaccine. Conjoint analyses are often used in marketing to research how different aspects of a product or service affect consumer choice. We build on public health studies that have analyzed the influence of vaccine characteristics on uptake within the population 42 , 46 .

Conjoint experiment

We first designed a choice-based conjoint experiment that allowed us to evaluate the relative influence of a range of vaccine attributes on respondents’ vaccine preferences. We examined five attributes summarized in Table 2 . Past research has shown that the first two attributes, efficacy and the incidence of side effects, are significant drivers of public preferences on a range of vaccines 47 , 48 , 49 , including COVID-19 6 , 7 , 13 , 50 . In this study, we increased the expected incidence of minor side effects from previous research 6 to reflect emerging evidence from Phase III trials. The third attribute, whether the vaccine received full FDA approval or an EUA, examines whether the speed of the approval process affects public vaccination preferences 6 . The fourth attribute, the manufacturer of the vaccine, allows us to examine whether the highly public pause in the AstraZeneca trial following an adverse event, and the significant differences in brand familiarity between smaller and less broadly known companies like Moderna and household name Johnson & Johnson affects public willingness to vaccinate. The fifth attribute examines the influence of a policy tool—offsetting the costs of vaccination or even incentivizing it financially—on public willingness to vaccinate.

Attribute levels and attribute order were randomly assigned across participants. A sample choice set is presented in Supplementary Fig. 1 . After viewing each profile individually, subjects were asked: “If you had to choose, would you choose to get this vaccine, or would you choose not to be vaccinated?” Subjects then made a binary choice, responding either that they “would choose to get this vaccine” or that they “would choose not to be vaccinated.” This is the dependent variable for the regression analyses in Table 3 . After making a binary choice to take the vaccine or not be vaccinated, we also asked subjects “how likely or unlikely would you be to get the vaccine described above?” Subjects indicated their vaccination preference on a seven-point scale ranging from “extremely likely” to “extremely unlikely.” Additional analyses using this ordinal dependent variable reported in Supplementary Table 3 yield substantively similar results to those presented in Table 3 .

To determine the effect of each attribute-level on willingness to vaccinate, we followed Hainmueller, Hopkins, and Yamamoto and employed an ordinary least squares (OLS) regression with standard errors clustered on respondent to estimate the average marginal component effects (AMCEs) for each attribute 51 . The AMCE represents the average difference in a subject choosing a vaccine when comparing two different attribute values—for example, 50% efficacy vs. 90% efficacy—averaged across all possible combinations of the other vaccine attribute values. The AMCEs are nonparametrically identified under a modest set of assumptions, many of which (such as randomization of attribute levels) are guaranteed by design. Model 1 in Table 3 estimates the AMCEs for each attribute. These AMCEs are illustrated in Fig. 1 .

Analyzing additional correlates of vaccine acceptance

To explore the association between respondents’ embrace of misinformation about COVID-19 treatments and vaccination willingness, the survey included an additional question battery. To measure the extent of belief in COVID-19 misinformation, we constructed a list of both accurate and inaccurate headlines about the coronavirus. We focused on treatments, relying on the World Health Organization’s list of myths, such as “Hand dryers are effective in killing the new coronavirus” and true headlines such as “Avoiding shaking hands can help limit the spread of the new coronavirus 52 .” Complete wording for each claim is provided in Supplementary Appendix 1 . Individuals read three true headlines and five myths, and then responded whether they believed each headline was true or false, or whether they were unsure. We coded responses to each headline so that an incorrect accuracy assessment yielded a 1; a correct accuracy assessment a -1; and a response of unsure was coded as 0. From this, we created an additive index of belief in misinformation that ranged from -8 to 8. The distribution of the misinformation index is presented in Supplementary Fig. 2 . A possible limitation of this measure is that because the survey was conducted online, some individuals could have searched for the answers to the questions before responding. However, the median misinformation index score for subjects in the top quartile in terms of time spent taking the survey was identical to the median for all other respondents. This may suggest that systematic searching for correct answers is unlikely.

To ensure that any association observed between belief in misinformation and willingness to vaccinate is not an artifact of how we operationalized susceptibility to misinformation, we also constructed two alternate measures of belief in misinformation. These measures are described in detail in the Supplementary Information (see Supplementary Figs. 3 and 4 ). Additional regression analyses using these alternate measures of misinformation beliefs yield substantively similar results (see Supplementary Table 4 ). Additional analyses examining whether belief in misinformation moderates the effect of efficacy and an FDA EUA on vaccine acceptance are presented in Supplementary Fig. 6 .

Finally, model 2 of Table 3 includes a range of additional control variables. Following past research, it includes a number of demographic variables, including indicator variables identifying subjects who identify as Democrats or Republicans; an indicator variable identifying females; a continuous variable measuring age (alternate analyses employing a categorical variable yield substantively similar results); an eight-point measure of educational attainment; and indicator variables identifying subjects who self-identify as Black or Latinx. Following previous research 6 , the model also controlled for three additional factors often associated with willingness to vaccinate: an indicator variable identifying whether each subject had health insurance; a variable measuring past frequency of influenza vaccination on a four-point scale ranging from “never” to “every year”; beliefs about the general safety of vaccines measured on a four-point scale ranging from “not at all safe” to “extremely safe”; and a measure of attitudes toward the pharmaceutical industry ranging from “very positive” to “very negative.”

Reporting summary

Further information on research design is available in the Nature Research Reporting Summary linked to this article.

Data availability

All data and statistical code to reproduce the tables and figures in the manuscript and Supplementary Information are published at the Harvard Dataverse via this link: 10.7910/DVN/ZYU6CO.

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Acknowledgements

S.K. and D.K. would like to thank the Cornell Atkinson Center for Sustainability for financial support.

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Sarah Kreps & Douglas L. Kriner

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S.K. and D.K. designed the experiment/survey instrument and conducted the statistical analysis. S.K., N.D., J.B., Y.H., and D.K. all contributed to the conceptual design of the research and to the writing of the paper.

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Kreps, S., Dasgupta, N., Brownstein, J.S. et al. Public attitudes toward COVID-19 vaccination: The role of vaccine attributes, incentives, and misinformation. npj Vaccines 6 , 73 (2021). https://doi.org/10.1038/s41541-021-00335-2

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What you need to know about covid-19 vaccines, answers to the most common questions about coronavirus vaccines..

COVID-19 vaccine questions

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Vaccines save millions of lives each year. The development of safe and effective COVID-19 vaccines are a crucial step in helping us get back to doing more of the things we enjoy with the people we love.

We’ve gathered the latest expert information to answer some of the most common questions about COVID-19 vaccines. Keep checking back as we will update this article as more information becomes available.

What are the benefits of getting vaccinated?

Vaccines save millions of lives each year and a COVID-19 vaccine could save yours. The COVID-19 vaccines are safe and effective, providing strong protection against serious illness and death. WHO reports that unvaccinated people have at least 10 times higher risk of death from COVID-19 than someone who has been vaccinated. 

It is important to be vaccinated as soon as it’s your turn, even if you already had COVID-19. Getting vaccinated is a safer way for you to develop immunity from COVID-19 than getting infected.

The COVID-19 vaccines are highly effective, but no vaccine provides 100 per cent protection. Some people will still get ill from COVID-19 after vaccination or pass the virus onto someone else. 

Therefore, it is important to continue practicing safety precautions to protect yourself and others, including avoiding crowded spaces, physical distancing, hand washing and wearing a mask.

Who should be vaccinated first?

Each country must identify priority populations, which WHO recommends are frontline health workers (to protect health systems) and those at highest risk of death due to COVID-19, such as older adults and people with certain medical conditions. Other essential workers, such as teachers and social workers, should then be prioritized, followed by additional groups as more vaccine doses become available.

The risk of severe illness from COVID-19 is very low amongst healthy children and adolescents, so unless they are part of a group at higher risk of severe COVID-19, it is less urgent to vaccinate them than these priority groups.

Children and adolescents who are at higher risk of developing severe illness from COVID-19, such as those with underlying illnesses, should be prioritized for COVID-19 vaccines.  

When shouldn’t you be vaccinated against COVID-19?

If you have any questions about whether you should receive a COVID-19 vaccine, speak to your healthcare provider. At present, people with the following health conditions should not receive a COVID-19 vaccine to avoid any possible adverse effects:

  • If you have a history of severe allergic reactions to any ingredients of a COVID-19 vaccine.
  • If you are currently sick or experiencing symptoms of COVID-19 (although you can get vaccinated once you have recovered and your doctor has approved).

Should I get vaccinated if I already had COVID-19?

Yes, you should get vaccinated even if you’ve previously had COVID-19. While people who recover from COVID-19 may develop natural immunity to the virus, it is still not certain how long that immunity lasts or how well it protects you against COVID-19 reinfection. Vaccines offer more reliable protection, especially against severe illness and death. Vaccination policies after COVID-19 infection vary by country. Check with your health care provider on the recommendation where you live.

Which COVID-19 vaccine is best for me?

All WHO-approved vaccines have been shown to be highly effective at protecting you against severe illness and death from COVID-19. The best vaccine to get is the one most readily available to you.

You can find a list of those approved vaccines on WHO’s site .  

Remember, if your vaccination involves two doses, it’s important to receive both to have the maximum protection. 

How do COVID-19 vaccines work?

Vaccines work by mimicking an infectious agent – viruses, bacteria or other microorganisms that can cause a disease. This ‘teaches’ our immune system to rapidly and effectively respond against it.

Traditionally, vaccines have done this by introducing a weakened form of an infectious agent that allows our immune system to build a memory of it. This way, our immune system can quickly recognize and fight it before it makes us ill. That’s how some of the COVID-19 vaccines have been designed.

Other COVID-19 vaccines have been developed using new approaches, which are called messenger RNA, or mRNA, vaccines. Instead of introducing antigens (a substance that causes your immune system to produce antibodies), mRNA vaccines give our body the genetic code it needs to allow our immune system to produce the antigen itself. mRNA vaccine technology has been studied for several decades. They contain no live virus and do not interfere with human DNA.

For more information on how vaccines work, please visit WHO .

Are COVID-19 vaccines safe?

Yes, COVID-19 vaccines have been safely used to vaccinate billions of people. The COVID-19 vaccines were developed as rapidly as possible, but they had to go through rigorous testing in clinical trials to prove that they meet internationally agreed benchmarks for safety and effectiveness. Only if they meet these standards can a vaccine receive validation from WHO and national regulatory agencies.

UNICEF only procures and supplies COVID-19 vaccines that meet WHO’s established safety and efficacy criteria and that have received the required regulatory approval.

How were COVID-19 vaccines developed so quickly?

Scientists were able to develop safe effective vaccines in a relatively short amount of time due to a combination of factors that allowed them to scale up research and production without compromising safety: 

  • Because of the global pandemic, there was a larger sample size to study and tens of thousands of volunteers stepped forward 
  • Advancements in technology (like mRNA vaccines) that were years in the making 
  • Governments and other bodies came together to remove the obstacle of funding research and development 
  • Manufacturing of the vaccines occurred in parallel to the clinical trials to speed up production 

Though they were developed quickly, all COVID-19 vaccines approved for use by the WHO are safe and effective.

What are the side effects of COVID-19 vaccines?

Vaccines are designed to give you immunity without the dangers of getting the disease. Not everyone does, but it’s common to experience some mild-to-moderate side effects that go away within a few days on their own.

Some of the mild-to-moderate side effects you may experience after vaccination include:

  • Arm soreness at the injection site
  • Muscle or joint aches

You can manage any side effects with rest, staying hydrated and taking medication to manage pain and fever, if needed.

If any symptoms continue for more than a few days then contact your healthcare provider for advice. More serious side effects are extremely rare, but if you experience a more severe reaction, then contact your healthcare provider immediately.

>> Read: What you need to know before, during and after receiving a COVID-19 vaccine

How do I find out more about a particular COVID-19 vaccine?

You can find out more about COVID-19 vaccines on WHO’s website .  

Can I stop taking precautions after being vaccinated?

Keep taking precautions to protect yourself, family and friends if there is still COVID-19 in your area, even after getting vaccinated. The COVID-19 vaccines are highly effective against serious illness and death, but no vaccine is 100% effective.  

The vaccines offer less protection against infection from the Omicron variant, which is now the dominant variant globally, but remain highly effective in preventing hospitalization, severe disease, and death. In addition to vaccination, it remains important to continue practicing safety precautions to protect yourself and others. These precautions include avoiding crowded spaces, physical distancing, hand washing, and wearing a mask (as per local policies).  

Can I still get COVID-19 after I have been vaccinated? What are ‘breakthrough cases’?

A number of vaccinated people may get infected with COVID-19, which is called a breakthrough infection. In such cases, people are much more likely to only have milder symptoms. Vaccine protection against serious illness and death remains strong.

With more infectious virus variants such as Omicron, there have been more breakthrough infections. That’s why it's recommended to continue taking precautions such as avoiding crowded spaces, wearing a mask and washing your hands regularly, even if you are vaccinated. 

And remember, it’s important to receive all of the recommended doses of vaccines to have the maximum protection.

How long does protection from COVID-19 vaccines last?

According to WHO, the effectiveness of COVID-19 vaccines wanes around 4-6 months after the primary series of vaccination has been completed. Taking a booster to strengthen your protection against serious disease is recommended if it is available to you. 

Do the COVID-19 vaccines protect against variants?

The WHO-approved COVID-19 vaccines continue to be highly effective at preventing severe illness and death.

However, the vaccines offer less protection against infection from Omicron, which is the dominant variant globally. That's why it's important to get vaccinated and continue measures to reduce the spread of the virus – which helps to reduce the chances for the virus to mutate – including physical distancing, mask wearing, good ventilation, regular handwashing and seeking care early if you have symptoms. 

Do I need to get a booster shot?  

Booster doses play an important role in protecting against severe disease, hospitalization and death. 

WHO recommends that you take all COVID-19 vaccine doses recommended to you by your health authority as soon as it is your turn, including a booster dose if recommended. 

Booster shots should be given first to high priority groups. Data shows that a booster shot plays a significant role in boosting waning immunity and protecting against severe disease from highly transmissible variants like Omicron. 

If available, an additional second booster shot is also recommended for some groups of people, 4-6 months after the first booster. That includes older people, those who have weakened immune systems, pregnant women and healthcare workers. 

Check with your local health authorities for guidance and the availability of booster shots where you live.  

What do we know about the bivalent COVID-19 booster doses that have been developed to target Omicron?

Bivalent COVID-19 booster shots have now been developed with both the original strain of the coronavirus and a strain of Omicron. These have been designed to better match the Omicron subvariants that have proven to be particularly transmissible. Lab studies have shown that these doses help you to mount a higher antibody response against Omicron. Both Moderna and Pfizer have developed these bivalent vaccines, and some countries have now approved their use.  

Check with your local health authorities for information about the availability of these doses and who can get them where you live. And it’s important to note that the original COVID-19 vaccines continue to work very well and provide strong protection against severe illness from Omicron.  

Can I receive different types of COVID-19 vaccines?  

Yes, however, policies on mixing vaccines vary by country. Some countries have used different vaccines for the primary vaccine series and the booster. Check with your local health authorities for guidance where you live and speak with your healthcare provider if you have any questions on what is best for you. 

I’m pregnant. Can I get vaccinated against COVID-19?

Yes, you can get vaccinated if you are pregnant. COVID-19 during pregnancy puts you at higher risk of becoming severely ill and of giving birth prematurely. 

Many people around the world have been vaccinated against COVID-19 while pregnant or breastfeeding. No safety concerns have been identified for them or their babies. Getting vaccinated while pregnant helps to protect your baby. For more information about receiving a COVID-19 vaccination while pregnant, speak to your healthcare provider.

>> Read: Navigating pregnancy during the COVID-19 pandemic

I’m breastfeeding. Should I get vaccinated against COVID-19?

Yes, if you are breastfeeding you should take the vaccine as soon as it is available to you. It is very safe and there is no risk to the mother or baby. None of the current COVID-19 vaccines have live virus in them, so there is no risk of you transmitting COVID-19 to your baby through your breastmilk from the vaccine. In fact, the antibodies that you have after vaccination may go through the breast milk and help protect your baby. >> Read: Breastfeeding safely during the COVID-19 pandemic

Can COVID-19 vaccines affect fertility?

No, you may have seen false claims on social media, but there is no evidence that any vaccine, including COVID-19 vaccines, can affect fertility in women or men. You should get vaccinated if you are currently trying to become pregnant.

Could a COVID-19 vaccine disrupt my menstrual cycle?

Some people have reported experiencing a disruption to their menstrual cycle after getting vaccinated against COVID-19. Although data is still limited, research is ongoing into the impact of vaccines on menstrual cycles.

Speak to your healthcare provider if you have concerns or questions about your periods.

Should my child or teen get a COVID-19 vaccine?

An increasing number of vaccines have been approved for use in children. They’ve been made available after examining the data on the safety and efficacy of these vaccines, and millions of children have been safely vaccinated around the world. Some COVID-19 vaccines have been approved for children from the age of 6 months old. Check with your local health authorities on what vaccines are authorized and available for children and adolescents where you live.  

Children and adolescents tend to have milder disease compared to adults, so unless they are part of a group at higher risk of severe COVID-19, it is less urgent to vaccinate them than older people, those with chronic health conditions and health workers. 

Remind your children of the importance of us all taking precautions to protect each other, such as avoiding crowded spaces, physical distancing, hand washing and wearing a mask. 

It is critical that children continue to receive the recommended childhood vaccines. 

How do I talk to my kids about COVID-19 vaccines?

News about COVID-19 vaccines is flooding our daily lives and it is only natural that curious young minds will have questions – lots of them. Read our explainer article for help explaining what can be a complicated topic in simple and reassuring terms.

It’s important to note that from the millions of children that have so far been vaccinated against COVID-19 globally, we know that side effects are very rare. Just like adults, children and adolescents might experience mild symptoms after receiving a dose, such as a slight fever and body aches. But these symptoms typically last for just a day or two. The authorized vaccines for adolescents and children are very safe.  

My friend or family member is against COVID-19 vaccines. How do I talk to them?

The development of safe and effective COVID-19 vaccines is a huge step forward in our global effort to end the pandemic. This is exciting news, but there are still some people who are skeptical or hesitant about COVID-19 vaccines. Chances are you know a person who falls into this category.

We spoke to Dr. Saad Omer, Director at the Yale Institute for Global Health, to get his tips on how to navigate these challenging conversations. >> Read the interview

How can I protect my family until we are all vaccinated?

Safe and effective vaccines are a game changer, but even once vaccinated we need to continue taking precautions for the time being to protect ourselves and others. Variants like Omicron have proven that although COVID-19 vaccines are very effective at preventing severe disease, they’re not enough to stop the spread of the virus alone. The most important thing you can do is reduce your risk of exposure to the virus. To protect yourself and your loved ones, make sure to:

  • Wear a mask where physical distancing from others is not possible.
  • Keep a physical distance from others in public places.
  • Avoid poorly ventilated or crowded spaces.
  • Open windows to improve ventilation indoors.
  • Try and focus on outdoor activities if possible.  
  • Wash your hands regularly with soap and water or an alcohol-based hand rub.

If you or a family member has a fever, cough or difficulty breathing, seek medical care early and avoid mixing with other children and adults.  

Can COVID-19 vaccines affect your DNA?

No, none of the COVID-19 vaccines affect or interact with your DNA in any way. Messenger RNA, or mRNA, vaccines teach the cells how to make a protein that triggers an immune response inside the body. This response produces antibodies which keep you protected against the virus. mRNA is different from DNA and only stays inside the cell for about 72 hours before degrading. However, it never enters the nucleus of the cell, where DNA is kept.

Do the COVID-19 vaccines contain any animal products in them?

No, none of the WHO-approved COVID-19 vaccines contain animal products.

I’ve seen inaccurate information online about COVID-19 vaccines. What should I do?

Sadly, there is a lot of inaccurate information online about the COVID-19 virus and vaccines. A lot of what we’re experiencing is new to all of us, so there may be some occasions where information is shared, in a non-malicious way, that turns out to be inaccurate.

Misinformation in a health crisis can spread paranoia, fear and stigmatization. It can also result in people being left unprotected or more vulnerable to the virus. Get verified facts and advice from trusted sources like your local health authority, the UN, UNICEF, WHO.

If you see content online that you believe to be false or misleading, you can help stop it spreading by reporting it to the social media platform.

What is COVAX?

COVAX is a global effort committed to the development, production and equitable distribution of vaccines around the world. No country will be safe from COVID-19 until all countries are protected.

There are 190 countries and territories engaged in the COVAX Facility, which account for over 90 per cent of the world’s population. Working with CEPI, GAVI, WHO and other partners, UNICEF is leading efforts to procure and supply COVID-19 vaccines on behalf of COVAX.  

Learn more about COVAX .

This article was last updated on 25 October 2022. It will continue to be updated to reflect the latest information. 

Related topics

More to explore, covid-19 response.

Resources and information about UNICEF’s response to the COVID-19 pandemic

How to talk to your children about COVID-19 vaccines

Tips for navigating the conversation

How to talk to friends and family about vaccines

Tips for handling tough conversations with your loved ones

COVAX information centre

UNICEF and partners led the largest vaccine procurement and supply operation in history

SAFETY AND EFFICACY OF INACTIVATED SARS-COV-2 VACCINES DURING HETEROLOGOUS INFECTION BY A SARS-RELATED CORONAVIRUS

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a thesis statement for vaccine

  • Affiliation: School of Medicine, Department of Microbiology and Immunology
  • Whole virus-based inactivated SARS-CoV-2 vaccines formulated with the aluminum hydroxide adjuvant are among the most widely used COVID-19 vaccines globally and have been critical to the COVID-19 pandemic response. Although these vaccines are protective against homologous coronavirus infection in healthy recipients, the emergence of novel SARS-CoV-2 variants and the presence of large zoonotic reservoirs harboring heterologous coronaviruses provide significant opportunities for vaccine breakthrough, raising the risk of adverse outcomes like vaccine-associated enhanced respiratory disease. To investigate this possibility, we used a mouse model of coronavirus disease to evaluate inactivated vaccine performance against either homologous challenge with SARS-CoV-2 or heterologous challenge with a bat-derived SARS-related coronavirus that represents a potential emerging disease threat. Here, we show that an inactivated SARS-CoV-2 vaccine adjuvanted with aluminum hydroxide causes enhanced respiratory disease in mice during heterologous infection, while use of an alternative adjuvant does not drive disease and promotes heterologous viral clearance. In this work, we highlight potential risks associated with vaccine breakthrough in recipients of aluminum hydroxide-adjuvanted inactivated coronavirus vaccines, and we demonstrate the impact of adjuvant selection on inactivated vaccine safety and efficacy against heterologous coronavirus infection.
  • Vaccine-associated enhanced respiratory disease
  • Inactivated COVID-19 vaccines
  • SARS-related coronavirus
  • Vaccinology
  • https://doi.org/10.17615/6s22-5n89
  • Dissertation
  • In Copyright - Educational Use Permitted
  • Heise, Mark T.
  • Baxter, Victoria K.
  • Goonetilleke, Nilu
  • Vogt, Matthew R.
  • Whitmire, Jason K.
  • Baric, Ralph S.
  • Doctor of Philosophy
  • University of North Carolina at Chapel Hill Graduate School

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How to write a vaccination research paper fast.

March 25, 2021

vaccination research paper

If you have just received your first vaccination research paper assignment, you probably don’t know what to do or where to start. This is probably why you are reading this blog, after all. Every semester, we receive hundreds of pleas for help from students in high school and college. They are struggling with writing an excellent vaccination research paper. In fact, many of these students are worrying that they might fail the class unless they get a top grade on their essay.

This is why we have decided to write this article. You will find information on how to write a paper about vaccination research. You will also get a list of interesting topics that should work great in 2022 (we also have COVID-19 vaccine topics there). Last, but not least, we will show you how to get a great example and give you a quick guide for writing a five-paragraph essay about vaccines.

Some Excellent Vaccination Research Topics

The best vaccination research paper outline, getting an example for your vaccine research paper, quick guide to write a vaccination paper, need more help.

Before you even start doing any research on vaccination, you should pick the topic of your paper. Truth be told, over 50% of all students pick the wrong topic. The problem is that you will most likely be tempted to choose a topic that’s very popular. The downside to this is that these same topics have probably already been chosen by some of your classmates. To make sure your paper is worthy of a top grade (and to make sure it stands out from the crowd), you need to find an original topic. The topic shouldn’t be too general, nor should it be too narrow. It should be about something of interest today. Also, you must find a topic that you have plenty of information about (to avoid spending days upon days writing the essay). To help you out, we have put together a short list of vaccination research topics:

  • The history of the vaccine
  • Are vaccines 100% effective?
  • Common side effects of Covid vaccination
  • Natural immunity versus vaccine immunity
  • Mandatory Covid vaccination
  • The impact of vaccination
  • How does a vaccine work?
  • Discuss the HPV vaccine
  • Write a vaccination position paper on influenza
  • Vaccination in African countries
  • ARN-based vaccines
  • The evolution of vaccination for Covid 19
  • Arguments against vaccination
  • Latest Ebola vaccination research
  • Arguments for vaccination
  • Should vaccination be mandatory for children?
  • Discussing the anti-vaccination stance
  • The effects of multiple vaccines
  • Links between Polio vaccines and the development of cancer
  • Do vaccines cause Autism?
  • Is vaccination research bad?

Check out our nursing research topics . You’ll surely like them.

Now that you have some interesting vaccination research paper topics to pick from, it’s time to talk about the vaccination research paper outline. It is very important to know how to structure your paper properly. The truth is that failing to do so will get you penalized quite badly. Let’s discuss the proper vaccine research paper outline in just two minutes

No matter what topic you choose (including coronavirus vaccination), you can safely use the five paragraph essay. Here is how such an essay would look like:

  • An introduction – first paragraph.
  • Body paragraph – second paragraph
  • Body paragraph – third paragraph
  • Body paragraph – fourth paragraph
  • A conclusion – fifth paragraph

It is definitely not difficult to write such a paper. However, we will provide you with a quick guide shortly. But first, let’s talk about getting you a good example; an example you can follow.

Let’s face it: finding good examples for a vaccine research paper can be difficult. Nowadays, the Internet is full of useless or poorly written content. In other words, you simply cannot trust anything you find online. Yes, it’s true that you may get a few hints on some website. Maybe get some interesting tips and ideas from online forums or blogs. However you will not be able to get a perfect example simply by searching on Google for it.

And no, reading vaccination research articles is not enough. You need a great example; an example you can actually use. The best way to get such a sample is to get in touch with us. Our professional academic writers can write a sample for you in no time. And the best part is that the example will be written from scratch just for you. We can even write an example paper about the vaccine for coronavirus, if you need one. You can, of course, use some parts of our sample in your own essay. After all, our sample will be 100 percent original.

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COVID-19 VACCINE HESITANCY AMONG STUDENTS IN A PUBLIC UNIVERSITY IN SOUTHERN CALIFORNIA

Joshua Casas Follow

Date of Award

Document type.

Restricted Project: Campus only access

Degree Name

Master of Public Health

Health Science and Human Ecology

First Reader/Committee Chair

Mshigeni, Salome

Background : COVID-19 is a respiratory disease caused by SARS-CoV -2, a new coronavirus discovered in 2019 (CDC, 2020), that may pose negative health effects on individuals who have not had the recommended vaccine. In the United States there is a growing number of individuals that are still hesitant towards the idea of taking a vaccine which can impact their health and the health of others.

Methods : This study utilized a mixed method research design to capture a sample of undergraduate college students’ perception and understanding of the COVID-19 vaccine. A cross sectional online survey was developed using Google Forms to gather data from a small sample of students enrolled in a general education introductory course in the Spring 2021 semester. The results were analyzed using the Statistical Package for The Social Sciences SPSS Software version 27.0.

Results : Based on two survey questions, “Will you be vaccinated for COVID-19 when vaccines are available to you?”, and “Where do you receive your information regarding vaccines for Cholera, Hepatitis, Rubella, Influenza, Tetanus Etc.?”, data showed that 68.75% of the participants who received their vaccine information from social media would accept the COVID-19 vaccine, while 51.35% of the participants who did not receive their vaccine information from social media would accept the COVID-19 vaccine. Data was categorized by participants who used social media to learn about vaccines and those who did not. This data illustrated the disparities among the different groups when social media was a factor (# of people that will be vaccinated 19 vs 11; # of people that will not be vaccinated 18 vs 5).

Conclusion :

The purpose of this study was to examine the reasons behind COVID-19 Vaccine Hesitancy among undergraduate college students at Public University in Southern California. The results suggest that the amount of influence social media has had and its connection with online misinformation play a big role as an influencer for the COVID-19 vaccine acceptance or opposition among college students. More research is needed to examine each age group beyond what is presented in this study with the goal of creating evidence-based intervention strategies for vaccine compliance for a variety of demographic characteristics.

Recommended Citation

Casas, Joshua, "COVID-19 VACCINE HESITANCY AMONG STUDENTS IN A PUBLIC UNIVERSITY IN SOUTHERN CALIFORNIA" (2021). Electronic Theses, Projects, and Dissertations . 1320. https://scholarworks.lib.csusb.edu/etd/1320

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The full benefits of adult pneumococcal vaccination: A systematic review

Elizabeth t. cafiero-fonseca.

1 Data for Decisions, LLC, Waltham, Massachusetts, United States of America

2 Performance Analysis and Improvement, Massachusetts General Hospital/Massachusetts General Physicians Organization, Boston, Massachusetts, United States of America

Andrew Stawasz

Sydney t. johnson.

3 Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts, United States of America

4 Global Health and Value, Pfizer Inc., Collegeville, Pennsylvania, United States of America

David E. Bloom

5 Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America

Associated Data

All relevant data are within the paper and its Supporting Information files.

Pneumococcal disease causes substantial morbidity and mortality, including among adults. Adult pneumococcal vaccines help to prevent these burdens, but they are underused. Accounting for the full benefits of adult pneumococcal vaccination may promote more rational resource allocation decisions with respect to adult pneumococcal vaccines.

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review to assess the extent to which the literature has empirically captured (e.g., through measurement or modeling) the full benefits of adult pneumococcal vaccination.

We systematically searched PubMed and Embase to identify studies published between January 1, 2010 and April 10, 2016 that examine adult pneumococcal vaccination. We included articles if they captured any health or economic benefit of an adult pneumococcal vaccine administered to adults age ≥ 50 or ≥ 18 in risk groups. Finally, we summarized the literature by categorizing the types of benefits captured, the perspective taken, and the strength of the evidence presented. Our protocol is number 42016038335 in the PROSPERO International prospective register of systematic reviews.

We identified 5,857 papers and included 150 studies for analysis. While most capture health gains and healthcare cost savings, far fewer studies consider additional benefit categories, such as productivity gains. However, the studies with a broader approach still exhibit significant limitations; for example, many present only abstracts, while others offer no new measurements. Studies that examine the 13-valent pneumococcal conjugate vaccine focus more on broad economic benefits, but still have limitations.

Conclusions

This review highlights the need for more robust empirical accounting of the full benefits of adult pneumococcal vaccination. Literature outside this realm indicates that these broad benefits may be substantial. Failing to investigate the full benefits may lead society to undervalue vaccines' contributions and therefore underinvest in their development and adoption.

Introduction

Pneumococcal disease causes significant morbidity and mortality in both developing and developed countries, causing 1.6 million deaths annually [ 1 ]—more than seasonal influenza [ 2 ], malaria [ 3 ], or HIV/AIDS [ 4 ]. Pneumococcal disease comprises several clinical syndromes caused by the Streptococcus pneumoniae (pneumococcus) bacterium. Case fatality rates vary depending on the manifestation of the disease and can range from approximately 5% for pneumococcal pneumonia to 22% for adult pneumococcal meningitis. Certain pneumococcal infections, especially meningitis, can cause significant long-term sequelae [ 5 ].

The elderly and other adults at increased risk of contracting pneumococcal disease—including those with comorbidities or a compromised immune system—bear much of the burden of pneumococcal disease. Because of the potential for interpersonal disease transmission, older adults living in long-term care facilities are at a higher risk for contracting pneumococcal disease [ 6 ]. The incidence rate of pneumococcal disease increases with advancing age, and because the number of people age 60 years or older worldwide is expected to double between 2015 and 2050 (from 900 million to 2.1 billion) [ 7 ], pneumococcal disease in older adults will continue to be an important public health concern.

Two vaccines offer adults protection from pneumococcal disease: a 23-valent pneumococcal polysaccharide vaccine (PPV23) first introduced in 1983 [ 8 ] and a 13-valent pneumococcal conjugate vaccine (PCV13) first introduced in 2009 [ 9 ]. In Europe, PCV13 was initially approved for children from six weeks to five years of age in 2009 and then for adults age 50 years and older in 2011. The United States followed a similar pattern of introduction, approving the vaccine for infants and young children ages six weeks through five years in 2010, followed by approval for adults 50 and older at the end of 2011 [ 10 ].

While great strides have been made in pneumococcal vaccine distribution since their introduction, significant gaps in adult pneumococcal vaccine coverage persist. For example, in the United States in 2014, only 61.3% of adults 65 and older received their recommended pneumococcal vaccines, and coverage among high-risk adults age 19–64 (such as smokers or those with chronic conditions such as diabetes or chronic obstructive pulmonary disease) was only 20.3% [ 11 ]. Across Europe, recommendations and funding for adult pneumococcal vaccinations vary greatly in terms of age and risk groups [ 12 , 13 ], making implementation and coverage less than optimal. Articulating and empirically measuring the full benefits of adult pneumococcal vaccination can help stimulate efforts to close coverage gaps and ensure adults receive appropriate protection from a vaccine-preventable disease.

The value of vaccination

The finding that health promotes economic well-being—both individually and collectively—is a significant advance in the field of economic development [ 14 – 16 ]. It suggests that health interventions like vaccination programs have benefits that extend beyond the intrinsic value of mortality and morbidity reductions. Along these lines, recent research highlights how economists and policymakers have failed to account for vaccine programs’ full benefits [ 17 – 34 ]. This shortcoming suggests that these programs are substantially undervalued and that many decisions regarding vaccination adoption, scale-up, and investment in vaccine discovery and development were poorly founded.

Given global population aging [ 35 ] and the burden of pneumococcal disease among the elderly, adult pneumococcal vaccination in particular merits detailed analysis of the nature and economic magnitude of its potential benefits. This includes a critical review of existing research on the benefits of pneumococcal vaccines in adults. However, our approach differs from other such published systematic reviews in that we aim to determine the extent to which the literature captures broad benefits. Other reviews are typically restricted to a subset of benefits, such as economic benefits [ 36 ] or vaccine effectiveness [ 37 – 39 ].

We grounded this review in previous work that describes and attempts to understand the full benefits of vaccination [ 17 , 19 , 28 , 30 , 40 – 42 ]. As in other studies focusing on the broad benefits of particular vaccines [ 17 , 28 ], we devised a taxonomy that identifies a comprehensive set of benefits of adult pneumococcal vaccination. The taxonomy distinguishes the narrow perspective, which includes benefits policymakers commonly think about, from a broader perspective, which includes additional benefits that policymakers rarely consider.

The following benefits constitute the narrow perspective and coincide with similar taxonomies for other diseases [ 17 , 28 ]:

  • Healthcare cost savings: The reduction in visits to medical practitioners, inpatient stays, and prescription drugs associated with pneumococcal disease treatment; and
  • Health gains: The intrinsic value of reduced morbidity, mortality, pain, and suffering from pneumococcal disease.

Similarly, these additional benefits derive from existing benefit taxonomies for other diseases and reflect the broader perspective [ 17 , 28 ]:

  • Outcome-related productivity gains: The gains in productivity and income that accrue when immunized adults who are protected from pneumococcal disease are able to work and earn more;
  • Care-related productivity gains: The value of caretakers’ productive time that is saved when they are released from the care and supervision of adults who are now healthier due to pneumococcal vaccination;
  • Health-based community externalities: The value of improved health outcomes among nonvaccinated community members. These improved outcomes may be due to herd effects (to the extent that such effects are realized after adult pneumococcal vaccination) or due to a slowing of antibiotics’ loss of effectiveness, which imposes health and economic burdens; and
  • Risk reduction gains: The value of pneumococcal vaccination’s role in reducing uncertainty and any concomitant anxiety, which would otherwise impose a cost on risk-averse people (e.g., value of peace of mind).

Other broad benefits are particularly relevant to pneumococcal vaccination, including:

  • Voluntary contributions to family and community: The value of the human capital that accumulates in children and grandchildren through the greater time and education investments their healthier parents and grandparents make in them and the additional contributions adults make to their communities through participation in various activities, which they are better able to do when healthier;
  • Prevention and amelioration of comorbidities: The inherent health benefits and further economic value of reduced incidence of comorbid health conditions (such as myocardial infarctions) and typical complications that follow from pneumococcal disease;
  • Reduction in nosocomial infections: The value of avoiding nosocomial infections that could have followed from hospitalizations for pneumococcal disease had an adult not been vaccinated; and
  • Promotion of social equity: The value of pneumococcal vaccination in diminishing social and economic inequalities, insofar as adult pneumococcal disease disproportionately affects the poor.

Using this taxonomy of benefits of adult pneumococcal vaccination as a guide, we systematically reviewed the literature to identify the breadth and depth of the evidence base on the benefits of adult pneumococcal vaccination.

Our principal research objective was to survey the extent to which the literature empirically captures the full benefits of adult pneumococcal vaccination, through either direct measurement or modeling. Our secondary research objective, which fed into this central goal, was to survey the literature in terms of the breadth (i.e., kinds) of benefits captured and the strength and nature of evidence surrounding these benefits.

Protocol and registration

The study protocol is registered on PROSPERO: International Prospective Register of Systematic Reviews and can be accessed at http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016038335 or viewed as supporting information S1 File . We conducted the review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [ 43 , 44 ].

To identify articles capturing the full benefits of adult pneumococcal vaccination, we performed a search on April 10, 2016 for the timeframe January 1, 2010 through April 10, 2016. We chose this timeframe because it captures a time during which both major adult pneumococcal vaccines were on the market. Although PCV13 had not been approved for older adults in Europe and the United States prior to 2011, we wanted to capture studies conducted to generate evidence on the potential benefits of adult pneumococcal vaccination, including modeling studies. We searched in two databases: PubMed and Embase. We used database terminology (Medical Subject Headings [MeSH] and Emtree, respectively) and keywords to capture more recent articles that had not yet been indexed in the database as of the search date. The search algorithm was based on two main topics: adult pneumococcal vaccination and benefits, which were subdivided into health benefits and economic benefits. S2 File presents the full search string, including the database terminology and keywords used. We exported the identified references into EndNote X7.5 and eliminated duplicate results. To check the sensitivity and quality of the search protocol, we identified 10 key articles that we felt the search should yield and confirmed that the search string returned all 10 articles. We also included articles from expert consultations to be as comprehensive as possible in the search.

Two reviewers screened the identified articles, first including or eliminating articles based on their titles and abstracts according to the inclusion and exclusion criteria that follow. Articles with ambiguous titles and abstracts underwent full text review by both reviewers. In the case the two reviewers disagreed, a third reviewer broke the tie. All reviewers were able to see the authors, institutions, journals of publication, and results when they applied the eligibility criteria. We recorded the reason for exclusion for studies excluded from full text review. To confirm that the reviewers applied the inclusion and exclusion criteria consistently, the two initial reviewers sorted 10 articles using these criteria. We reviewed discrepancies in the two reviewers’ judgments regarding these articles and discussed them to clarify the meaning of the criteria and to facilitate their consistent application.

We obtained most articles from Harvard, Tufts, and University of Massachusetts Boston libraries, or Google Scholar. We attempted to contact the authors of any articles unavailable from these sources and purchased articles that were still inaccessible when possible.

Eligibility criteria

Inclusion criteria.

According to our participants, interventions, comparators, outcomes, and study design (PICOS) criteria [ 43 ] ( Table 1 ), we included articles in our review if they reported experimental, observational, or model-based studies that capture health or economic benefits of adult pneumococcal vaccination. These could include

  • Economic evaluations of adult pneumococcal disease vaccination (including any method of analysis, such as cost-effectiveness analysis, cost-utility analysis, cost-minimization analysis, budget impact analysis, or benefit-cost analysis);
  • Studies that calculate the benefit of any adult pneumococcal disease vaccination in health terms (e.g., quality-adjusted life years or QALYs, cases averted); or
  • Studies that capture other benefits of adult pneumococcal vaccination that accrue to individuals or populations (e.g., reduction of hospitalizations due to pneumococcal pneumonia, reduction of nosocomial infections resulting from hospitalization due to pneumococcal disease).

Disease endpoints of interest included any form of adult pneumococcal disease, including pneumonia, meningitis, bacteremia, otitis media, sinusitis, bronchitis, ear infection, sinus infection, blood infection, and septicemia, or any comorbidities associated with pneumococcal disease. We included studies from any geographic area. We only included studies examining vaccinated adults age 50 or above, or adults 18 and older in “risk groups” (as defined by the authors of the paper; examples include adults with chronic illness, weakened immune systems, cochlear implants, or cerebrospinal fluid leaks, or adults living in long-term care facilities). We included studies of any pneumococcal vaccine product (as long as the vaccine is given to adults); any vaccination strategy; any length of follow-up; and, for economic studies, any currency.

Exclusion criteria

We excluded economic studies that did not compare costs with outcomes (e.g., price or cost studies, as opposed to, e.g., cost-benefit or cost-effectiveness). We excluded health studies relating solely to internal biological processes (e.g., antibody responses to vaccination) without directly connecting these processes to overall health or economic outcomes (e.g., disability-adjusted life years or DALYs, averted medical costs). We also excluded studies that only explore benefits stemming from vaccinating non-adults. We did not consider studies other than published articles, institutional reports (e.g., World Health Organization reports), and conference proceedings. We therefore excluded reviews, commentaries, editorials, news articles, and policy briefs. We excluded studies reported in any language other than English.

Data extraction

We developed a template for extracting information from the included articles, pilot-tested it on a sample of five studies, and revised the template based on the pilot experience. Two reviewers divided the list of included articles alphabetically by the last name of the first author, extracted data according to the template, and conducted an audit on a subset of the included articles to quality-check the extraction. We extracted the following information from each included study:

  • Study characteristics (study citation, control and treatment groups, limitations, assumed vaccination coverage, assumed duration of protection, time horizon of analysis, perspective taken, type of study, and follow-up time);
  • Characteristics of the study population (setting, age group[s], and risk group[s] if applicable);
  • Characteristics of the vaccination strategy (vaccine product[s] and vaccination strategy[ies]);
  • Benefits captured in the study (type of outcome[s] measured, units, and results); and
  • Contextual factors of interest (study sponsor or other comments on the analysis).

See S3 File for the template used to extract study information.

Application of the inclusion and exclusion criteria yielded 150 unique studies for analysis [ 45 – 194 ]. Fig 1 shows the yields at each stage of the review. Table 2 summarizes the reasons for excluding articles that reached the full text review stage. After attempting to access all the articles that reached the full text review stage, we were unable to obtain two articles and therefore excluded them from analysis [ 195 , 196 ]. While the protocol allowed inclusion of articles recommended by experts during expert consultations and from snowball searching of references in included papers, we did not include any such articles, as our search captured all articles that either experts or reference lists brought to our attention.

An external file that holds a picture, illustration, etc.
Object name is pone.0186903.g001.jpg

S4 File contains the extracted information for all included articles. We could not to apply criteria to grade the quality of the evidence in the included studies because most studies captured in our review are modeling studies. Major published methods for assessing quality of evidence do not include modeling studies in their hierarchy [ 197 ]. In addition, some included articles are not modeling studies, meaning that methods of quality assessment would be difficult to apply in a consistent, meaningful manner. Furthermore, because of the varied nature of included studies, we were not able to assess risk of bias in a meaningful way.

State of the literature

Table 3 summarizes the literature in terms of capturing the full benefits of adult pneumococcal vaccination. We found that, while the literature effectively captures narrow benefits, it rarely (if ever) captures all other benefits.

*This represents the number (and percent) of included studies that capture the benefit category in question; categories are not mutually exclusive.

Narrow benefits

Fifty-three percent of studies included in our systematic review included healthcare cost savings, though parameters used to estimate this dimension varied and were often based on estimates. Health gains were included in all but one study included for analysis. Many studies in the review account for this benefit directly. Others account for it indirectly by reporting QALYs or life years (LYs) lost to pneumococcal disease for cost-effectiveness or budget impact calculations.

Other broad benefits

The most commonly captured benefit from the broad perspective was outcome-related productivity gains. Sixteen studies (10.7%) included this benefit [ 74 – 76 , 81 , 85 , 87 , 98 , 108 , 115 , 117 , 127 , 132 , 142 , 144 , 157 , 165 ]. These studies estimated how much work individuals miss due to a case of pneumococcal disease and compute the value of that missed work by multiplying missed time by the wage rate. At times, the amount of missed work is weighted by the proportion of the population that is economically active [ 74 ]. Two studies (1.3%) accounted for care-related productivity gains [ 74 , 127 ]. One study (0.7%) accounted for health-based community externalities vis-à-vis the value of pneumococcal vaccination in slowing the rate of antimicrobial resistance [ 160 ]. Our included studies did not account for any other benefits in our taxonomy.

Even within the literature that examines benefits other than our narrow ones, study quality and reporting are at times limited. For example, of the 17 unique studies that account for at least one broad benefit, seven (41.2%) present only study abstracts [ 75 , 81 , 85 , 87 , 98 , 115 , 144 ]. Of the remaining 10 studies [ 74 , 76 , 108 , 117 , 127 , 132 , 142 , 157 , 160 , 165 ], other limitations abound, including, for example, borrowing epidemiological trend data from other countries [ 108 ], lack of data necessitating many assumptions and low estimate precision [ 157 ], and possible confounding due to a study’s observational nature [ 160 ].

Perspectives assumed by economic studies

Examining the perspectives from which economic analyses were performed provides further insights into the state of the literature. Of the 75 included studies that explicitly stated a perspective, 51 (68.0%) examine costs from a health payer’s perspective, meaning they only consider direct costs (i.e., healthcare cost savings). Moreover, 24 studies claim to adopt a societal perspective (either as the only perspective studied or in addition to another perspective, such as health payer’s perspective), implying they consider other broad benefits [ 198 ]. However, this likely overstates the number of studies that look beyond narrow benefits. Some studies that were purportedly performed from the societal perspective appear only to consider narrow benefits. We therefore conclude that some studies’ perspectives may have been mislabeled.

Interestingly, three economic modeling studies—two from Brazil and one from Mexico—took an employer’s perspective to analyze the effects of vaccinating employees against pneumococcal disease on outcome-related productivity gains [ 81 , 85 , 98 ]. While the three studies presented only abstracts, and are therefore inconclusive by themselves, their findings unanimously favored the benefits of adult pneumococcal vaccination. This unanimity suggests that perspectives besides health payer might be worth exploring further.

Nature of PCV13 studies

Because PCV13 is the newest adult pneumococcal vaccine, isolating the included studies that analyze PCV13 alone is worthwhile. In general, the 32 (21.3%) studies that present an analysis of PCV13 alone tend to take a more economically focused approach than the other included studies. Twenty-seven (84.4%) of these PCV13-only studies account for healthcare cost savings [ 55 , 63 , 64 , 80 , 82 , 87 , 91 , 98 , 110 , 117 , 123 , 127 , 128 , 130 – 132 , 150 , 151 , 153 , 156 – 158 , 168 , 173 , 178 , 184 , 194 ], compared with 79 (52.7%) of all included studies. Similarly, seven of these studies (21.9%) account for outcome-related productivity gains [ 81 , 87 , 98 , 117 , 127 , 132 , 157 ], which represents double the share of all included studies (10.7%).

But PCV13-only studies have limitations. For example, a common limitation is that vaccine efficacy in adults is merely assumed for the purposes of economic modeling. This limitation was particularly common before the results of the CAPITA trial, a major randomized control trial of PCV13 in adults 65 and older, were published [ 57 ].

This systematic review shows that the literature does effectively capture some benefits of adult pneumococcal vaccination—notably, health gains and healthcare cost savings. To a limited extent, the literature takes a broader approach to estimating the benefits of adult pneumococcal vaccination. However, most benefits beyond the narrow approach are rarely, if ever, captured.

But this is not to say that these additional benefits are negligible. In fact, existing literature outside the scope of adult pneumococcal vaccines suggests that some benefits are potentially sizeable and are therefore worth investigating further.

The first of these potentially important benefits surrounds the notion that pneumococcal vaccines slow the rate of antimicrobial resistance (AMR) in at least two ways: by slowing the spread of especially resistant serotypes (such as serotype 19A, which is targeted by both commercially available adult vaccines) and by preventing illnesses and thus precluding the need for antibiotics. Although the literature on adult vaccination largely overlooks this effect, pneumococcal conjugate vaccines have been singled out as potentially significant players in the fight to reduce the rate of antibiotic resistance [ 199 , 200 ]. This effect has clear community health benefits.

Second, recent evidence from the epidemiological literature suggests that some serotypes have low incidence among the young but high incidence among older adults [ 201 ]. Therefore, herd effects from vaccinating adults seem possible, which would spread the protective effects of these vaccines to nonvaccinated community members. This could be particularly important in settings with high concentrations of older adults, such as nursing homes. The strength of such herd effects would depend in large part on contextual factors such as childhood vaccine uptake rates [ 202 ]. Such factors should be accounted for when estimating the value of adult vaccination strategies.

Third, vaccinating adults attending mass gatherings may be an effective approach to limiting adult transmission [ 203 ]. Recognizing this, the Saudi Arabian government requires some vaccines for Hajj and Umrah pilgrims [ 204 ], including vaccines against meningitis and poliomyelitis. Including pneumococcal vaccination in the requirements for participants at mass gatherings could carry benefits for many parties: the vaccine recipient, other attendees who come into contact with vaccine recipients, travel companies that could offer the vaccine to appeal to risk-averse attendees, and government health ministries that would save money on treatment costs.

Fourth, parents and grandparents who are healthier are measurably better able to care for children and grandchildren [ 205 , 206 ] and should in principle make greater voluntary contributions to their communities. Pneumococcal vaccines could contribute to these valuable ends.

Fifth, adults are demonstrably willing to pay to reduce risks to income [ 207 ] and to health [ 208 ]—both of which pneumococcal vaccines can help ameliorate.

Sixth, insofar as adult pneumococcal disease disproportionately affects the poor, vaccination can diminish social and economic inequalities [ 209 , 210 ], an outcome that many consider inherently valuable.

Failing to investigate these and other sources of benefit further potentially leads to undervaluing adult pneumococcal vaccines' contributions and therefore underinvesting in their development and adoption. Additional work in this area should create an evidence base aimed at remedying these shortcomings.

Limitations of this study

One limitation of our review is that we only included English-language studies. While we recognize that studies written in other languages likely contribute to the evidence base on the benefits of adult pneumococcal vaccination, our team’s shared language ability is limited to English. Another limitation of our study is the inability to apply a standard bias assessment to the included studies, such as the Cochrane Risk of Bias tool [ 197 ], which assesses risk of bias in randomized controlled trials, or ROBIS [ 211 ], a tool for assessing the risk of bias in systematic reviews. In lieu of a standard bias assessment, we recognize and comment on many of the limitations in the included studies (see S4 File ). A third limitation of our analysis is that while many studies indicated a societal perspective, this was not clearly defined. Thus, we may have miscategorized some studies due to lack of information.

Finally, other vaccinations delivered in the same context, including influenza vaccination among target groups or pediatric vaccination programs, can affect the potential benefits of adult pneumococcal vaccination. This may make generalizing results to a different country context difficult. Several of our included studies demonstrate that co-administration of influenza and pneumococcal vaccination can have positive benefits [ 61 , 62 , 88 , 164 ]. A recent systematic review and meta-analysis showed that high childhood vaccination coverage can lead to substantial herd effects, thus protecting unvaccinated adults from disease and reducing the magnitude of the potential benefits of adult vaccination [ 202 ]. The studies included in our review inconsistently account for herd effects from childhood vaccination (see S4 File for more detail). Therefore, any analysis of the full benefits of adult pneumococcal vaccination must consider this context.

We conducted this systematic review to identify the breadth and depth of the benefits of adult pneumococcal vaccination captured in the literature. The review followed PRISMA guidelines (See S5 File ). We included 150 unique studies for analysis. The literature effectively captures narrow benefits but rarely captures the full range of benefits in our framework. Further research is needed to quantify the broad benefits of adult pneumococcal vaccination.

Supporting information

The Full Benefits of Adult Pneumococcal Vaccination: A Systematic Review .

Search Terms. The Full Benefits of Adult Pneumococcal Vaccination: A Systematic Review .

Extraction Template. The Full Benefits of Adult Pneumococcal Vaccination: A Systematic Review .

Extraction Table. The Full Benefits of Adult Pneumococcal Vaccination: A Systematic Review .

PRISMA Checklist .

Acknowledgments

Carol Mita of Harvard University’s Countway Library guided the process of generating our search string and contributed useful advice regarding the systematic review process. Mathew McKenna of Data for Decisions, LLC, provided valuable assistance in extracting relevant information from included studies. Many experts in the field of pneumococcal vaccination, including Lakshmi Ganapathi, Peifeng “Perry” Hu, Allison McGeer, Mark Steinhoff, and Ramnath Subbaraman, helped form the foundational understanding of pneumococcal disease and pneumococcal vaccines that has guided this work. Lakshmi Reddy Bloom of Data for Decisions, LLC made valuable contributions to the development of the taxonomy used in this systematic review. JP Sevilla and Daria Burnes of Data for Decisions, LLC, and Kristine Husøy Onarheim of the University of Bergen provided insightful feedback on previous drafts of this manuscript. Finally, we are grateful for helpful comments from colleagues at Pfizer, Inc.

Funding Statement

Funding for this systematic review was provided by Pfizer Inc. ( http://www.pfizer.com/ ) to Data for Decisions, LLC. RS, an employee of Pfizer Inc., is a co-author and played a role in study design, analysis, and preparation of the manuscript. Data for Decisions, LLC provided support in the form of compensation for DEB, ECF, AS, and STJ, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the "author contributions" section.

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2024 Top Faculty Awards Announced

2024 ysph faculty awards.

From left to right: Associate Professor Michaela Dinan, Assistant Clinical Professor Michael Wininger, and Assistant Professor Kai Chen.

Dean Megan L. Ranney Thursday announced the recipients of this year’s Distinguished Teaching Award and Distinguished Student Mentoring Award. Two outstanding members of the Yale School of Public Health faculty are being honored with the 2024 Distinguished Teaching Award this year – Associate Professor Michaela Dinan and Assistant Clinical Professor Michael Wininger. Michaela Dinan’s students cited her “unparalleled commitment to student success” while fostering “a supportive and inclusive learning environment” in nominating her for the award. Students spoke highly of Michaela’s mentorship, passion, and engaging curriculum stating: “She consistently delivers high-quality content, ensuring that each week is filled with valuable learning experiences.” It is evident that Michaela’s teaching has made an enduring impact, with students sharing that they aspire to emulate her level of dedication in their own work. Michael Wininger was lauded by his students for his versatility, active and inclusive instruction, and ability to deliver concepts “in fresh and innovative ways.” One student said: “His ability to seamlessly weave personal experiences, real-world examples, and academic theories left students eagerly awaiting each lecture session.” Michael was praised for consistently supporting his students' development both inside and outside the classroom, and for being a “true mentor” who focuses on the overall growth and success of each student. The 2024 Distinguished Student Mentoring Award was given to Kai Chen. Assistant Professor Kai Chen’s students praised his dedication and commitment as a mentor and for going “above and beyond” to ensure their academic success. Students referenced Kai’s passion for his work. One student said Kai’s encouragement “has ensured that I will create the best possible version of my thesis that it can be.” Dean Ranney invited everyone to join her in congratulating Michaela, Michael, and Kai on receiving these well-deserved honors and for being leaders in shaping the next generation of public health professionals!

Featured in this article

  • Michaela Dinan, PhD Associate Professor Tenure; Co-Leader, Cancer Prevention and Control, Yale Cancer Center
  • Michael Wininger, PhD Assistant Clinical Professor of Biostatistics
  • Kai Chen, PhD Assistant Professor of Epidemiology (Environmental Health); Director of Research, Climate Change and Health; Deputy Faculty Director, Climate Change and Health; Affiliated Faculty, Yale Institute for Global Health

IMAGES

  1. How to Write a Thesis Statement for a Research Paper: Steps and

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  5. ≫ The Anti-Vaxxer Epidemic: Why Vaccination Should Be Mandatory Free

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VIDEO

  1. Overview

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  3. Impact of vaccine hesitancy and strategies to increase immunization uptake

  4. Thesis Defense Combating misinformation vaccine hesitancy in the VA

  5. Thesis Statement- WRITING ( breakthroughcollaborative )

  6. What should a thesis statement ideally be?

COMMENTS

  1. Vaccine Confidence, Coverage, and Hesitancy Worldwide: A Literature

    Thesis Summary . Vaccines are one of the world's most impactful medical therapies. They are cost-effective, successfully proven, and one of the quickest treatment options available today (Clark et al., 2016). They save millions of lives every year and have eliminated certain diseases on a

  2. The Benefits of Vaccinations: An Argumentative Essay Example

    Thesis Statement: Research shows that the benefits of vaccination outweigh the risks because vaccines can prevent serious illness and disease in individuals, vaccinations can also prevent widespread outbreaks of diseases in populations and the side effect of vaccinations, though occasionally serious, are vary rare. Don't use plagiarized sources.

  3. Public attitudes toward COVID-19 vaccination: The role of vaccine

    While efficacious vaccines have been developed to inoculate against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; also known as COVID-19), public vaccine hesitancy could still ...

  4. Argumentative Essay About Vaccines

    Thesis Statement: The Federal Government should make vaccinations mandatory for everybody because: (1) vaccines are designed to protect us and others from certain diseases; (2) vaccines are one of the easiest ways to protect our health; and (3) despite my opposition's claim, vaccines are not unsafe. Introduction

  5. Student Name: Mrs. Minickiello

    THESIS STATEMENT Parents should follow the American Pediatric Association's vaccination schedule because vaccines reduce drastically once prevalent and devastating disease, do not impact brain development or function, reduce the risk for those who cannot be given the vaccine, and are cost effective when compared to the cost of treatment.

  6. Vaccine hesitancy in the era of COVID-19

    The percentage of COVID-19 vaccine acceptance was not so high (up to 86.1% students or 77.6% general population); for influenza vaccine, the maximum percentage was 69%. Several factors influenced the acceptance or refusal (ethnicity, working status, religiosity, politics, gender, age, education, income, etc.).

  7. COVID-19 vaccine rollout: Examining COVID-19 vaccination perceptions

    uncertainty around the virus and consequently the vaccine. This thesis aims to explore nurses' decision-making around COVID-19 vaccination, with a specific focus on the role of uncertainty both about the pandemic and available vaccines. In what follows, this study first reviews the state of the COVID-19 pandemic, and specifically the

  8. USD RED

    A study of how people perceive the COVID-19 vaccine compared to other historic vaccines, based on surveys of University of South Dakota students and faculty.

  9. The Perception and Attitudes toward COVID-19 Vaccines: A Cross

    Vaccine hesitancy is a major threat to the success of COVID-19 vaccination programs. The present cross-sectional online survey of adult Poles (n = 1020) expressing a willingness to receive the COVID-19 vaccine was conducted between February and March 2021 and aimed to assess (i) the general trust in different types of vaccines, (ii) the level of acceptance of the COVID-19 vaccines already in ...

  10. In Defense of Vaccine Mandates: An Argument from Consent Rights

    While others (especially Brennan, 2018) have argued that vaccine mandates do not violate general constraints against government restriction, we take our advance to be framing the defense of mandates in the very language of rights and consent most commonly used by their opponents. For purposes of this paper, we begin with three assumptions.

  11. Long-term effectiveness of COVID-19 vaccines against infections

    Our analyses indicate that vaccine effectiveness generally decreases over time against SARS-CoV-2 infections, hospitalisations, and mortality. The baseline vaccine effectiveness levels for the omicron variant were notably lower than for other variants. Therefore, other preventive measures (eg, face-mask wearing and physical distancing) might be necessary to manage the pandemic in the long term.

  12. What you need to know about COVID-19 vaccines

    العربية. 25 October 2022. Vaccines save millions of lives each year. The development of safe and effective COVID-19 vaccines are a crucial step in helping us get back to doing more of the things we enjoy with the people we love. We've gathered the latest expert information to answer some of the most common questions about COVID-19 ...

  13. PDF COVID-19 Vaccine Hesitancy in a US Public University Cohort Samuel

    A thesis Submitted in partial fulfillment of the Requirements for the degree of Master of Public Health University of Washington 2021 Committee: Helen Y. Chu ... Vaccine hesitancy is a long-known issue, and defined by the World Health Organization (WHO) SAGE Working Group(1): "Vaccine hesitancy refers to delay in acceptance or refusal of ...

  14. How to Write a Thesis Statement

    Step 1: Start with a question. You should come up with an initial thesis, sometimes called a working thesis, early in the writing process. As soon as you've decided on your essay topic, you need to work out what you want to say about it—a clear thesis will give your essay direction and structure.

  15. Dissertation or Thesis

    In this work, we highlight potential risks associated with vaccine breakthrough in recipients of aluminum hydroxide-adjuvanted inactivated coronavirus vaccines, and we demonstrate the impact of adjuvant selection on inactivated vaccine safety and efficacy against heterologous coronavirus infection. Date of publication. 2024; Keyword

  16. Vaccination Research Paper

    Also, remember to include the thesis statement towards the beginning of the intro. Write three body paragraphs. Of course, you can write more, but 3 is the minimum for the five paragraph essay. Each body paragraph in your vaccination paper will discuss one single main idea or talking point.

  17. An Ethical Anaylsis of the Arguments Both For and Against COVID-19

    Vaccine mandates risk treating individuals as a means to an end and risk running afoul of the second categorical imperative. Utilitarian advocates would argue for a vaccine mandate as it provides the greatest well-being for the most people possible. The utilitarian argument that vaccine mandates are doing the best for the most falls flat when ...

  18. Covid-19 Vaccine Hesitancy Among Students in A Public University in

    Casas, Joshua, "COVID-19 VACCINE HESITANCY AMONG STUDENTS IN A PUBLIC UNIVERSITY IN SOUTHERN CALIFORNIA" (2021). Electronic Theses, Projects, and Dissertations. 1320. Background: COVID-19 is a respiratory disease caused by SARS-CoV -2, a new coronavirus discovered in 2019 (CDC, 2020), that may pose negative health effects on individuals who ...

  19. Statement for healthcare professionals: How COVID-19 vaccines are

    Healthcare professionals and public health authorities have a central role in discussing vaccination against COVID-19 with their patients. Vaccines play a critical role in preventing deaths, hospitalisation caused by infectious diseases. Emerging data on effectiveness indicates that licenced COVID-19vaccines are contributing to controlling the spread of the disease. Until widespread ...

  20. Vaccines

    Understanding the motivations and decisions behind COVID-19 vaccine acceptance is crucial for designing targeted public health interventions to address vaccine hesitancy. We conducted a qualitative analysis to explore COVID-19 vaccine acceptance among diverse ethnic subgroups of Black Americans in the United States. This study investigates the 2021-2022 responses of 79 African American, Afro ...

  21. Public statement for collaboration on COVID-19 vaccine development

    Public statement for collaboration on COVID-19 vaccine development. Last updated 16 April 2020. On 31 December 2019, WHO was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province of China. Chinese authorities identified the SARS-CoV-2 as the causative virus on 7 January 2020, and the disease was ...

  22. The Anti-vaccination Movement: A Regression in Modern Medicine

    This paper evaluates and reviews the origins of the anti-vaccination movement, the reasons behind the recent strengthening of the movement, role of the internet in the spread of anti-vaccination ideas, and the repercussions in terms of public health and safety. Keywords: vaccination, mmr vaccine, measles outbreak, virus, anti-vaccine movement.

  23. Coronavirus disease (COVID-19): Vaccine research and development

    In a human challenge vaccine study, healthy volunteers are given an experimental vaccine, and then deliberately exposed to the organism causing the disease to see if the vaccine works. Some scientists believe that this approach could accelerate COVID-19 vaccine development, in part because it would require far fewer volunteers than a typical study.

  24. The full benefits of adult pneumococcal vaccination: A systematic

    Two vaccines offer adults protection from pneumococcal disease: a 23-valent pneumococcal polysaccharide vaccine (PPV23) first introduced in 1983 and a 13-valent pneumococcal conjugate vaccine (PCV13) first introduced in 2009 . In Europe, PCV13 was initially approved for children from six weeks to five years of age in 2009 and then for adults ...

  25. 2024 Top Faculty Awards Announced < Yale School of Public Health

    Dean Megan L. Ranney Thursday announced the recipients of this year's Distinguished Teaching Award and Distinguished Student Mentoring Award. Two outstanding members of the Yale School of Public Health faculty are being honored with the 2024 Distinguished Teaching Award this year - Associate Professor Michaela Dinan and Assistant Clinical ...