COVID-19 Vaccine Hesitancy and Early Adverse Events Reported in a Cohort of 7,881 Italian Physicians
Keywords:
Vaccine Hesitancy, Early adverse events, COVID-19, Sars-CoV-2, PhysiciansAbstract
Background. The COVID-19 vaccination campaign began in Italy at the end of December 2020, with the primary aim of immunizing healthcare professionals, using the EMA approved mRNA vaccines (Comirnaty® by Pfizer/BioNTech; mRNA-1273 by Moderna) and recombinant adenoviral vaccine (Vaxzevria® by AstraZeneca). The study aimed at evaluating the prevalence and motivations underlying Vaccine Hesitancy, as well as the incidence and type of adverse events associated with COVID-19 vaccination.
Methods. Cross-sectional study. Data were collected January 1st to 28th 2021 using a purposely created online self-administered questionnaire from a selected cohort of Italian physicians.
Results. Overall, 7,881 questionnaires were analyzed: 6,612 physicians had received one dose, and 1,670 two doses of Comirnaty®; 30 had received one dose of mRNA-1273. Vaccine Hesitancy rate was 3.6%; it correlated with prior SARS-CoV-2 infection, diabetes, Adverse Eventss at previous vaccinations and refusal of 2020 flu vaccine, and was mainly motivated by concerns about vaccine Adverse Events. Typical Adverse Events were pain/itching/paresthesia at the inoculation site, followed by headache, fever, fatigue and myalgia/arthralgia occurring more frequently after the second dose (77.8 vs 66.9%; p<0.001), and in subjects with a prior SARS-CoV-2 infection.
Conclusion. Adherence to COVID-19 vaccination is high among physicians. Adverse Events are typically mild and more frequent in people with a prior SARS-CoV-2 infection.
References
1. EpiCentro. Infografica web - Dati della Sorveglianza integrata COVID-19 in Italia. 2021 Feb 7. Available on: https://www.epicentro.iss. it/coronavirus/sars-cov-2-dashboard [Last accessed: 2021 Jul 30].
2. Polack FP, Thomas SJ, Kitchin N, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med. 2020 Dec 31; 383(27): 2603-15. doi: 10.1056/NEJMoa2034577. Epub 2020 Dec 10.
3. Baden LR, El Sahly HM, Essink B, et al. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N Engl J Med. 2021 Feb 4; 384(5): 403-16. doi: 10.1056/NEJMoa2035389. Epub 2020 Dec 30.
4. Ramasamy MN, Minassian AM, Ewer KJ, et al. Safety and immunogenicity of ChAdOx1 nCoV-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): a single-blind, randomised, controlled, phase 2/3 trial. Lancet. 2020 Dec 19; 396(10267): 197993. doi: 10.1016/S0140-6736(20)32466-1. Epub 2020 Nov 19.
5. Kim JH, Marks F, Clemens JD. Looking beyond COVID-19 vaccine phase 3 trials. Nat Med. 2021 Feb; 205-11. doi: 10.1038/s41591-021-01230-y. Epub 2021 Jan 19.
6. Bubar KM, Reinholt K, Kissler SM, et al. Model-informed COVID-19 vaccine prioritization strategies by age and serostatus. Science. 2021 Feb 26; 371(6532): 916-21. doi: 10.1126/ science.abe6959. Epub 2021 Jan 21.
7. Ministero della Salute. Vaccinazione antiSARS-CoV-2/COVID-19 - Piano strategico. Elementi di preparazione e di implementazione della strategia vaccinale. 2021 Jan 10. Available on: http://www.salute.gov.it/imgs/C_17_ pubblicazioni_2986_allegato.pdf [Last accessed: 2021 Jul 30].
8. MacDonald NE; SAGE Working Group on
Vaccine Hesitancy. Vaccine hesitancy: Defini-
tion, scope and determinants. Vaccine. 2015 Aug 14; 33(34): 4161-4. doi: 10.1016/j.
vaccine.2015.04.036. Epub 2015 Apr 17.
9. European Centre for Disease Prevention and Control (ECDC). Vaccine hesitancy among healthcare workers and their patients in Europe: a qualitative study. (Internet). LU: Publications Office; 2015. Available on: https://data.europa. eu/doi/10.2900/425780 [Last accessed: 2021 Jul 30].
10. Neumann-Böhme S, Varghese NE, Sabat I, et al. Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19. Eur J Health Econ. 2020 Sep; 21(7): 977-82. doi: 10.1007/s10198-020-01208-6.
11. Peretti-Watel P, Seror V, Cortaredona S, et al. A future vaccination campaign against COVID-19 at risk of vaccine hesitancy and politicisation. Lancet Infect Dis. 2020 Jul; 20(7): 769-70. doi: 10.1016/S1473-3099(20)30426-6. Epub 2020 May 20.
12. Reiter PL, Pennell ML, Katz ML. Acceptability of a COVID-19 vaccine among adults in the United States: How many people would get vaccinated? Vaccine. 2020 Sep 29; 38(42): 6500-7. doi: 10.1016/j.vaccine.2020.08.043. Epub 2020 Aug 20.
13. Dodd RH, Cvejic E, Bonner C, Pickles K, McCaffery KJ; Sydney Health Literacy Lab COVID-19 group. Willingness to vaccinate against COVID-19 in Australia. Lancet Infect Dis. 2021 Mar 3; doi: 10.1016/S1473-3099(20)30559-4. Epub 2020 Jun 30.
14. Chen M, Li Y, Chen J, et al. An online survey of the attitude and willingness of Chinese adults to receive COVID-19 vaccination. Hum Vaccin Immunother. 2021 Jul 3; 17(7): 2279-88. doi: 10.1080/21645515.2020.1853449. Epub 2021 Jan 31.
15. Seale H, Heywood AE, Leask J, et al. Examining Australian public perceptions and behaviors towards a future COVID-19 vaccine. BMC Infect Dis. 2021 Jan 28; 21(1): 120. doi: 10.1186/ s12879-021-05833-1.
16. Yoda T, Katsuyama H. Willingness to Receive COVID-19 Vaccination in Japan. Vaccines (Basel). 2021 Jan 14; 9(1): 48. doi: 10.3390/ vaccines9010048.
17. Grech V, Gauci C, Agius S. Vaccine hesitancy among Maltese healthcare workers toward influenza and novel COVID-19 vaccination. Early Hum Dev. 2020 Oct 1; 105213. doi: 10.1016/j. earlhumdev.2020.105213. Epub ahead of print.
18. Grech V, Bonnici J, Zammit D. WITHDRAWN: Vaccine hesitancy in Maltese family physicians and their trainees vis-à-vis influenza and novel COVID-19 vaccination. Early Hum Dev. 2020 Nov 12; 105259. doi: 10.1016/j.
earlhumdev.2020.105259. Epub ahead of print.
19. Di Giuseppe G, Pelullo CP, Paolantonio A, Della Polla G, Pavia M. Healthcare Workers’ Willingness to Receive Influenza Vaccination in the Context of the COVID-19 Pandemic: A Survey in Southern Italy. Vaccines. 2021 Jul 9; 9(7): 766. https://doi.org/10.3390/vaccines9070766.
20. Salomoni MG, Di Valerio Z, Gabrielli E, et al. Hesitant or Not Hesitant? A Systematic Review on Global COVID-19 Vaccine Acceptance in Different Populations. Vaccines. 2021 Aug 6; 9(8): 873. https://doi.org/10.3390/vaccines9080873.
21. Godlee F. What should we do about vaccine hesitancy? BMJ. 2019 Jun 6; 365: l4044. doi: https://doi.org/10.1136/bmj.l4044.
22. Graham BS. Rapid COVID-19 vaccine development. Science. 2020 May 29; 368(6494): 945-6. doi: 10.1126/science.abb8923. Epub 2020 May 8.
23. Harrison EA, Wu JW. Vaccine confidence in the time of COVID-19. Eur J Epidemiol. 2020 Apr; 35(4): 325-30. doi: 10.1007/s10654-02000634-3. Epub 2020 Apr 22.
24. Agenzia Italiana del Farmaco (AIFA). Primo rapporto AIFA sulla sorveglianza dei vaccini COVID-19. 2021 Feb 9. Available on: https:// www.aifa.gov.it/-/primo-rapporto-aifa-sulla-sorveglianza-dei-vaccini-covid-19 [Last accessed:
2021 Jul 30].
25. Watson GI, Nichols JA, Robshaw JRM. Revaccination against measles—a pilot study. J R Coll Gen Pract. 1975 Dec; 25(161): 863-73.
26. Dan JM, Mateus J, Kato Y, et al. Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science. 2021 Feb 5; 371(6529): eabf4063. doi: 10.1126/science. abf4063. Epub 2021 Jan 6.
27. Callaway E. Could new COVID variants undermine vaccines? Labs scramble to find out. Nature. 2021 Jan 7; 589(7841): 177-8. doi:
10.1038/d41586-021-00031-0.
28. Cao W-C, Liu W, Zhang P-H, Zhang F, Richardus JH. Disappearance of antibodies to SARSassociated coronavirus after recovery. N Engl J Med. 2007 Sep 13; 357(11): 1162-3. doi: 10.1056/NEJMc070348.
29. Wu L-P, Wang N-C, Chang Y-H, et al. Duration of Antibody Responses after Severe Acute Respiratory Syndrome. Emerg Infect Dis. 2007 Oct; 13(10): 1562–4. doi: 10.3201/eid1310.070576.
30. Callow KA, Parry HF, Sergeant M, Tyrrell DA. The time course of the immune response to experimental coronavirus infection of man. Epidemiol Infect. 1990 Oct; 105(2): 435-46.
doi: 10.1017/s0950268800048019.
31. Callaway E. The race for coronavirus vaccines: a graphical guide. Nature. 2020 Apr; 580(7805): 576-7. doi: 10.1038/d41586-020-01221-y.
32. Pardi N, Hogan MJ, Porter FW, Weissman D. mRNA vaccines — a new era in vaccinology. Nat Rev Drug Discov. 2018 Apr; 17(4): 261-79. doi: 10.1038/nrd.2017.243.Epub 2018 Jan 12.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.