Impact of COVID-19 vaccination on risk perception: a cross- sectional study on vaccinated people

Abstract Background High risk perception and perceived threat of COVID-19 had played an important role on public attitudes toward vaccination and protective countermeasures acting as motivational factors to perform behaviors that facilitated disease prevention. To explore COVID-19 vaccination influence we conducted a cross-sectional study on vaccinated people (18-80 years old). Methods Partecipants, randomly selected, were recruited during the vaccination campaign in the Hub of Cosenza, Calabria Region, Italy, at the end of the 2nd wave of pandemic (Jul-Aug 2021). A multivariable logistic regression model was built to calculate odds ratios (OR) and 95% confidence intervals (95% CI) comparing risk perception and preventive measures confidence pre vs. post vaccination. Results Globally 625 partecipants fully responded; 51.4% women, mean age 40.5 years (SD +/-15.36). Infection risk perception and protective measures adherence significantly decreased after the vaccination even if a significant gender gap was present; women were always more worried and respectful than men. More prudent partecipants had a significantly higher mean age. 64.2% of participants believed that compliance with social distancing was yet absolutely necessary after the immunization and about half of them believed that also the use of masks was yet necessary. Results of multivariable analysis confirmed that risk perception decreases after vaccination in different contexts: workplace (0.65; 95% CI 0.44-0.94); sport activities (0.60; 95% CI 0.39-0.95); bars and restaurants (0.51; 95% CI 0.33-0.80); means of transport (0.32; 95% CI 0.19-0.50) as well as handwashing practice (2.23 95% CI 1.20-4.12). Conclusions The research shows that COVID-19 vaccination significantly decreases self-perceived risk and adherence to preventive measures. Public Health communication strategies could underline that COVID-19 vaccination is indispensabile but not sufficient to protect the World against this devastating catastrophe. Key messages • Public Health should promote consciousness and strengthen the importance of health-protective measures in order to further reduce risk of human-to-human transmission after immunization. • Even after vaccination, extra precautions are still required and necessary to do not nullify vaccination protective effect, mostly in more exposed and less careful groups like young people.


Issue/Problem:
The risk of SARS-Cov-2 infection and its adverse health effects proved to be higher among socially disadvantaged groups, including migants and ethnic minorities. Hard-to-reach (HTR) migrants, such as undocumented people, those living in informal settelments (e.g squats) or roma people have experienced severe barries to access COVID-19 information, testing and vaccination services. Description of the problem: During 2020 and 2021, the Migrants'Health Unit of Roma 2 Local Health Unit (ASL) developed different strategies to control the COVID-19 epidemics in HTR communities, addressing both the containment of clusters in informal settelments and access to COVID-19 vaccination for these population.

Methods:
A multicomponent and multidisciplinary strategy was implemented, based on a strong collaboration of different services across the ASL and with Non Governmental Organizations (NGOs). Starting from a mapping of the settlements and the identification of the main critical issues for the control of the epidemic in the target populations, interventions were carried out that included the involvement of NGOS in active surveillance, reporting of suspected cases of COVID-19 to the ASL and information to the communities, and the reorganization of health interventions (eg, swabs, epidemiological investigations, COVID-19 vaccinations) directly in HTR communities' life places.

Results:
In the period from April 2020 to February 2021, 15 outbreaks were controlled, for a total of over 4500 persons reached, and 265 COVID-19 cases identified. From July to November 2021, vaccinations were offered in outreach or with dedicated vaccination sessions, which reached 1664 people. The intervention model, based on a deep context analysis, strong multisectoral collaboration, community involvement, lays the foundations for the design of public health strategies, not only aimed at HTR populations.

Key messages:
Controlling COVID-19 in Hard-to-reach migrant populations was possible thanks to a strong collaboration between public health services and NGOs. Public health interventions addressed complex groups should envisage intersectoral collaborations, reorientation of services in order to meet target groups' need and community involvement.

Background:
High risk perception and perceived threat of COVID-19 had played an important role on public attitudes toward vaccination and protective countermeasures acting as motivational factors to perform behaviors that facilitated disease prevention.
To explore COVID-19 vaccination influence we conducted a cross-sectional study on vaccinated people (18-80 years old).

Methods:
Partecipants, randomly selected, were recruited during the vaccination campaign in the Hub of Cosenza, Calabria Region, Italy, at the end of the 2nd wave of pandemic (Jul-Aug 2021).
A multivariable logistic regression model was built to calculate odds ratios (OR) and 95% confidence intervals (95% CI) comparing risk perception and preventive measures confidence pre vs. post vaccination.

Results:
Globally 625 partecipants fully responded; 51.4% women, mean age 40.5 years (SD +/-15.36). Infection risk perception and protective measures adherence significantly decreased after the vaccination even if a significant gender gap was present; women were always more worried and respectful than men. More prudent partecipants had a significantly higher mean age. 64.2% of participants believed that compliance with social distancing was yet absolutely necessary after the immunization and about half of them believed that also the use of masks was yet necessary. Results of multivariable analysis confirmed that risk perception decreases after vaccination in different contexts: workplace (0.65; 95% CI 0.44-0.94); sport activities (0.60; 95% CI 0.39-0.95); bars and restaurants (0.51; 95% CI 0.33-0.80); means of transport (0.32; 95% CI 0.19-0.50) as well as handwashing practice (2.23 95% CI 1.20-4.12).

Conclusions:
The research shows that COVID-19 vaccination significantly decreases self-perceived risk and adherence to preventive measures. Public Health communication strategies could underline that COVID-19 vaccination is indispensabile but not sufficient to protect the World against this devastating catastrophe.
Key messages: Public Health should promote consciousness and strengthen the importance of health-protective measures in order to further reduce risk of human-to-human transmission after immunization. Even after vaccination, extra precautions are still required and necessary to do not nullify vaccination protective effect, mostly in more exposed and less careful groups like young people.

Background:
Pregnant and breastfeeding women are at an increased risk of severe illness from COVID-19 compared to people who are not pregnant. Therefore, the CDC recommends COVID-19 vaccination for women who are pregnant, breastfeeding, and trying to become pregnant or who may become pregnant in the future. Despite this, low vaccination coverages are reported in this population sub-group. The purpose of this study is to estimate the proportion of pregnant and breastfeeding women expressing hesitation to the COVID-19 vaccine worldwide. Determinants of vaccine compliance and options suggestedto address vaccine hesitancy were also analyzed.

Methods:
Forty-six studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar, and Scopus databases between January 1, 2020 and February 6, 2022. The following terms were used for the search strategy: (adherence OR hesitancy OR compliance OR attitude) AND (covid Ã OR SARS Ã ) AND (vaccin Ã OR immun Ã ) AND (pregnan Ã OR postpartum OR breastfeeding OR lactating).

Results:
The vaccine hesitation rate was 48.4% (95%CI = 43.4-53.4%). In a sub analysis by study period, the pooled prevalence of vaccine hesitation was 40.0% (95%CI = 31.6-46.6%) considering surveys administered in 2020, 58.0% (95%CI = 48.9-66.9%) considering surveys administered in the first semester of 2021, and 38.1% (95%CI = 25.9-51.2%) considering surveys administered in the second semester of 2021. The main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events for both mother and fetus/child.

Conclusions:
In order to achieve high vaccination coverage, a multifactorial approach is needed, requiring major social, scientific, and health efforts. The success of the vaccination campaign in this population depends on the capillarity and consistency of the interventions implemented.

Key messages:
Vaccine hesitancy can be a determining factor in the success (or otherwise) of the anti-COVID-19 immunization campaign. Vaccine hesitancy in pregnant and breastfeeding women is a genuine public health concern worldwide. Abstract citation ID: ckac129.666 Impact of booster vaccination on COVID-19 outcomes in Portuguese population aged 80 or more years old