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      COVID-19 vaccine confidence and hesitancy among health care workers: A cross-sectional survey from a MERS-CoV experienced nation

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          Abstract

          Objectives

          This study aimed to identify coronavirus disease 2019 (COVID-19) vaccine perception, acceptance, confidence, hesitancy, and barriers among health care workers (HCWs).

          Methods

          An online national cross-sectional pilot-validated questionnaire was self-administered by HCWs in Saudi Arabia, which is a nation with MERS-CoV experience. The main outcome variable was HCWs’ acceptance of COVID-19 vaccine candidates. The factors associated with vaccination acceptance were identified through a logistic regression analysis, and the level of anxiety was measured using a validated instrument to measure general anxiety levels.

          Results

          Out of the 1512 HCWs who completed the study questionnaire—of which 62.4% were women—70% were willing to receive COVID-19 vaccines. A logistic regression analysis revealed that male HCWs (ORa = 1.551, 95% CI: 1.122–2.144), HCWs who believe in vaccine safety (ORa = 2.151; 95% CI: 1.708–2.708), HCWs who believe that COVID vaccines are the most likely way to stop the pandemic (ORa = 1.539; 95% CI: 1.259–1.881), and HCWs who rely on the Centers for Disease Control and Prevention website for COVID 19 updates (ORa = 1.505, 95% CI: 1.125–2.013) were significantly associated with reporting a willingness to be vaccinated. However, HCWs who believed that the vaccines were rushed without evidence-informed testing were found to be 60% less inclined to accept COVID-19 vaccines (ORa = 0.394, 95% CI: 0.298–0.522).

          Conclusion

          Most HCWs are willing to receive COVID-19 vaccines once they are available; the satisfactoriness of COVID-19 vaccination among HCWs is crucial because health professionals’ knowledge and confidence toward vaccines are important determining factors for not only their own vaccine acceptance but also recommendation for such vaccines to their patients.

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          Most cited references50

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            A Novel Coronavirus from Patients with Pneumonia in China, 2019

            Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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              Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia.

              A previously unknown coronavirus was isolated from the sputum of a 60-year-old man who presented with acute pneumonia and subsequent renal failure with a fatal outcome in Saudi Arabia. The virus (called HCoV-EMC) replicated readily in cell culture, producing cytopathic effects of rounding, detachment, and syncytium formation. The virus represents a novel betacoronavirus species. The closest known relatives are bat coronaviruses HKU4 and HKU5. Here, the clinical data, virus isolation, and molecular identification are presented. The clinical picture was remarkably similar to that of the severe acute respiratory syndrome (SARS) outbreak in 2003 and reminds us that animal coronaviruses can cause severe disease in humans.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: SoftwareRole: ValidationRole: Visualization
                Role: Data curationRole: Formal analysisRole: InvestigationRole: ValidationRole: Visualization
                Role: Data curationRole: MethodologyRole: ResourcesRole: VisualizationRole: Writing – review & editing
                Role: ResourcesRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: SoftwareRole: VisualizationRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: Resources
                Role: InvestigationRole: MethodologyRole: Resources
                Role: ValidationRole: Writing – review & editing
                Role: ResourcesRole: SoftwareRole: Visualization
                Role: ResourcesRole: SoftwareRole: ValidationRole: Visualization
                Role: Data curationRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: Project administrationRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: SupervisionRole: ValidationRole: Writing – review & editing
                Role: InvestigationRole: MethodologyRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                29 November 2021
                2021
                29 November 2021
                : 16
                : 11
                : e0244415
                Affiliations
                [1 ] Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
                [2 ] Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
                [3 ] College of Medicine, King Saud University, Riyadh, Saudi Arabia
                [4 ] Division of Pediatric Cardiology, Cardiac Science Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
                [5 ] Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
                [6 ] Critical Care Dept, College of Medicine, King Saud University, Riyadh, Saudi Arabia
                [7 ] Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
                [8 ] College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
                [9 ] Department of Medicine, College of Medicine, Qassim University, Qassim, Saudi Arabia
                [10 ] Director Research and Innovation Centre, King Saud Medical City, Ministry of Health & College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
                [11 ] Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
                [12 ] Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Health Care, Dhahran, Saudi Arabia
                [13 ] Infectious disease division, Department of Medicine, Indiana University School of Medicine, Indiana, United States of America
                [14 ] Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
                Federal University of Rio de Janeiro, BRAZIL
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0003-2274-007X
                https://orcid.org/0000-0002-4389-9322
                https://orcid.org/0000-0002-9380-079X
                https://orcid.org/0000-0002-6051-9125
                https://orcid.org/0000-0001-8404-6652
                https://orcid.org/0000-0002-4682-5927
                https://orcid.org/0000-0003-2126-7874
                https://orcid.org/0000-0002-4979-3895
                https://orcid.org/0000-0002-4291-8536
                https://orcid.org/0000-0002-7706-2328
                https://orcid.org/0000-0002-6516-7771
                https://orcid.org/0000-0002-4051-6592
                https://orcid.org/0000-0002-3128-5921
                https://orcid.org/0000-0002-5099-0714
                https://orcid.org/0000-0002-5752-2235
                Article
                PONE-D-20-39216
                10.1371/journal.pone.0244415
                8629228
                34843462
                394eff7e-c0e4-45ee-84bd-a393ed866cc4
                © 2021 Barry et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 14 December 2020
                : 13 October 2021
                Page count
                Figures: 1, Tables: 4, Pages: 16
                Funding
                The authors received no specific funding for this work.
                Categories
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                Raw dataset based on the questionnaires submitted by the participants in our study can be accessed through Dryad (DOI): doi: 10.5061/dryad.cnp5hqc5h.
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