Royal society of Canada COVID-19 report: Enhancing COVID-19 vaccine acceptance in Canada

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Abstract

COVID-19 vaccine acceptance exists on a continuum from a minority who strongly oppose vaccination, to the “moveable middle” heterogeneous group with varying uncertainty levels about acceptance or hesitancy, to the majority who state willingness to be vaccinated. Intention for vaccine acceptance varies over time. COVID-19 vaccination decisions are influenced by many factors including knowledge, attitudes, and beliefs; social networks; communication environment; COVID-19 community rate; cultural and religious influences; ease of access; and the organization of health and community services and policies.

Reflecting vaccine acceptance complexity, the Royal Society of Canada Working Group on COVID-19 Vaccine Acceptance developed a framework with four major factor domains that influence vaccine acceptance (people, communities, health care workers; immunization knowledge; health care and public health systems including federal/provincial/territorial/indigenous factors)—each influencing the others and all influenced by education, infection control, extent of collaborations, and communications about COVID-19 immunization. The Working Group then developed 37 interrelated recommendations to support COVID vaccine acceptance nested under four categories of responsibility: 1. People and Communities, 2. Health Care Workers, 3. Health Care System and Local Public Health Units, and 4. Federal/Provincial/Territorial/Indigenous. To optimize outcomes, all must be engaged to ensure co-development and broad ownership.

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Vaccine hesitancy: Definition, scope and determinants.

Noni MacDonald (2015)

The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.

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Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

Derek K. Chu, Elie A. Akl, Stephanie Duda … (2020)

Summary Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. Methods We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respiratory syndrome, and Middle East respiratory syndrome from 21 standard WHO-specific and COVID-19-specific sources. We searched these data sources from database inception to May 3, 2020, with no restriction by language, for comparative studies and for contextual factors of acceptability, feasibility, resource use, and equity. We screened records, extracted data, and assessed risk of bias in duplicate. We did frequentist and Bayesian meta-analyses and random-effects meta-regressions. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO, CRD42020177047. Findings Our search identified 172 observational studies across 16 countries and six continents, with no randomised controlled trials and 44 relevant comparative studies in health-care and non-health-care settings (n=25 697 patients). Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] −10·2%, 95% CI −11·5 to −7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; p interaction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD −14·3%, −15·9 to −10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12–16-layer cotton masks; p interaction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD −10·6%, 95% CI −12·5 to −7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings. Interpretation The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance. Funding World Health Organization.

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Dilemmas in a general theory of planning

Horst Rittel, Melvin M. Webber (1973)

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Author and article information

Journal

Title: FACETS

Abbreviated Title: FACETS

Publisher: Canadian Science Publishing

ISSN (Electronic): 2371-1671

Publication date Created: January 01 2021

Publication date (Print): January 01 2021

Volume: 6

Pages: 1184-1246

Affiliations

[1 ]Department of Pediatrics (Infectious Diseases), Faculty of Medicine, Dalhousie University and IWK Health Centre, Halifax, Canada

[2 ]Division of Infectious Diseases, Dalhousie University and IWK Health Centre, Halifax, Canada

[3 ]Scientific Group on Immunization at the Quebec National Institute of Public Health, Québec, Canada

[4 ]Department of Anthropology, Université Laval, Québec, QC G1V 0A6, Canada

[5 ]Department of Pediatrics, Division of Infectious Diseases, Dalhousie University, Halifax, NS B3H 2Y9, Canada

[6 ]School of Education, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada

[7 ]Department of First Nations Studies, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada

[8 ]National Collaborating Centre for Indigenous Health, Prince George, BC V2N 4Z9, Canada

[9 ]Department of Pediatrics, Technoscience and Regulation Research Unit, Dalhousie University, Halifax, NS B3H 4R2, Canada

[10 ]Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada

[11 ]Health Sciences North Research Institute, Sudbury, ON P3E 2H2, Canada

[12 ]Pediatric Pain, Health and Communication Lab (PPHC), University of Guelph, Guelph, ON N1G 2W1, Canada

[13 ]Department of Psychology, University of Guelph, Guelph, ON N1G 2W1, Canada

[14 ]Clinical and Health Psychologist with the Pediatric Chronic Pain Program, McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada

[15 ]Schulich Executive Education Centre, York University, North York, ON M3J 1P3, Canada

[16 ]School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada

[17 ]Clinical Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada

[18 ]The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada

Article

DOI: 10.1139/facets-2021-0037

SO-VID: 641de7a4-d0fa-43ba-8431-be207b68a046

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