{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T07:25:46Z","timestamp":1768634746153,"version":"3.49.0"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coronavirus 2019 (COVID-19) has become a public-health emergency of international concern. Most efforts to contain the spread and transmission of the virus rely on campaigns and interventions targeted to reduce Vaccine Hesitancy and Refusal (VHR).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>this study aims to assess the major factors associated with VHR in the older population in Portugal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>a nation-wide cross-sectional study was conducted in the older Portuguese population (\u226565\u00a0years old) through computer-assisted telephone interviewing. Logistic regression was used to determine the adjusted odds ratio (OR) of the independent variables (perceptions, knowledge and attitudes) and of the outcome (VHR).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>the response rate was 60.1% (602\/1,001). Perceptions, knowledge and attitudes were strongly associated with VHR probability. A 1-point Likert scale increase in concerns about the vaccines\u2019 efficacy and safety increased the risk of VHR by 1.96 (95% confidence interval [CI]: 1.40\u20136.28) and 3.13 (95%CI: 2.08\u20138.22), respectively. A reduction of VHR probability for \u2018reliability of the information released by social media\u2019 (OR\u2009=\u20090.34, 95%CI: 0.16\u20130.70) and for \u2018trust in national and international competent authorities\u2019 (OR\u2009=\u20090.34, 95%CI: 0.17\u20130.69) is also observed per 1-point increase.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>as VHR seems to be strongly associated with perceptions, knowledge and attitudes, the design and promotion of vaccination campaigns\/educational interventions specifically targeted at changing these potentially modifiable determinants may help to tackle COVID-19 VHR and achieve a wider vaccine coverage.<\/jats:p>\n               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Sciences, , Aveiro,","place":["Portugal"]}]},{"given":"V\u00edtor","family":"Roque","sequence":"additional","affiliation":[{"name":"Research Unit for Inland Development, Guarda Polytechnic Institute (UDI-IPG) , Guarda,","place":["Portugal"]}]},{"given":"Eva Rebelo","family":"Gomes","sequence":"additional","affiliation":[{"name":"Allergy and Clinical Immunology Service , , Porto,","place":["Portugal"]},{"name":"University Hospital Center of Porto , , Porto,","place":["Portugal"]}]},{"given":"Adolfo","family":"Figueiras","sequence":"additional","affiliation":[{"name":"Health Research Institute of Santiago de Compostela (IDIS) , , Santiago de Compostela,","place":["Spain"]},{"name":"University of Santiago de Compostela , , Santiago de Compostela,","place":["Spain"]},{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP) , Santiago de Compostela,","place":["Spain"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0169-3788","authenticated-orcid":false,"given":"F\u00e1tima","family":"Roque","sequence":"additional","affiliation":[{"name":"Research Unit for Inland Development, Guarda Polytechnic Institute (UDI-IPG) , Guarda,","place":["Portugal"]},{"name":"Health Sciences Research Center , , Covilh\u00e3,","place":["Portugal"]},{"name":"University of Beira Interior (CICS-UBI) , , Covilh\u00e3,","place":["Portugal"]}]},{"given":"Maria Teresa","family":"Herdeiro","sequence":"additional","affiliation":[{"name":"iBiMED \u2013 Institute of Biomedicine , Department of Medical Sciences, , Aveiro,","place":["Portugal"]},{"name":"University of Aveiro , Department of Medical Sciences, , Aveiro,","place":["Portugal"]}]}],"member":"286","published-online":{"date-parts":[[2022,3,8]]},"reference":[{"key":"2024103110065404800_ref1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-048172","article-title":"Public acceptance of 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