Evidence map›Paper›PMID 40169745›Full record

ArticleScientific reports2025

Spatial multilevel analysis of individual, household, and community factors associated with COVID-19 vaccine hesitancy in the Dominican Republic.

Behzad Kiani, Benn Sartorius, Beatris Mario Martin, Angela Cadavid Restrepo, Helen J Mayfield, Cecilia Then Paulino, Petr Jarolim, Micheal De St Aubin, Ronald Skews Ramm, Devan Dumas and 11 more

Abstract read
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Behzad KianiUniversity of Queensland Centre for Clinical Research (UQCCR), Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4029, Australia. B.Kiani@uq.edu.au.
Benn SartoriusUniversity of Queensland Centre for Clinical Research (UQCCR), Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4029, Australia.
Beatris Mario MartinUniversity of Queensland Centre for Clinical Research (UQCCR), Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4029, Australia.
Angela Cadavid RestrepoSchool of Public Health, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
Helen J MayfieldUniversity of Queensland Centre for Clinical Research (UQCCR), Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4029, Australia.
Cecilia Then PaulinoMinistry of Health and Social Assistance, Santo Domingo, Dominican Republic.
Petr JarolimBrigham and Women's Hospital, Boston, MA, USA.
Micheal De St AubinBrigham and Women's Hospital, Boston, MA, USA.
Ronald Skews RammMinistry of Health and Social Assistance, Santo Domingo, Dominican Republic.
Devan DumasBrigham and Women's Hospital, Boston, MA, USA.
Salome GarnierBrigham and Women's Hospital, Boston, MA, USA.
Marie Caroline EtienneBrigham and Women's Hospital, Boston, MA, USA.
Farah PeñaMinistry of Health and Social Assistance, Santo Domingo, Dominican Republic.
Gabriela AbdallaBrigham and Women's Hospital, Boston, MA, USA.
Adam KucharskiDepartment of Infectious Disease Epidemiology and Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
William DukeFaculty of Health Sciences, Pedro Henriquez Urena National University, Santo Domingo, Dominican Republic.
Margaret BaldwinBrigham and Women's Hospital, Boston, MA, USA.
Bernarda HenríquezMinistry of Health and Social Assistance, Santo Domingo, Dominican Republic.
Lucia de la CruzMinistry of Health and Social Assistance, Santo Domingo, Dominican Republic.
Eric J NillesBrigham and Women's Hospital, Boston, MA, USA.
Colleen L LauUniversity of Queensland Centre for Clinical Research (UQCCR), Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4029, Australia.

Funding

CGH CDC HHS U01 GH002238
6 · The paper itself

Abstract

Vaccine hesitancy or refusal poses a significant public health challenge resulting in the resurgence of preventable diseases and undermining the effectiveness of national and global health initiatives. This study investigates multilevel determinants of COVID-19 vaccine hesitancy in the Dominican Republic (DR) shortly after the launch of the national COVID-19 vaccination campaign in February 2021. Participants aged 18 years and older were enrolled through a national multistage cluster survey conducted from June-October 2021. The Health Belief Model guided the selection of potential factors contributing to vaccine hesitancy. Hierarchical mixed-effect logistic regression models were used to examine individual, household, and community factors associated with vaccine hesitancy. COVID-19 vaccine hesitancy was observed in 12.6% (95% CI: 11.7-13.5%) of participants (n = 5,566), with spatial variations at the cluster level. Individual factors associated with lower odds of vaccine hesitancy included older age, higher education levels, mulatto ethnicity, and perceiving vaccination as crucial for health. In contrast, factors significantly associated with hesitancy included being born in the DR and concerns about COVID-19 vaccine side effects. For factors at the household level, differential trust in health information sources significantly influenced vaccine hesitancy, with certain sources correlating with increased hesitancy and others with reduced vaccine hesitancy. Better access to healthcare, as indicated by a higher number of hospitals per population, was paradoxically associated with increased vaccine hesitancy. Future strategies to reduce vaccine hesitancy in the DR might consider these multifaceted factors.

Indexed as

COVID-19COVID-19 VaccinesVaccination HesitancyAdolescentAdultAgedDominican RepublicFamily CharacteristicsFemaleHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedMultilevel AnalysisSARS-CoV-2Spatial AnalysisCOVID-19 VaccinesCOVID-19Health belief modelHousehold dynamicsSocioeconomicThe Dominican RepublicVaccine acceptanceVaccine hesitancy

Identifiers

PMID40169745
PMCPMC11961636

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.