title: COVID-19 vaccine willingness and long COVID predictors among Chinese residents in Canada
Creators: name: Shariati, Matin 
Publisher: name: Memorial University of Newfoundland
publisherIdentifier: https://ror.org/04haebc03
publisherIdentifierScheme: ROR
Year: 2025

description: Purpose This thesis investigated two critical aspects of the COVID-19 pandemic among Chinese residents in Canada: vaccine willingness and long COVID prevalence. Vaccination has been identified as a critical approach to controlling the COVID-19 pandemic. Long COVID, characterized by persistent COVID-19 symptoms beyond the initial infection, emerged as a public health concern worldwide. This study aimed to assess the COVID-19 vaccine willingness and the associated factors among Chinese residents in Canada during the early stage of the pandemic. Moreover, this study investigated the frequency, main symptoms, and the associated risk factors of long COVID among Chinese residents in Canada. Methods Two surveys were conducted: the first one, at the time of the initial distribution of the COVID-19 vaccine in Canada in early 2021, examined diverse aspects of COVID-19 vaccine willingness such as sociodemographic information, beliefs, perceptions, experiences, and emotions; the second survey, done in early 2023, focused on long COVID, defined as symptoms persisting beyond 12 weeks’ post-infection, to explore related experiences, sociodemographic factors, psychological resilience, clinical status, and vaccination history. Both surveys were cross-sectional and were administered among Chinese residents aged over 16 in Canada and who have lived in Canada for at least six months. Utilizing SAS software version 9.4, multiple variable logistic regression iii analyses were employed to investigate the determinants influencing vaccine willingness and examine the risk factors associated with long COVID, considering P-value<0.05. Results Among the 970 eligible respondents of the former study, about 40% expressed reluctance or uncertainty about COVID-19 vaccination, citing safety concerns. Men exhibited twice the willingness compared to women (OR 2.09, 95% CI 1.43-3.04, p=0.0001). A high level of education also influenced acceptance (OR 1.85, 95% CI 1.33-2.59, P=0.0003). Healthcare workers were about three times more likely to accept vaccination (OR 2.94, 95% CI 1.42-6.07, p=0.0035). Also, Blood group B individuals were more willing to receive the COVID-19 vaccine than those with other blood types (OR 2.25, 95% CI 1.23-4.13, p=0.0086). Those believing in vaccine efficacy (OR 3.43, 95% CI 1.57-7.47, p=0.0019) and who received influenza vaccination since October 2020 (OR 2.79, 95% CI 2.01-3.89, p<0.0001) were more inclined to accept COVID-19 vaccination. In the later study of 488 eligible participants for long COVID, 24.1% reported symptoms. Fatigue (46.3%), memory problems (42.9%), and anxiety/depression (30.2%) were common. More than 70% had underlying diseases, with allergies most prevalent (31.8%). 96.7% were fully vaccinated. Women were 2.24 times more likely to report long COVID (95% CI: 1.09-4.57; P=0.026). Worsening health status pre-COVID-19 increased the odds of long COVID (OR= 4.29; 95% CI: 2.05-6.92; P=0.008). Long COVID was more likely in those with reported vaccine side effects (OR=2.17; 95% CI: 1.14-4.11; P=0.017). Conclusions Findings from this research highlighted the critical influence of factors such as vaccine safety concerns, trust in health authorities, and beliefs regarding vaccine efficacy on COVID-19 vaccine willingness. These insights emphasized the necessity for tailored public health messaging and interventions to address the specific concerns of diverse communities and enhance vaccine uptake. Enhancing vaccine uptake requires providing adequate information and tailored public health interventions to address safety concerns. Additionally, this study revealed a notable prevalence of long COVID among Chinese Canadians, particularly affecting women and those with poor health. This underscored the heightened healthcare needs of these groups to effectively prevent long COVID. Further research into the relationship between long COVID and previous vaccine side effects is necessary to effectively inform future public health strategies.