A machine learning approach to identify psychological factors driving vaccine hesitancy in high income countries

Abstract Understanding factors driving vaccine hesitancy is crucial to vaccination success. We surveyed adults (N=2510) from February to March 2021 across five sites (Australia=502, Germany=516, Hong Kong=445, UK=512, USA=535) using a cross-sectional design and stratified quota sampling for age, sex, and education. We assessed willingness to take a vaccine and a comprehensive set of putative predictors. Predictive power was analysed with regression analyses and machine learning algorithms. Only 57.4% of the participants indicated that they would definitely or probably get vaccinated. A parsimonious machine-learning model could identify vaccine hesitancy with high accuracy (i.e. 83% sensitivity and 82% specificity) using 10 variables only. The most relevant predictors were vaccination conspiracy beliefs, paranoid concerns related to the pandemic, COVID anxiety, high perceived risk of infection, low perceived social rank, lower age, and female gender. Campaigns seeking to increase vaccine uptake need to take mistrust as the main driver of vaccine hesitancy into account.

Download Full-text

A machine learning approach to identify psychological factors driving vaccine hesitancy in high income countries

10.21203/rs.3.rs-787170/v2 ◽

2021 ◽

Author(s):

Tania Lincoln ◽

Björn Schlier ◽

Felix Strakeljahn ◽

Brandon Gaudiano ◽

Suzanne So ◽

...

Keyword(s):

Machine Learning ◽

Perceived Risk ◽

Social Rank ◽

Female Gender ◽

Machine Learning Algorithms ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Conspiracy Beliefs ◽

Cross Sectional Design

Abstract Understanding factors driving vaccine hesitancy is crucial to vaccination success. We surveyed adults (N = 2510) from February to March 2021 across five sites (Australia = 502, Germany = 516, Hong Kong = 445, UK = 512, USA = 535) using a cross-sectional design and stratified quota sampling for age, sex, and education. We assessed willingness to take a vaccine and a comprehensive set of putative predictors. Predictive power was analysed with regression analyses and machine learning algorithms. Only 57.4% of the participants indicated that they would definitely or probably get vaccinated. A parsimonious machine-learning model could identify vaccine hesitancy with high accuracy (i.e. 83% sensitivity and 82% specificity) using 10 variables only. The most relevant predictors were vaccination conspiracy beliefs, paranoid concerns related to the pandemic, COVID anxiety, high perceived risk of infection, low perceived social rank, lower age, and female gender. Campaigns seeking to increase vaccine uptake need to take mistrust as the main driver of vaccine hesitancy into account.

Download Full-text

Willingness to Receive the COVID-19 and Seasonal Influenza Vaccines among the Saudi Population and Vaccine Uptake During the Initial Stage of the National Vaccination Campaign: A Cross-Sectional Survey

Vaccines ◽

10.3390/vaccines9070765 ◽

2021 ◽

Vol 9 (7) ◽

pp. 765

Author(s):

Amel Ahmed Fayed ◽

Abeer Salem Al Shahrani ◽

Leenah Tawfiq Almanea ◽

Nardeen Ibrahim Alsweed ◽

Layla Mohammed Almarzoug ◽

...

Keyword(s):

Saudi Arabia ◽

Perceived Risk ◽

Online Survey ◽

Seasonal Influenza ◽

Vaccination Campaign ◽

Vaccine Uptake ◽

Influenza Vaccines ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

To Receive

This study aimed to assess the willingness to receive the coronavirus disease 2019 (COVID-19) and seasonal influenza vaccines and vaccine uptake during the early stage of the national vaccination campaign in Saudi Arabia. A cross-sectional online survey was conducted among adult Saudis between 20 January and 20 March 2021. The questionnaire addressed vaccine hesitancy, perceived risk, willingness, and vaccine uptake. Approximately 39% of the participants expressed vaccine hesitancy, and 29.8% and 24% felt highly vulnerable to contracting COVID-19 and seasonal influenza, respectively. The majority (59.5%) were willing to receive the COVID-19 vaccine, although only 31.7% were willing to receive the flu vaccine. Adjusted analysis showed that vaccine hesitancy (OR 0.34, 95% CI 0.27–0.43) and the perception of being at high risk (OR 2.78, 95% CI 1.68–4.60) independently affected the intention to be vaccinated. Vaccine hesitancy was similar among those who were willing to be vaccinated (29.8%) and those who had already been vaccinated (33.1%). The perceived risk was significantly higher among those who had been vaccinated (48.1%) than among those who were willing to be vaccinated but had not yet been vaccinated (29.1%). In conclusion, the acceptance of the COVID-19 vaccine in Saudi Arabia is high. Saudis who received the vaccine had a similar level of vaccine hesitancy and a higher level of perceived risk.

Download Full-text

Enhancing COVID-19 Vaccines Acceptance: Results from a Survey on Vaccine Hesitancy in Northern Italy

Vaccines ◽

10.3390/vaccines9040378 ◽

2021 ◽

Vol 9 (4) ◽

pp. 378

Author(s):

Chiara Reno ◽

Elisa Maietti ◽

Maria Pia Fantini ◽

Elena Savoia ◽

Lamberto Manzoli ◽

...

Keyword(s):

Low Income ◽

Perceived Risk ◽

Online Survey ◽

Classification Tree ◽

Female Gender ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Emilia Romagna Region ◽

Representative Random Sample ◽

Main Determinants

In March 2021, the coronavirus disease 2019 (COVID-19) pandemic still poses a threat to the global population, and is a public health challenge that needs to be overcome. Now more than ever, action is needed to tackle vaccine hesitancy, especially in light of the availability of effective and safe vaccines. A cross-sectional online survey was carried out on a representative random sample of 1011 citizens from the Emilia-Romagna region, in Italy, in January 2021. The questionnaire collected information on socio-demographics, comorbidities, past vaccination refusal, COVID-19-related experiences, risk perception of infection, and likelihood to accept COVID-19 vaccination. Multiple logistic regression analyses and classification tree analyses were performed to identify significant predictors of vaccine hesitancy and to distinguish groups with different levels of hesitancy. Overall, 31.1% of the sample reported hesitancy. Past vaccination refusal was the key discriminating variable followed by perceived risk of infection. Other significant predictors of hesitancy were: ages between 35 and 54 years, female gender, low educational level, low income, and absence of comorbidities. The most common concerns about the COVID-19 vaccine involved safety (54%) and efficacy (27%). Studying the main determinants of vaccine hesitancy can help with targeting vaccination strategies, in order to gain widespread acceptance—a key path to ensure a rapid way out of the current pandemic emergency.

Download Full-text

Vaccine hesitancy in the French population in 2016, and its association with vaccine uptake and perceived vaccine risk–benefit balance

Eurosurveillance ◽

10.2807/1560-7917.es.2018.23.17.17-00816 ◽

2018 ◽

Vol 23 (17) ◽

Cited By ~ 22

Author(s):

Dominique Rey ◽

Lisa Fressard ◽

Sébastien Cortaredona ◽

Aurélie Bocquier ◽

Arnaud Gautier ◽

...

Keyword(s):

Human Papillomavirus ◽

Elderly People ◽

Perceived Risk ◽

Multivariable Analysis ◽

Vaccine Uptake ◽

World Health ◽

Vaccine Hesitancy ◽

Human Papillomavirus Vaccine ◽

French Population ◽

Cross Sectional

Background Vaccine hesitancy (VH) is prominent in France. Objectives: This study aimed to estimate the prevalence and socio-demographic correlates of VH in sub-groups of the French population and to investigate the association of VH with both vaccine uptake and perceived risk–benefit balance (RBB) for four vaccines. Methods: During the 2016 Health Barometer – a national cross-sectional telephone survey in a representative sample of the French population – parents of 1–15 year-old children, parents of 11–15 year-old girls and elderly people aged 65–75 years were asked about VH (using three questions adapted from the World Health Organization definition), vaccine uptake and perceived RBB for measles and hepatitis B (children’s parents), human papillomavirus (girls’ parents) and seasonal influenza (elderly people) vaccines. Results: A total of 3,938 parents including 959 girls' parents – and 2,418 elderly people were interviewed. VH prevalence estimates were 46% (95% confidence interval (CI): 44–48) among parents, 48% (95%CI: 45–51) among girls’ parents and 35% (95% CI: 33–36) among elderly people, with higher estimates associated with high education level, children’s age (10–15 years), and, for the elderly, poor perception of health status. VH was associated with uncertainty about and/or an unfavourable perception of vaccines’ RBB for the four vaccines and with lower self-reported vaccine uptake, except for human papillomavirus vaccine in girls. Results were confirmed by multivariable analysis. Conclusion: Further research is needed to study the association between VH and vaccine uptake for other vaccines, and to design and validate measurement tools to monitor VH over time.

Download Full-text

SARS-CoV-2: Vaccine Hesitancy among Underrepresented Racial and Ethnic Groups with HIV in Miami, Florida

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab154 ◽

2021 ◽

Author(s):

Deborah L Jones ◽

Ana S Salazar ◽

Violeta J Rodriguez ◽

Raymond R Balise ◽

Claudia Uribe Starita ◽

...

Keyword(s):

Race And Ethnicity ◽

Cross Sectional Study ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Baseline Survey ◽

Advisory Group ◽

Medical Mistrust ◽

Cross Sectional ◽

Exact Test ◽

Novel Coronavirus

Abstract Background SARS-CoV-2 and HIV disproportionally affect underrepresented ethnoracial groups in the US. Medical mistrust and vaccine hesitancy will likely impact acceptability of SARS-CoV-2 vaccines. This study examined SARS-CoV-2 vaccine hesitancy among underrepresented ethnoracial groups with HIV and identified factors that may reduce vaccine uptake. Methods We conducted a cross-sectional study of adults ≥18 years with HIV residing in Miami, FL. Participants were invited to participate in the ACTION (A Comprehensive Translational Initiative on Novel Coronavirus) cohort study. A baseline survey was administered from April-August 2020 and followed by a COVID-19 vaccine hesitancy survey from August-November 2020. The COVID-19 vaccine hesitancy survey was adapted from the Strategic Advisory Group Experts survey. Comparisons by race and ethnicity were performed using the Freedman-Haltmann extension of Fisher’s exact test Results A total of 94 participants were enrolled, mean age 54.4 years, 52% female, 60% Black non-Latinx, and 40% non-Black Latinx. Black non-Latinx participants were less likely to agree that vaccinations are important for health when compared to non-Black Latinx (67.8% vs 92.1%, p=0.009), less likely to agree that vaccines are effective in preventing disease (67.8% vs 84.2%, p=0.029), less likely to believe that vaccine information is reliable and trustworthy (35.7% vs 71.1%, p=0.002), and less likely to believe vaccines were unnecessary because COVID-19 would disappear soon (11% vs 21%, p=0.049). Conclusion Medical mistrust, vaccine hesitancy and negative sentiments about SARS-CoV-2 vaccines are prevalent among underrepresented ethnoracial groups with HIV, particularly Black non-Latinx. Targeted strategies to increase vaccine uptake in this population are warranted.

Download Full-text

Attitudes toward the SARS-CoV-2 Vaccine: Results from the Saudi Residents’ Intention to Get Vaccinated against COVID-19 (SRIGVAC) Study

Vaccines ◽

10.3390/vaccines9070798 ◽

2021 ◽

Vol 9 (7) ◽

pp. 798

Author(s):

Sami H. Alzahrani ◽

Mukhtiar Baig ◽

Mohammed W. Alrabia ◽

Mohammed R. Algethami ◽

Meshari M. Alhamdan ◽

...

Keyword(s):

Saudi Arabia ◽

Health Beliefs ◽

Multinomial Logistic Regression ◽

Demographic Data ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Relative Risk Ratio ◽

Cross Sectional ◽

Vaccine Acceptance ◽

Web Based

Vaccine uptake could influence vaccination efforts to control the widespread COVID-19 pandemic; however, little is known about vaccine acceptance in Saudi Arabia. The present study aimed to assess the Saudi public’s intent to get vaccinated against COVID-19 and explore the associated demographic determinants of their intentions as well as the reasons for vaccine hesitancy. A cross-sectional, web-based survey was distributed to public individuals in Saudi Arabia between 25 December 2020 and 15 February 2021. Participants were asked if they were willing to get vaccinated, and the responses, along with demographic data were entered into a multinomial logistic regression model to assess the relative risk ratio (RRR) for responding “no” or “unsure” versus “yes”. Among 3048 participants (60.1% female, 89.5% Saudi), 52.9% intend to get vaccinated, 26.8% were unsure, and 20.3% refused vaccination. Vaccine hesitancy was significantly higher among females (RRR = 2.70, p < 0.0001) and those who had not been recently vaccinated for influenza (RRR = 2.63, p < 0.0001). The likelihood was lower among Saudis (RRR = 0.49, p < 0.0001), those with less than a secondary education (RRR = 0.16, p < 0.0001), perceived risks of COVID-19, and residents of the southern region (RRR = 0.46, p < 0.0001). The most often cited reasons for hesitancy were short clinical testing periods and concerns about adverse events or effectiveness. Vaccine hesitancy is mediated by many demographic factors and personal beliefs. To address vaccine-related concerns and amend deeply rooted health beliefs, communication should provide transparent information.

Download Full-text

Adenovirus and RNA-based COVID-19 vaccines’ perceptions and acceptance among healthcare workers in Saudi Arabia: a national survey

BMJ Open ◽

10.1136/bmjopen-2020-048586 ◽

2021 ◽

Vol 11 (6) ◽

pp. e048586

Author(s):

Mohamad-Hani Temsah ◽

Mazin Barry ◽

Fadi Aljamaan ◽

Abdullah Alhuzaimi ◽

Ayman Al-Eyadhy ◽

...

Keyword(s):

Saudi Arabia ◽

Healthcare Workers ◽

Online Survey ◽

Healthcare Providers ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Validated Questionnaire ◽

Vectored Vaccine ◽

To Receive

ObjectivesThe aim of this study was to compare the perception, confidence, hesitancy and acceptance rate of various COVID-19 vaccine types among healthcare workers (HCWs) in Saudi Arabia, a nation with Middle East respiratory syndrome coronavirus experience.DesignNational cross-sectional, pilot-validated questionnaire.SettingOnline, self-administered questionnaire among HCWs.ParticipantsA total of 2007 HCWs working in the Kingdom of Saudi Arabia participated; 1512 (75.3%) participants completed the survey and were included in the analysis.InterventionData were collected through an online survey sent to HCWs during 1–15 November 2020. The main outcome measure was HCW acceptance of COVID-19 candidate vaccines. The associated factors of vaccination acceptance were identified through a logistic regression analysis and via measurement of the level of anxiety, using the Generalised Anxiety Disorder 7 scale.ResultsAmong the 1512 HCWs who were included, 62.4% were women, 70.3% were between 21 and 40 years of age, and the majority (62.2%) were from tertiary hospitals. In addition, 59.5% reported knowing about at least one vaccine; 24.4% of the participants were sure about their willingness to receive the ChAdOx1 nCoV-19 vaccine, and 20.9% were willing to receive the RNA BNT162b2 vaccine. However, 18.3% reported that they would refuse to receive the Ad5-vectored vaccine, and 17.9% would refuse the Gam-COVID-Vac vaccine. Factors that influenced the differential readiness of HCWs included their perceptions of the vaccine’s efficiency in preventing the infection (33%), their personal preferences (29%) and the vaccine’s manufacturing country (28.6%).ConclusionsAwareness by HCWs of the several COVID-19 candidate vaccines could improve their perceptions and acceptance of vaccination. Reliable sources on vaccine efficiency could improve vaccine uptake, so healthcare authorities should use reliable information to decrease vaccine hesitancy among frontline healthcare providers.

Download Full-text

Prevalence of physical inactivity and associated factors among adolescents from public schools in Uruguaiana, Rio Grande do Sul State, Brazil

Cadernos de Saúde Pública ◽

10.1590/0102-311x00077512 ◽

2013 ◽

Vol 29 (11) ◽

pp. 2217-2229 ◽

Cited By ~ 9

Author(s):

Gabriel Gustavo Bergmann ◽

Mauren Lúcia de Araújo Bergmann ◽

Alexandre Carriconde Marques ◽

Pedro Curi Hallal

Keyword(s):

Physical Activity ◽

Public Schools ◽

Physical Education ◽

Physical Inactivity ◽

Associated Factors ◽

Female Gender ◽

Older Children ◽

Cross Sectional ◽

Behavioral Variables ◽

Cross Sectional Design

This study aimed to identify the prevalence of physical inactivity and associated factors in adolescents, using a cross-sectional design with a sample of 1,455 adolescents (741 females). Data were collected using a questionnaire consisting of socio-demographic, perceptual, and behavioral variables. Physical activity was estimated with the Physical Activity Questionnaire for Older Children and Adolescents. Prevalence of physical inactivity was 68% (95%CI: 65.6%-70.4%). The following variables remained associated with physical inactivity in the adjusted analysis (p < 0.05): living in an apartment, female gender, older adolescents, lower self-rated physical activity compared to peers, low perception of maternal physical activity, passive commuting to school, non-participation in physical education at school, non-enjoyment of physical education classes, and limited involvement in other types of physical exercise besides physical education at school. There were a high proportion of inactive adolescents. Strategies to prevent physical inactivity in adolescents should be elaborated with a central role for the school and family.

Download Full-text

Factors Associated with Depression and Anxiety in Adults ≥60 Years Old during the COVID-19 Pandemic: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182211859 ◽

2021 ◽

Vol 18 (22) ◽

pp. 11859

Author(s):

Gianluca Ciuffreda ◽

Sara Cabanillas-Barea ◽

Andoni Carrasco-Uribarren ◽

María Isabel Albarova-Corral ◽

María Irache Argüello-Espinosa ◽

...

Keyword(s):

Systematic Review ◽

Female Gender ◽

Cochrane Library ◽

Poor Sleep ◽

Depression And Anxiety ◽

Poor Sleep Quality ◽

Cross Sectional ◽

Factors Associated ◽

Population Prevalence ◽

Cross Sectional Design

COVID-19 represents a threat to public health and the mental health of the aged population. Prevalence and risk factors of depression and anxiety have been reported in previous reviews in other populations; however, a systematic review on the factors associated with depression and anxiety in older adults is not currently present in the literature. We searched PubMed, Embase, Scopus, ProQuest Psychology Database, Science Direct, Cochrane Library and SciELO databases (23 February 2021). The results were obtained by entering a combination of MeSH or Emtree terms with keywords related to COVID-19, elderly, depression and anxiety in the databases. A total of 11 studies were included in the systematic review. Female gender, loneliness, poor sleep quality and poor motor function were identified as factors associated with both depression and anxiety. Aspects related to having a stable and high monthly income represent protective factors for both depression and anxiety, and exercising was described as protective for depression. This study synthesised information and analysed the main factors associated with depression and anxiety in the older population during the COVID-19 pandemic. However, the cross-sectional design of most of the included studies does not allow a causal relationship between the factors analysed and depression or anxiety.

Download Full-text

Examining the Utility of Social Media in COVID-19 Vaccination: Unsupervised Learning of 672,133 Twitter Posts (Preprint)

10.2196/preprints.29789 ◽

2021 ◽

Author(s):

Tau Ming Liew ◽

Cia Sin Lee

Keyword(s):

Machine Learning ◽

Social Media ◽

Temporal Variations ◽

Emotional Reactions ◽

Barriers And Facilitators ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Effective Vaccine ◽

Public Attention ◽

Public Concerns

BACKGROUND Although COVID-19 vaccines have recently become available, efforts in global mass vaccination can be hampered by the widespread issue of vaccine hesitancy. OBJECTIVE The aim of this study was to use social media data to capture close-to-real-time public perspectives and sentiments regarding COVID-19 vaccines, with the intention to understand the key issues that have captured public attention, as well as the barriers and facilitators to successful COVID-19 vaccination. METHODS Twitter was searched for tweets related to “COVID-19” and “vaccine” over an 11-week period after November 18, 2020, following a press release regarding the first effective vaccine. An unsupervised machine learning approach (ie, structural topic modeling) was used to identify topics from tweets, with each topic further grouped into themes using manually conducted thematic analysis as well as guided by the theoretical framework of the COM-B (capability, opportunity, and motivation components of behavior) model. Sentiment analysis of the tweets was also performed using the rule-based machine learning model VADER (Valence Aware Dictionary and Sentiment Reasoner). RESULTS Tweets related to COVID-19 vaccines were posted by individuals around the world (N=672,133). Six overarching themes were identified: (1) emotional reactions related to COVID-19 vaccines (19.3%), (2) public concerns related to COVID-19 vaccines (19.6%), (3) discussions about news items related to COVID-19 vaccines (13.3%), (4) public health communications about COVID-19 vaccines (10.3%), (5) discussions about approaches to COVID-19 vaccination drives (17.1%), and (6) discussions about the distribution of COVID-19 vaccines (20.3%). Tweets with negative sentiments largely fell within the themes of emotional reactions and public concerns related to COVID-19 vaccines. Tweets related to facilitators of vaccination showed temporal variations over time, while tweets related to barriers remained largely constant throughout the study period. CONCLUSIONS The findings from this study may facilitate the formulation of comprehensive strategies to improve COVID-19 vaccine uptake; they highlight the key processes that require attention in the planning of COVID-19 vaccination and provide feedback on evolving barriers and facilitators in ongoing vaccination drives to allow for further policy tweaks. The findings also illustrate three key roles of social media in COVID-19 vaccination, as follows: surveillance and monitoring, a communication platform, and evaluation of government responses.

Download Full-text