Vaccine Confidence and Hesitancy at the Start of COVID-19 Vaccine Deployment in the UK: An Embedded Mixed-Methods Study

Background: Approval for the use of COVID-19 vaccines has been granted in a number of countries but there are concerns that vaccine uptake may be low amongst certain groups.Methods: This study used a mixed methods approach based on online survey and an embedded quantitative/qualitative design to explore perceptions and attitudes that were associated with intention to either accept or refuse offers of vaccination in different demographic groups during the early stages of the UK's mass COVID-19 vaccination programme (December 2020). Analysis used multivariate logistic regression, structural text modeling and anthropological assessments.Results: Of 4,535 respondents, 85% (n = 3,859) were willing to have a COVID-19 vaccine. The rapidity of vaccine development and uncertainties about safety were common reasons for COVID-19 vaccine hesitancy. There was no evidence for the widespread influence of mis-information, although broader vaccine hesitancy was associated with intentions to refuse COVID-19 vaccines (OR 20.60, 95% CI 14.20–30.30, p < 0.001). Low levels of trust in the decision-making (OR 1.63, 95% CI 1.08, 2.48, p = 0.021) and truthfulness (OR 8.76, 95% CI 4.15–19.90, p < 0.001) of the UK government were independently associated with higher odds of refusing COVID-19 vaccines. Compared to political centrists, conservatives and liberals were, respectively, more (OR 2.05, 95%CI 1.51–2.80, p < 0.001) and less (OR 0.30, 95% CI 0.22–0.41, p < 0.001) likely to refuse offered vaccines. Those who were willing to be vaccinated cited both personal and public protection as reasons, with some alluding to having a sense of collective responsibility.Conclusion: Dominant narratives of COVID-19 vaccine hesitancy are misconceived as primarily being driven by misinformation. Key indicators of UK vaccine acceptance include prior behaviors, transparency of the scientific process of vaccine development, mistrust in science and leadership and individual political views. Vaccine programmes should leverage the sense of altruism, citizenship and collective responsibility that motivated many participants to get vaccinated.

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Vaccine Confidence and Hesitancy at the start of COVID-19 vaccine deployment in the UK: An embedded mixed-methods study

10.1101/2021.07.13.21260425 ◽

2021 ◽

Author(s):

Chrissy h Roberts ◽

Hannah Brindle ◽

Nina Trivedy Rogers ◽

Rosalind M Eggo ◽

Luisa Enria ◽

...

Keyword(s):

Mixed Methods ◽

Online Survey ◽

Vaccine Development ◽

Collective Responsibility ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Demographic Groups ◽

Vaccine Confidence ◽

The Uk ◽

Dominant Narratives

Introduction Approval for the use of COVID-19 vaccines has been granted in a number of countries but there are concerns that vaccine uptake may be low amongst certain groups. Methods This study used a mixed methods approach based on online survey and an embedded quantitative/qualitative design to explore perceptions and attitudes that were associated with intention to either accept or refuse offers of vaccination in different demographic groups during the early stages of the UK's mass COVID-19 vaccination programme (December 2020). Analysis used multivariate logistic regression, structural text modelling and anthropological assessments. Results Of 4,535 respondents, 85% (n=3,859) were willing to have a COVID-19 vaccine. The rapidity of vaccine development and uncertainties about safety were common reasons for COVID-19 vaccine hesitancy. There was no evidence for the widespread influence of mis-information, although broader vaccine hesitancy was associated with intentions to refuse COVID-19 vaccines (OR 20.60, 95% CI 14.20-30.30, p<0.001). Low levels of trust in the decision-making (OR 1.63, 95% CI 1.08, 2.48, p=0.021) and truthfulness (OR 8.76, 95% CI 4.15-19.90, p<0.001) of the UK government were independently associated with higher odds of refusing COVID-19 vaccines. Compared to political centrists, conservatives and liberals were respectively more (OR 2.05, 95%CI 1.51-2.80, p<0.001) and less (OR 0.30, 95% CI 0.22-0.41, p<0.001) likely to refuse offered vaccines. Those who were willing to be vaccinated cited both personal and public protection as reasons, with some alluding to having a sense of collective responsibility. Conclusion Dominant narratives of COVID-19 vaccine hesitancy are misconceived as primarily being driven by misinformation. Key indicators of UK vaccine acceptance include prior behaviours, transparency of the scientific process of vaccine development, mistrust in science and leadership and individual political views. Vaccine programmes should leverage the sense of altruism, citizenship and collective responsibility that motivated many participants to get vaccinated.

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Ethnic and minority group differences in engagement with COVID-19 vaccination programmes – at Pandemic Pace; when vaccine confidence in mass rollout meets local vaccine hesitancy

Israel Journal of Health Policy Research ◽

10.1186/s13584-021-00467-9 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

John A. Reid ◽

Mzwandile A. Mabhala

Keyword(s):

Public Health ◽

Ethnic Minorities ◽

Social Systems ◽

Minority Group ◽

Reproductive Age ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Vaccine Confidence ◽

The Uk ◽

Roll Out

AbstractIsrael, the UK, the USA, and some other wealthier countries lead in the implementation of COVID-19 vaccine mass vaccination programmes. Evidence from these countries indicates that their ethnic minorities could be as disproportionately disadvantaged in COVID-19 vaccines roll-out as they were affected by COVID-19-related serious illnesses. Their disadvantage is linked to their lower social status and fewer social goods compared with dominant population groups.Albeit limited by methodology, early studies attribute lower uptake of COVID-19 amongst ethnic minorities to the wider determinants of vaccine uptake, hesitancy or lack of vaccine confidence, including lower levels of trust and greater concerns about vaccine safety. Early sentinel studies are needed in all early adopter countries.One emerging theme among those of reproductive age in minority communities concerns a worry regarding COVID-19 vaccine’s potential adverse effect on fertility. Respected professional groups reassure this is not a credible rationale. Drug and vaccine regulators use understandable, cautious and conditional language in emergency licencing of new gene-based vaccines. Technical assessments on whether there is any potential genotoxicity or reproductive toxicity should be more emphatic.From a public health perspective, sentinel studies should identify such community concerns and act early to produce convincing explanations and evidence. Local public health workforces need to be diverse, multiskilled, and able to engage well with minorities and vulnerable groups. The local Directors of Public Health in the UK are based in each local government area and have a remit and opportunity to stimulate speedy action to increase vaccine uptake.During the rapid Pandemic Pace of the vaccines roll-out, extra efforts to minimise uptake variations are likely to achieve improvements in the next year or two. We expect variations will not disappear however, given that underlying inequalities persist in less inclusive social systems.

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COVID-19 vaccine hesitancy is associated with beliefs on the origin of the novel coronavirus in the UK and Turkey

Psychological Medicine ◽

10.1017/s0033291720004067 ◽

2020 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Gul Deniz Salali ◽

Mete Sefa Uysal

Keyword(s):

Online Survey ◽

Vaccine Development ◽

Research Effort ◽

Vaccine Hesitancy ◽

Effective Vaccine ◽

The Novel ◽

Natural Origin ◽

The Public ◽

Novel Coronavirus ◽

The Uk

Abstract Background Much research effort is focused on developing an effective vaccine for combatting coronavirus disease 2019 (COVID-19). Vaccine development itself, however, will not be enough given that a sufficient amount of people will need to be vaccinated for widespread immunity. Vaccine hesitancy is on the rise, varies across countries, and is associated with conspiratorial worldview. Given the rise in COVID-19-related conspiracy theories, we aimed to examine the levels of COVID-19 vaccine hesitancy and its association with beliefs on the origin of the novel coronavirus in a cross-cultural study. Methods We conducted an online survey in the UK (N = 1088) and Turkey (N = 3936), and gathered information on participants' willingness to vaccinate for a potential COVID-19 vaccine, beliefs on the origin of the novel coronavirus, and several behavioural and demographic predictors (such as anxiety, risk perception, government satisfaction levels) that influence vaccination and origin beliefs. Results In all, 31% of the participants in Turkey and 14% in the UK were unsure about getting themselves vaccinated for a COVID-19 vaccine. In both countries, 3% of the participants rejected to be vaccinated. Also, 54% of the participants in Turkey and 63% in the UK believed in the natural origin of the novel coronavirus. Believing in the natural origin significantly increased the odds of COVID-19 vaccine acceptance. Conclusions Our results point at a concerning level of COVID-19 vaccine hesitancy, especially in Turkey, and suggest that wider communication of the scientific consensus on the origin of the novel coronavirus with the public may help future campaigns targeting COVID-19 vaccine hesitancy.

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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.

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Impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases in the UK: a mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2021-048772 ◽

2021 ◽

Vol 11 (6) ◽

pp. e048772

Author(s):

Toby O Smith ◽

Pippa Belderson ◽

Jack R Dainty ◽

Linda Birt ◽

Karen Durrant ◽

...

Keyword(s):

Mixed Methods ◽

Qualitative Study ◽

Online Survey ◽

Musculoskeletal Diseases ◽

Community Dwelling ◽

Secondary Outcome ◽

Healthcare Provision ◽

Social Restriction ◽

The Uk ◽

The Impact

ObjectivesTo determine the impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases (RMDs) and to explore how people adapted to these measures over time.DesignMixed-methods investigation comprising a national online longitudinal survey and embedded qualitative study.SettingUK online survey and interviews with community-dwelling individuals in the East of England.ParticipantsPeople in the UK with RMDs were invited to participate in an online survey. A subsection of respondents were invited to participate in the embedded qualitative study.Primary and secondary outcome measuresThe online survey, completed fortnightly over 10 weeks from April 2020 to August 2020, investigated changes in symptoms, social isolation and loneliness, resilience and optimism. Qualitative interviews were undertaken assessing participant’s perspectives on changes in symptoms, exercising, managing instrumental tasks such a shopping, medication and treatment regimens and how they experienced changes in their social networks.Results703 people with RMDs completed the online survey. These people frequently reported a deterioration in symptoms as a result of COVID-19 pandemic social restrictions (52% reported increase vs 6% reported a decrease). This was significantly worse for those aged 18–60 years compared with older participants (p=0.017). The qualitative findings from 26 individuals with RMDs suggest that the greatest change in daily life was experienced by those in employment. Although some retired people reported reduced opportunity for exercise outside their homes, they did not face the many competing demands experienced by employed people and people with children at home.ConclusionsPeople with RMDs reported a deterioration in symptoms when COVID-19 pandemic social restriction measures were enforced. This was worse for working-aged people. Consideration of this at-risk group, specifically for the promotion of physical activity, changing home-working practices and awareness of healthcare provision is important, as social restrictions continue in the UK.

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Willingness of Black and White Adults to Accept Vaccines in Development: An Exploratory Study Using National Survey Data

American Journal of Health Promotion ◽

10.1177/0890117120979918 ◽

2020 ◽

pp. 089011712097991

Author(s):

Sandra Crouse Quinn ◽

Yuki Lama ◽

Amelia Jamison ◽

Vicki Freimuth ◽

Veeraj Shah

Keyword(s):

Online Survey ◽

Social Science Research ◽

Science Research ◽

Chronic Health Condition ◽

Vaccine Hesitancy ◽

Cancer Type ◽

Cross Sectional ◽

Black And White ◽

Vaccine Type ◽

Vaccine Confidence

Purpose: Explore acceptability of vaccines in development: cancer, Type II diabetes, Alzheimer’s disease, Lyme disease, Ebola, and obesity. Research questions: To what extent does acceptability vary by vaccine type? To what extent does acceptability of vaccines in development vary by race and other key demographics? To what extent are general vaccine hesitancy and key demographics associated with acceptability of vaccines in development? Design: Cross-sectional online survey administered through GfK’s KnowledgePanel in 2015. Analysis completed in 2020. Subjects: Nationally representative sample of Black and White American adults (n = 1,643). Measures: Willingness to accept a novel vaccine was measured on a 4-point Likert scale. Independent variables included demographics (e.g. age, race, gender) and measures of vaccine hesitancy, trust, and the “Three C’s” of vaccine confidence, complacency, and convenience. Analysis: Exploratory analysis including descriptive statistics and regression modeling. Results: Acceptability varied from 77% for a cancer vaccine to 55% for an obesity vaccine. White race, male gender, older age, having a chronic health condition, and higher socioeconomic status were associated with higher acceptability. Higher vaccine confidence and lower vaccine hesitancy were predictors for acceptability. Conclusion: The success of a vaccine depends on widespread public acceptance. Vaccine hesitancy may hinder acceptance of future vaccines, with significant differences by demographics. Future social science research is necessary to better understand and address vaccine hesitancy.

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Intention to Be Vaccinated for COVID-19 among Italian Nurses during the Pandemic

Vaccines ◽

10.3390/vaccines9050500 ◽

2021 ◽

Vol 9 (5) ◽

pp. 500

Author(s):

Marco Trabucco Aurilio ◽

Francesco Saverio Mennini ◽

Simone Gazzillo ◽

Laura Massini ◽

Matteo Bolcato ◽

...

Keyword(s):

Vaccine Efficacy ◽

Online Survey ◽

Vaccine Development ◽

Vaccine Coverage ◽

World Health ◽

Vaccine Hesitancy ◽

Effective Vaccine ◽

Online Questionnaire ◽

Cross Sectional ◽

Female Sex

Background: While the COVID-19 pandemic has spread globally, health systems are overwhelmed by both direct and indirect mortality from other treatable conditions. COVID-19 vaccination was crucial to preventing and eliminating the disease, so vaccine development for COVID-19 was fast-tracked worldwide. Despite the fact that vaccination is commonly recognized as the most effective approach, according to the World Health Organization (WHO), vaccine hesitancy is a global health issue. Methods: We conducted a cross-sectional online survey of nurses in four different regions in Italy between 20 and 28 December 2020 to obtain data on the acceptance of the upcoming COVID-19 vaccination in order to plan specific interventions to increase the rate of vaccine coverage. Results: A total of 531 out of the 5000 nurses invited completed the online questionnaire. Most of the nurses enrolled in the study (73.4%) were female. Among the nurses, 91.5% intended to accept vaccination, whereas 2.3% were opposed and 6.2% were undecided. Female sex and confidence in vaccine efficacy represent the main predictors of vaccine intention among the study population using a logistic regression model, while other factors including vaccine safety concerns (side effects) were non-significant. Conclusions: Despite the availability of a safe and effective vaccine, intention to be vaccinated was suboptimal among nurses in our sample. We also found a significant number of people undecided as to whether to accept the vaccine. Contrary to expectations, concerns about the safety of the vaccine were not found to affect the acceptance rate; nurses’ perception of vaccine efficacy and female sex were the main influencing factors on attitudes toward vaccination in our sample. Since the success of the COVID-19 immunization plan depends on the uptake rate, these findings are of great interest for public health policies. Interventions aimed at increasing employee awareness of vaccination efficacy should be promoted among nurses in order to increase the number of vaccinated people.

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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.

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COVID-19 vaccine brand hesitancy and other challenges to vaccination in the Philippines

PLOS Global Public Health ◽

10.1371/journal.pgph.0000165 ◽

2022 ◽

Vol 2 (1) ◽

pp. e0000165

Author(s):

Arianna Maever L. Amit ◽

Veincent Christian F. Pepito ◽

Lourdes Sumpaico-Tanchanco ◽

Manuel M. Dayrit

Keyword(s):

Ecological Model ◽

The Philippines ◽

Vaccine Uptake ◽

Phone Call ◽

Vulnerable Groups ◽

Vaccine Hesitancy ◽

Middle Income ◽

Political Issues ◽

Vaccination Uptake ◽

Vaccine Confidence

Effective and safe COVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus, and prevent hospitalisations and deaths. However, COVID-19 vaccine uptake is challenged by vaccine hesitancy and anti-vaccination sentiments, a global shortage of vaccine supply, and inequitable vaccine distribution especially among low- and middle-income countries including the Philippines. In this paper, we explored vaccination narratives and challenges experienced and observed by Filipinos during the early vaccination period. We interviewed 35 individuals from a subsample of 1,599 survey respondents 18 years and older in the Philippines. The interviews were conducted in Filipino, Cebuano, and/or English via online platforms such as Zoom or via phone call. All interviews were recorded, transcribed verbatim, translated, and analysed using inductive content analysis. To highlight the complex reasons for delaying and/or refusing COVID-19 vaccines, we embedded our findings within the social ecological model. Our analysis showed that individual perceptions play a major role in the decision to vaccinate. Such perceptions are shaped by exposure to (mis)information amplified by the media, the community, and the health system. Social networks may either positively or negatively impact vaccination uptake, depending on their views on vaccines. Political issues contribute to vaccine brand hesitancy, resulting in vaccination delays and refusals. Perceptions about the inefficiency and inflexibility of the system also create additional barriers to the vaccine rollout in the country, especially among vulnerable and marginalised groups. Recognising and addressing concerns at all levels are needed to improve COVID-19 vaccination uptake and reach. Strengthening health literacy is a critical tool to combat misinformation that undermines vaccine confidence. Vaccination systems must also consider the needs of marginalised and vulnerable groups to ensure their access to vaccines. In all these efforts to improve vaccine uptake, governments will need to engage with communities to ‘co-create’ solutions.

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Harnessing Twitter data to survey public attention and attitudes towards COVID-19 vaccines in the UK

Scientific Reports ◽

10.1038/s41598-021-02710-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Seena Fazel ◽

Le Zhang ◽

Babak Javid ◽

Isabell Brikell ◽

Zheng Chang

Keyword(s):

Social Media ◽

Vaccine Development ◽

Vaccine Hesitancy ◽

Potential Contribution ◽

Public Attention ◽

Media Campaigns ◽

News Announcements ◽

News Announcement ◽

Socio Demographic Factors ◽

The Uk

AbstractAttitudes to COVID-19 vaccination vary considerably within and between countries. Although the contribution of socio-demographic factors to these attitudes has been studied, the role of social media and how it interacts with news about vaccine development and efficacy is uncertain. We examined around 2 million tweets from 522,893 persons in the UK from November 2020 to January 2021 to evaluate links between Twitter content about vaccines and major scientific news announcements about vaccines. The proportion of tweets with negative vaccine content varied, with reductions of 20–24% on the same day as major news announcement. However, the proportion of negative tweets reverted back to an average of around 40% within a few days. Engagement rates were higher for negative tweets. Public health messaging could consider the dynamics of Twitter-related traffic and the potential contribution of more targeted social media campaigns to address vaccine hesitancy.

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