Background Opinion polls on vaccination intentions suggest that COVID-19 vaccine hesitancy is increasing worldwide; however, the usefulness of opinion polls to prepare mass vaccination campaigns for specific new vaccines and to estimate acceptance in a country's population is limited. We therefore aimed to assess the effects of vaccine characteristics, information on herd immunity, and general practitioner (GP) recommendation on vaccine hesitancy in a representative working-age population in France. MethodsIn this survey experiment, adults aged 18-64 years residing in France, with no history of SARS-CoV-2 infection, were randomly selected from an online survey research panel in July, 2020, stratified by gender, age, education, household size, and region and area of residence to be representative of the French population. Participants completed an online questionnaire on their background and vaccination behaviour-related variables (including past vaccine compliance, risk factors for severe COVID-19, and COVID-19 perceptions and experience), and were then randomly assigned according to a full factorial design to one of three groups to receive differing information on herd immunity (>50% of adults aged 18-64 years must be immunised [either by vaccination or infection]; >50% of adults must be immunised [either by vaccination or infection]; or no information on herd immunity) and to one of two groups regarding GP recommendation of vaccination (GP recommends vaccination or expresses no opinion). Participants then completed a series of eight discrete choice tasks designed to assess vaccine acceptance or refusal based on hypothetical vaccine characteristics (efficacy [50%, 80%, 90%, or 100%], risk of serious side-effects [1 in 10 000 or 1 in 100 000], location of manufacture [EU, USA, or China], and place of administration [GP practice, local pharmacy, or mass vaccination centre]). Responses were analysed with a two-part model to disentangle outright vaccine refusal (irrespective of vaccine characteristics, defined as opting for no vaccination in all eight tasks) from vaccine hesitancy (acceptance depending on vaccine characteristics). Findings Survey responses were collected from 1942 working-age adults, of whom 560 (28•8%) opted for no vaccination in all eight tasks (outright vaccine refusal) and 1382 (71•2%) did not. In our model, outright vaccine refusal and vaccine hesitancy were both significantly associated with female gender, age (with an inverted U-shaped relationship), lower educational level, poor compliance with recommended vaccinations in the past, and no report of specified chronic conditions (ie, no hypertension [ for vaccine hesitancy] or no chronic conditions other than hypertension [ for outright vaccine refusal]). Outright vaccine refusal was also associated with a lower perceived severity of COVID-19, whereas vaccine hesitancy was lower when herd immunity benefits were communicated and in working versus nonworking individuals, and those with experience of COVID-19 (had symptoms or knew someone with CO...

In absence of effective pharmaceutical treatments, the individual's compliance with a series of behavioral recommendations provided by the public health authorities play a critical role in the control and prevention of SARS-CoV2 infection. However, we still do not know much about the rate and determinants of adoption of the recommended health behaviors. This paper examines the compliance with the main behavioral recommendations, and compares sociocultural, psychosocial, and social cognitive explanations for its variation in the French population. Based on the current literature, these 3 categories of factors were identified as potential determinants of individual differences in the health preventive behaviors. The data used for these analyses are drawn from 2 cross-sectional studies (N = 2,000 in survey 1 and 2,003 in survey 2) conducted after the lockdown and before the peak of the COVID-19 epidemic in France. The participants were drawn from a larger internet consumer panel where recruitment was stratified to generate a socio-demographically representative sample of the French adult population. Overall, the results show a very high rate of compliance with the behavioral recommendations among the participants. A hierarchical regression analysis was then performed to assess the potential explanatory power of these approaches in complying with these recommendations by successively entering sociocultural factors, psychosocial factors, social cognitive factors in the model. Only the inclusion of the cognitive variables substantially increased the explained variance of the self-reported adoption of preventive behaviors (R2 change = 23% in survey 1 and 2), providing better support for the social cognitive than the sociocultural and psychosocial explanations.

ObjectiveDescribe demographical, social and psychological correlates of willingness to receive a COVID-19 vaccine.SettingSeries of online surveys undertaken between March and October 2020.ParticipantsA total of 25 separate national samples (matched to country population by age and sex) in 12 different countries were recruited through online panel providers (n=25 334).Primary outcome measuresReported willingness to receive a COVID-19 vaccination.ResultsReported willingness to receive a vaccine varied widely across samples, ranging from 63% to 88%. Multivariate logistic regression analyses reveal sex (female OR=0.59, 95% CI 0.55 to 0.64), trust in medical and scientific experts (OR=1.28, 95% CI 1.22 to 1.34) and worry about the COVID-19 virus (OR=1.47, 95% CI 1.41 to 1.53) as the strongest correlates of stated vaccine acceptance considering pooled data and the most consistent correlates across countries. In a subset of UK samples, we show that these effects are robust after controlling for attitudes towards vaccination in general.ConclusionsOur results indicate that the burden of trust largely rests on the shoulders of the scientific and medical community, with implications for how future COVID-19 vaccination information should be communicated to maximise uptake.