A Comparison of Vaccine Hesitancy of COVID-19 Vaccination in China and the United States

Abstract

Objectives: To investigate the differences in vaccine hesitancy and preference of the currently available COVID-19 vaccines between two countries, namely, China and the United States (U.S.). Method: A cross-national survey was conducted in both China and the United States, and discrete choice experiments, as well as Likert scales, were utilized to assess vaccine preference and the underlying factors contributing to vaccination acceptance. Propensity score matching (PSM) was performed to enable a direct comparison between the two countries. Results: A total of 9077 (5375 and 3702 from China and the United States, respectively) respondents completed the survey. After propensity score matching, over 82.0% of respondents from China positively accepted the COVID-19 vaccination, while 72.2% of respondents from the United States positively accepted it. Specifically, only 31.9% of Chinese respondents were recommended by a doctor to have COVID-19 vaccination, while more than half of the U.S. respondents were recommended by a doctor (50.2%), local health board (59.4%), or friends and families (64.8%). The discrete choice experiments revealed that respondents from the United States attached the greatest importance to the efficacy of COVID-19 vaccines (44.41%), followed by the cost of vaccination (29.57%), whereas those from China held a different viewpoint, that the cost of vaccination covered the largest proportion in their trade-off (30.66%), and efficacy ranked as the second most important attribute (26.34%). Additionally, respondents from China tended to be much more concerned about the adverse effect of vaccination (19.68% vs. 6.12%) and have a lower perceived severity of being infected with COVID-19. Conclusion: Although the overall acceptance and hesitancy of COVID-19 vaccination in both countries are high, underpinned distinctions between these countries were observed. Owing to the differences in COVID-19 incidence rates, cultural backgrounds, and the availability of specific COVID-19 vaccines in the two countries, vaccine rollout strategies should be nation-dependent.

COVID-19 Vaccine Hesitancy in the United States: A Systematic Review

“…Besides the difference in the timeline of each study, hesitancy was mainly driven by the lack of education and understanding of the process of vaccine development. As pharmaceutical companies develop multiple vaccines for the emerging strains, the expedited process of approval has raised concerns about its effectiveness ( 52 ), explaining their preferred choice of mRNA vaccines as opposed to any available vaccines ( 18 ).…”

“…Recent results have shown somewhat reduced hesitancy, corresponding to the dates of vaccine approval and mass roll-out ( 13 ) and it is speculated that as the pandemic becomes more “real” to the Americans, vaccine acceptance can improve. Being one of the representative countries hardest hit by COVID-19, estimating vaccine hesitancy in the U.S could be important for future vaccine promotion and herd immunity ( 18 ). This systematic review aims to broaden the scope of discussion by studying factors coupled with vaccine hesitancy in the US population and the study's findings will be beneficial not only for COVID-19 vaccination coverage but also improving the existing healthcare system's preparedness for routine and emergency vaccination.…”

Oxford COVID-19 Vaccine Hesitancy in School Principals: Impacts of Gender, Well-Being, and Coronavirus-Related Health Literacy

“…The Oxford COVID-19 Vaccine Hesitancy questionnaire was developed to assess the willingness to take an approved COVID-19 vaccine [ 13 ]. The sum score of 7 items was used for analysis and interpretation [ 13 ], instead of using only one question and categorical values in other studies [ 10 , 21 , 22 , 23 , 24 ].…”

Association between Immunoglobulin G Levels and Adverse Effects Following Vaccination with the BNT162b2 Vaccine among Japanese Healthcare Workers

“…One of the problems associated with vaccination is a vaccine’s potentially adverse effects. COVID-19 vaccines were developed rapidly for general use, and various side effects have been reported worldwide [ 14 , 15 ]. The rate of adverse effects of COVID-19 vaccines differs between countries because the type of vaccines used also differs by country [ 16 ].…”