A matter of trust: a qualitative comparison of the determinants of COVID-19 vaccine hesitancy in Taiwan, the United States, the Netherlands, and Haiti

Abstract

COVID-19 vaccination is an effective intervention preventing individuals from contracting SARS-CoV-2 or transmitting the virus to others. However, in many countries, vaccine hesitancy has impeded the progress of mass vaccination to reach herd immunity. This study aimed to understand the similarities and differences in the determinants of COVID-19 vaccine hesitancy in Taiwan, the United States, the Netherlands, and Haiti. A qualitative study was conducted by face-to-face interviews with participants in Taiwan and remote online interviews with participants in the United States, the Netherlands, and Haiti. In total, 47 interviews were conducted. A reflective thematic analysis was employed to analyze the collected data. Distrust of COVID-19 vaccines was reported by the participants in all countries. A perception of a lack of necessity or urgency to be vaccinated was reported by the Taiwanese and Haitian participants. Lack of knowledge regarding COVID-19 vaccines was reported by the Taiwanese, U.S. and Haitian participants, contributing to hesitation or refusal to vaccination. Regarding misinformation and rumors, misinformation was found among a few Taiwanese and Dutch participants. Additionally, rumors concerning COVID-19 vaccines were mentioned by the Dutch and Haitian participants. Furthermore, a lack of verified information was reported by the participants in all four countries. Overall, the current study suggests that vaccine hesitancy exists among participants in Taiwan, the United States, the Netherlands, and Haiti. Building trust in the COVID-19 vaccine, cultivating vaccine literacy, clarifying misinformation and rumors concerning COVID-19 vaccines, and providing verified information are critical for increasing public acceptance of the COVID-19 vaccine.

When good messages go wrong: Perspectives on COVID-19 vaccines and vaccine communication from generally vaccine accepting individuals in Canada

“… 22 , 69 While some studies have shown that that lack of information and misinformation about COVID-19 vaccines lead to vaccine refusal (see ref. 12 , 14 our generally vaccine-accepting participants were distrustful of shifts in messages and guidelines about the vaccines even when delivered by trustworthy sources (e.g., public health officials and official agencies). Given the frequency in which earlier messages (e.g., get the first vaccine offered, keep the same brand of vaccine for both doses) were communicated, the changes to guidance were not explained with the same level of frequency to override people’s original understanding.…”

“… 12–14 and Asia (see ref. 14 found that a people who perceive the risk of COVID-19 as low tend to reject COVID-19 vaccines. However, we found that our participants perceived the risk of COVID-19 as high but consider COVID-19 vaccines as being riskier.…”

“… 65–67 Other studies conducted with general population in the United States (see ref. 8 , 14 , 17 Europe (see ref. 12–14 and Asia (see ref.…”

“…Additionally, perceptions of COVID-19 vaccines as being developed too fast lead to people believing they are not safe 15 Frustration over confusing guidelines and misinformation lead to mistrust and negative feelings towards COVID-19 vaccines. 14 , 16 Furthermore, a study found that high risk perceptions of COVID-19 do not lead to higher vaccine uptake. 17 Many factors influence COVID-19 vaccine uptake, such as sociodemographic characteristics (i.e., age, gender, ethnicity, and language) (see refs.…”

An Analysis of COVID-19 Vaccine Hesitancy in the U.S. at the County Level

“…This study also found VH to be higher among African-Americans (34%), Hispanics (29%), those who had children at home (25%), rural dwellers (29%), people in the northeastern US (25%), and those who identified as Republicans (29%). Several studies determine that trust on COVID-19 vaccine (Wang et al 2022), healthcare workers, healthcare system, science, and policymakers who design vaccination strategies, are important factors in reducing VH. This mistrust is due to misinformation and rumors.…”