Acceptance, Hesitancy, and Refusal in Anti-COVID-19 Vaccination: A Cluster Analysis Aiming at the Typology behind These Three Concepts

Abstract

This paper presents the findings of a study aiming at an innovative typology of attitudes towards COVID-19 vaccination. The proposed typology tries to go beyond the common sociological studies who divide the public into three categories: pro-vaxxers, anti-vaxxers, and hesitants. Our purpose is obtaining a more complex typology using cluster analysis. The article is based on a nation-wide survey conducted in Romania. The sample of the survey was statistically representative to the population of Romania and was composed of 1002 participants. A k-means algorithm for classifying cases was used to identify how the studied population structures itself when it comes to attitudes towards COVID-19 vaccination. We see hesitancy as an expression of concern or doubt about the value or safety of the vaccination, but also as fear or dis(trust) in the authorities, or as disinterest. We found out that the Romanian public falls into three categories regarding the attitude towards COVID-19 vaccination: the “non-fanatical” pro-vaxxers, the anti-vaxxers, and those without a clear opinion (uninterested and/or undecided). What we usually call “vaccine hesitancy” can be found, depending on motivation or type of hesitancy, in both of the last two clusters.

The Psychology of COVID-19 Booster Hesitancy, Acceptance and Resistance in Australia

“…This class reflected a ‘moderate’ subgroup, in between those with strong compliant and noncompliant beliefs and behaviours. The interpretation of this moderate subgroup was distinctive and consistent with the acceptant, hesitant and resistant subgroups found in previous vaccination research [ 4 ]. It also provided a greater opportunity for subsequent analyses to understand policy-relevant group differences between those who were acceptant, hesitant and resistant to COVID-19 vaccines/boosters.…”

“…Previous research has conceptualised vaccination intentions and behaviours as ranging from complete acceptance to total refusal, and those holding varying degrees of uncertainty or hesitancy in between [ 3 , 4 , 5 ]. Understanding what drives people’s behaviours, intentions and attitudes towards the COVID-19 booster doses can help to inform effective, tailored approaches to promoting booster uptake by addressing underlying reasons or concerns and removing barriers, particularly in those who are undecided or ambivalent [ 6 , 7 ].…”

“…Differences in the vaccine intentions of recipients before and during the emergency phases of the pandemic are well documented, ranging from complete acceptance to outright refusal and varying degrees of hesitancy [ 3 , 4 , 5 , 19 ]. In the present study, we focused on nonmandatory COVID-19 booster vaccination intentions, particularly hesitancy.…”

Perceptions of COVID-19 Vaccines: Protective Shields or Threatening Risks? A Descriptive Exploratory Study among the Italian Population

“…Our study also showed that the decision-making experience of vaccination reflects the interaction of several factors at the individual (i.e., cognitions and emotions), group (i.e., experiences of family members, type of job), and societal level (i.e., misinformation, mistrust in science and government). Our findings are in line with previous studies from Italy and other countries [ 10 , 36 , 37 , 42 ], showing that a lack of confidence in vaccinations, distrust in the scientific community and authorities as well as concerns about vaccine-related side effects and safety may decrease vaccination rates.…”

“…A recent review identified the lack of confidence in vaccine safety as one of the main reasons for low vaccination acceptance rates in Italy [ 10 ]. Likewise, Cristea and colleagues (2022) interpreted vaccine hesitancy as an expression of concern about vaccination safety and distrust in the authorities among the Romanian population [ 42 ]. In this regard, vaccination refusal could be considered a kind of ‘political stance’ to fight obligations laid down by political institutions, which could be perceived as restrictive measures of personal freedoms.…”