Are psychological status and trust in information related to vaccine hesitancy during COVID-19 pandemic? A latent class and mediation analyses in Italy

Abstract

Despite the recognized benefits of the COVID-19 vaccination, vaccine hesitancy (VH) remains one of the biggest challenges of the mass vaccination campaign. Most studies investigating VH determinants focused on socio-demographics and direct relationships. In this study, we aimed at: 1) identifying subgroups of people differently affected by the pandemic, in terms of psychological status; 2) investigating the role of psychological status and trust in information as possible mediators of the relationship between individual characteristics and VH. To this purpose, a latent class analysis (LCA) followed by a mediation analysis were carried out on data from a survey conducted in January 2021 on 1011 Italian citizens. LCA identified four different subgroups characterized by a differential psychological impact of the pandemic: the extremely affected (21.1%), the highly affected (49.1%), the moderately affected (21.8%) and the slightly affected (8%). We found that VH decreased with the increase of psychological impact (from 59.3% to 23.9%). In the mediation analysis, past vaccination refusal, age 45-54 years and lower-than-average income, were all indirectly related to higher VH through mistrust in COVID-19 information. Differently, the psychological impact counteracted the greater VH in females, the negative effect of social media among youngest (<35 years) and the negative effect of mistrust in the lower-than-average-income subgroup. Knowledge of psychological profile of hesitant individuals, their level of trust and the sources of information they access, together with their sociodemographic characteristics provides a more comprehensive picture of VH determinants that can be used by public health stakeholders to effectively design and adapt communication campaigns.

COVID-19 Vaccine Refusal and Delay among Adults in Italy: Evidence from the OBVIOUS Project, a National Survey in Italy

“…The World Health Organization (WHO) listed vaccine hesitancy among the ten threats to global health of 2019 and re-defined it as a motivational state of being conflicted or opposed to vaccination [1,2]. Many researchers agree that vaccine hesitancy should not be thought of as a dichotomous variable (yes/no), but rather as a continuum [3][4][5][6][7][8] related both to the individual and the socio-political context in which he/she lives [9,10].…”

Revisiting Vaccine Hesitancy in Residential Care Homes for the Elderly for Pandemic Preparedness: A Lesson from COVID-19

“…Our study period (July-November 2022) was only three months after the peak of daily RCHE incidence in the primary Omicron wave [1]. The earlier finding that the heavier psychological impact induced by the pandemic lowered the level of vaccine hesitancy [39] probably explained our findings. Nevertheless, the COVID-19 pandemic is far from over in 2023 [40], and there is a call for preventing reinfection due to the further increase in disease burden [41], a longitudinal study tracking the changes of vaccine hesitancy in RCHEs is warranted.…”

Vaccine Hesitancy in Women of Childbearing Age and Occupational Physicians: Results from a Cross-Sectional Study (Italy, 2022)

“…Similarly designed studies are acknowledged as reliable and cost-effective, but they are also affected by an extensive double "self-selection" of participating individuals. On the one hand, as participating individuals are recruited through social media platforms, the sample will only include individuals familiar with new media [36,109,[111][112][113]. In turn, this could lead to the oversampling of individuals more accustomed to sharing personal information through internet access, usually more frequently reported among younger age groups.…”