COVID-19 vaccine hesitancy and short-term and long-term intentions among unvaccinated young adults: a mixed-method approach

Abstract

Background Only 63.8% of Americans who are 18-to-24-years-old have been fully vaccinated for COVID-19 as of June 1, 2022. The Grand Forks County, North Dakota is facing a similar challenge. As of June 2022, 47% of individuals in the 19-to-29-year-old age group are vaccinated. Focusing on unvaccinated individuals in their 20s, Study 1 aims to understand the ways in which receiving COVID-19 vaccines is construed using qualitative interviews; and Study 2 compares the predictors of short-term vaccination intention (i.e., next month) with those of long-term vaccination intention (i.e., three to 5 years) using an online survey. Methods For Study 1, we conducted five focus groups and four in-depth interviews via Zoom with a total of 26 unvaccinated individuals in their 20s living in the Grand Forks County. Constant comparison process was used to categorize data into themes and to recognize characteristics of the identified themes. The aim was to develop themes and associated characteristics. For Study 2, we conducted an online survey with a convenience sample of 526 unvaccinated individuals. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between attitudes, perceptions, and beliefs in misinformation and short-term and long-term vaccination intentions, accounting for demographics and socioeconomic status. Results In Study 1, two themes were identified: feelings of uncertainty sparked by profits and monetization and navigating the fear of the unknown. In Study 2, an increase in the confidence of COVID-19 vaccines showed significantly higher odds of short-term intention (OR = 2.658, 95%CI 1.770, 3.990) and long-term intention (OR = 1.568, 95% CI 1.105, 2.226). Believing in misinformation had significantly lower odds of short-term intention (OR = 0.712, 95%CI 0.513, 0.990), while more positive attitudes (OR = 1.439, 95% CI 1.024, 2.024), stronger preference in calculating the benefits of COVID-19 vaccines (OR = 2.108, 95% CI 1.541, 2.882), and greater perceived susceptibility (OR = 1.471, 95% CI 1.045, 2.070) to and severity of contracting COVID-19 (OR = 1.362, 95% CI 1.020, 1.820) were significantly associated with higher odds of long-term intention. Conclusions Short-term and long-term intentions were predicted differently. Instilling strong confidence in COVID-19 vaccines should increase both short-term and long-term intentions.

Prevalence, correlates, and drivers of COVID-19 vaccine hesitancy among Canadians.

“…Indeed, our results, along with other studies, indicate that not being medically vulnerable to COVID-19 and perceiving vaccination as low priority are associated with greater vaccine hesitancy (Kim et al, 2022; Soares et al, 2021). Accordingly, those aged 21–64 may be less worried about the physical effects of contracting COVID-19 or may be exposed to vaccination misinformation via social media more often than older adults, rendering them more hesitant towards vaccination (Kim et al, 2022). Interventions aimed at increasing vaccine uptake may be most successful if directed towards those who are hesitant rather than rejecting of the vaccine (such as those who do not consider themselves medically vulnerable), as hesitant folks may be more amenable to vaccine uptake intervention efforts.…”

“…It may be that although very young adults endorse accepting attitudes towards vaccination, they have a lower risk perception of contracting COVID-19 and therefore, are slower at taking steps to receive a vaccination relative to older adults. Indeed, our results, along with other studies, indicate that not being medically vulnerable to COVID-19 and perceiving vaccination as low priority are associated with greater vaccine hesitancy (Kim et al, 2022; Soares et al, 2021). Accordingly, those aged 21–64 may be less worried about the physical effects of contracting COVID-19 or may be exposed to vaccination misinformation via social media more often than older adults, rendering them more hesitant towards vaccination (Kim et al, 2022).…”

Motivators and Barriers to COVID-19 Vaccination in Young Adults Living in the USA

“…Young adults living in the United States have consistently been vaccinated at lower rates, so previous studies have investigated factors for vaccine hesitancy and reported similar factors found in the general population (Adams et al, 2021; Fisher et al, 2020; Gurley et al, 2021; S. J. Kim et al, 2022).…”

“…Negative perceptions related to unknown long-term effects of the COVID-19 vaccine and unknown underlying conditions were found to be major barriers affecting young adults' vaccination decisions (Adams et al, 2021;Brandt, et al, 2021;Gurley et al, 2021; S. J. Kim et al, 2022). Concerns about vaccine safety is another barrier to COVID-19 vaccination among young adults (Adams et al, 2021).…”

“…J. Kim et al, 2022). Negative perceptions related to unknown long-term effects of the COVID-19 vaccine and unknown underlying conditions were found to be major barriers affecting young adults’ vaccination decisions (Adams et al, 2021; Brandt, et al, 2021; Gurley et al, 2021; S. J. Kim et al, 2022).…”