COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II

Abstract

Background Our aim was to estimate provisional willingness to receive a coronavirus 2019 (COVID-19) vaccine, identify predictive socio-demographic factors, and, principally, determine potential causes in order to guide information provision. Methods A non-probability online survey was conducted (24th September−17th October 2020) with 5,114 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. The Oxford COVID-19 vaccine hesitancy scale assessed intent to take an approved vaccine. Structural equation modelling estimated explanatory factor relationships. Results 71.7% (n=3,667) were willing to be vaccinated, 16.6% (n=849) were very unsure, and 11.7% (n=598) were strongly hesitant. An excellent model fit (RMSEA=0.05/CFI=0.97/TLI=0.97), explaining 86% of variance in hesitancy, was provided by beliefs about the collective importance, efficacy, side-effects, and speed of development of a COVID-19 vaccine. A second model, with reasonable fit (RMSEA=0.03/CFI=0.93/TLI=0.92), explaining 32% of variance, highlighted two higher-order explanatory factors: ‘excessive mistrust’ (r=0.51), including conspiracy beliefs, negative views of doctors, and need for chaos, and ‘positive healthcare experiences’ (r=−0.48), including supportive doctor interactions and good NHS care. Hesitancy was associated with younger age, female gender, lower income, and ethnicity, but socio-demographic information explained little variance (9.8%). Hesitancy was associated with lower adherence to social distancing guidelines. Conclusions COVID-19 vaccine hesitancy is relatively evenly spread across the population. Willingness to take a vaccine is closely bound to recognition of the collective importance. Vaccine public information that highlights prosocial benefits may be especially effective. Factors such as conspiracy beliefs that foster mistrust and erode social cohesion will lower vaccine up-take.

COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates

“…Stratified per country, a total of 60 surveys were found with the largest sample size (n = 5114) in the study conducted in the UK by Freeman et al, while the smallest sample size (n = 123) was found in the study conducted in Malta by Gretch et al, among general practitioners and trainees [48,49]. Out of these 60 surveys, 47 were among the general public, eight surveys were among healthcare workers (doctors, nurses, or others), three surveys were among parents/guardians and two surveys involved University students ( Table 1).…”

Effect of information about COVID-19 vaccine effectiveness and side effects on behavioural intentions: two online experiments

“…Second, it is currently unclear that transparent communication of information would necessarily affect vaccination rates in any predictable way. On the one hand, explaining the results of clinical trials and the regulatory procedures in place may serve to alleviate concerns over vaccine efficacy and safety and ultimately increase intention to vaccinate as suggested by some researchers (Freeman et al, 2021). On the other, as noted by Petersen et al (2020), it is also possible that individuals may find the information more concerning, increasing their perception of vaccines as relatively more dangerous or ineffective.…”

“…Numerous cross-sectional surveys around the world have identified perceptions of vaccines as safe and effective as key predictors of COVID-19 vaccination intentions (e.g. Callaghan et al, 2021;Freeman et al, 2021;Karlsson et al, 2021;Y. Lin et al, 2020;Paul et al, 2021;Wang et al, 2021;Wong et al, 2020).…”

“…We also include two further exploratory messages as experimental conditions. The first focuses on addressing concerns over the speed of vaccine development and approval, which is also associated with vaccine hesitancy (Freeman et al, 2021)…”

“…Lin et al, 2021). While these broader factors are important, research has also shown that specific beliefs about and attitudes towards COVID-19 vaccinations are also closely linked to vaccination intentions (Freeman et al, 2021;C. Lin et al, 2021).…”