COVID-19 vaccine intentions in the United States, a social-ecological framework

Abstract

Background COVID-19 vaccine hesitancy is a major obstacle for pandemic mitigation. As vaccine hesitancy occurs along multiple dimensions, we used a social-ecological framework to guide the examination of COVID-19 vaccine intentions. Methods Using an online survey in the US conducted in July 2020, we examined intentions to obtain a COVID-19 vaccine, once available. 592 respondents provided data, including measures of demographics, vaccine history, social norms, perceived risk, and trust in sources of COVID-19 information. Bivariate and multivariate multinomial models were used to compare respondents who did not intend to get or were ambivalent about COVID-19 vaccination and to those who intended to be vaccinated against COVID-19. Results Only 59.1% of the sample reported that they intended to obtain a COVID-19 vaccine. In the multivariate multinomial model, those respondents who did not intend to be vaccinated, as compared to those who did, had significantly lower levels of trust in the CDC as a source of COVID-19 information (aOR= 0.29, CI=0.17-0.50), reported lower social norms of COVID-19 preventive behaviors (aOR=0.6, CI 0.51-0.88), scored higher on COVID-19 Skepticism (aOR=1.44, CI=1.28-1.61), identified as more politically conservative (aOR=1.23, CI=1.05-1.45), were less likely to have obtained a flu vaccine in the prior year (aOR=0.21, CI= 0.11-0.39), were less likely to be female (aOR=0.51, CI=0.29-0.87), and were much more likely to be Black compared to White (aOR=10.7, CI=4.09-28.1). A highly similar pattern was observed among those who were ambivalent about receiving a COVID-19 vaccine compared to those who intended to receive one. Conclusion The results of this study suggest several avenues for COVID-19 vaccine promotion campaigns, including social network diffusion strategies and cross-partisan messaging, to promote vaccine trust. The racial and gender differences in vaccine intentions also suggest the need to tailor campaigns based on gender and race.

Sociodemographic Determinants of COVID-19 Vaccine Hesitancy, Fear of Infection, and Protection Self-Efficacy

“…These findings were consistent with several other studies that found those who did not intend to be vaccinated were much less likely to be female and much more likely to be Black/African American compared to White. 22 , 23 Consistent with prior studies, Black/African American were 3 times as likely to report COVID-19 vaccine hesitancy. 24 , 25 These findings were concerning because people with lower incomes and/or lower education levels and communities of color experienced greater COVID-19 disparities in infection, hospitalization, and death.…”

Investigating the Links Between Vaccination Against COVID-19 and Public Attitudes Toward Protective Countermeasures: Implications for Public Health

“…Consistent with Chu's and Liu ( 33 ) related research, our research confirms the enthusiasm and initiative of men in the COVID-19 vaccination. However, previous studies have also reached the opposite conclusion, just as Latkin et al ( 35 ) hold that females generally express greater intentions to obtain a COVID-19 vaccine than males. These findings further suggest that vaccination campaigns should consider gender differences in attitudes and acceptance.…”

“…Quite a few people are afraid of and reluctant to get the COVID-19 vaccination. Latkin et al ( 35 ) used a socio-ecological framework to explore Americans' intentions regarding the COVID-19 vaccination. The results found that only 59.1% of people intended to get the vaccination.…”

Hesitant or Not Hesitant? A Systematic Review on Global COVID-19 Vaccine Acceptance in Different Populations

“…Main sample features of the studies included in the analysis are shown in Table 1 [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ,…”