Determinants of COVID-19 Vaccinations among a State-Wide Year-Long Surveillance Initiative in a Conservative Southern State

Abstract

By the end of 2021, the COVID-19 pandemic resulted in over 54 million cases and more than 800,000 deaths in the United States, and over 350 million cases and more than 5 million deaths worldwide. The uniqueness and gravity of this pandemic have been reflected in the public health guidelines poorly received by a growing subset of the United States population. These poorly received guidelines, including vaccine receipt, are a highly complex psychosocial issue, and have impacted the successful prevention of disease spread. Given the intricate nature of this important barrier, any single statistical analysis methodologically fails to address all convolutions. Therefore, this study utilized different analytical approaches to understand vaccine motivations and population-level trends. With 12,975 surveys from a state-wide year-long surveillance initiative, we performed three robust statistical analyses to evaluate COVID-19 vaccine hesitancy: principal component analysis, survival analysis and spatial time series analysis. The analytic goal was to utilize complementary mathematical approaches to identify overlapping themes of vaccine hesitancy and vaccine trust in a highly conservative US state. The results indicate that vaccine receipt is influenced by the source of information and the population’s trust in the science and approval process behind the vaccines. This multifaceted statistical approach allowed for methodologically rigorous results that public health professionals and policy makers can directly use to improve vaccine interventions.

COVID-19 Testing Practices, Preventive Behaviors, and Factors Associated With Test Positivity: Population-Based Statewide Survey Study

“…Moreover, availability of the vaccine began in mid-January for individuals aged 70 or older, which likely also impacted testing demand. At the time of the survey, 58.7% (4213/7170) of respondents had ever been tested for COVID-19, whereas it has previously been reported that 66.7% received the vaccine, suggesting the possibility that a number of respondents did not actively seek testing due to fear of exposure [ 23 ]. Our results show the likelihood of test positivity was highest among Black/African Americans and older individuals (aged ≥50 years).…”

Understanding COVID‐19 Vaccine Hesitancy Among K‐12 Staff, Parents, and Students: District of Columbia, February to April, 2022

“…While other studies have used survival (time‐to‐event) analysis as it relates to vaccine effectiveness and hesitancy, this study is unique in that it assessed time to vaccine uptake by using actual COVID‐19 vaccination dates, conducting analyses based on date of vaccine eligibility in DC, and verifying dates using a jurisdictional immunization registry 25,42 . Due to the point in time of the study, obtaining vaccination information was easy and non‐intrusive.…”

“…While other studies have used survival (time-toevent) analysis as it relates to vaccine effectiveness and hesitancy, this study is unique in that it assessed time to vaccine uptake by using actual COVID-19 vaccination dates, conducting analyses based on date of vaccine eligibility in DC, and verifying dates using a jurisdictional immunization registry. 25,42 Due to the point in time of the study, obtaining vaccination information was easy and non-intrusive. We found that most participants had COVID-19 vaccination cards readily available since vaccination was required to participate in activities dining at restaurants, attending a performance, or traveling by air at the time of the study.…”

Spatial Analysis of Determinants of COVID-19 Vaccine Hesitancy in Portugal

“…Mass vaccination programs were an essential strategy to tackle the spread of SARS-CoV-2 and reduce severe forms of COVID-19, allowing for total social and economic activity [ 2 , 3 , 5 , 7 , 8 , 9 , 10 ]. However, one of the potential threats to this goal was vaccine hesitancy [ 3 , 5 , 9 , 10 , 11 , 12 ].…”

“…However, vulnerable pockets of unvaccinated people might remain since unvaccinated individuals may cluster together [ 6 , 10 , 12 , 26 ]. With the plateauing of vaccination uptake rates and the emergence of new variants, it is fundamental to identify, characterize, and monitor clusters of the population that remain hesitant, due to the risk of community transmission remaining active in these groups [ 3 , 9 , 10 , 12 , 23 , 27 ]. Being a migrant or living in a socially deprived setting has been associated with a lower vaccine uptake because of hesitancy or lack of access [ 5 , 9 , 12 , 23 , 26 ].…”