Effects of different types of written vaccination information on COVID-19 vaccine hesitancy in the UK (OCEANS-III): a single-blind, parallel-group, randomised controlled trial

Abstract

Background The effectiveness of the COVID-19 vaccination programme depends on mass participation: the greater the number of people vaccinated, the less risk to the population. Concise, persuasive messaging is crucial, particularly given substantial levels of vaccine hesitancy in the UK. Our aim was to test which types of written information about COVID-19 vaccination, in addition to a statement of efficacy and safety, might increase vaccine acceptance. Methods For this single-blind, parallel-group, randomised controlled trial, we aimed to recruit 15 000 adults in the UK, who were quota sampled to be representative. Participants were randomly assigned equally across ten information conditions stratified by level of vaccine acceptance (willing, doubtful, or strongly hesitant). The control information condition comprised the safety and effectiveness statement taken from the UK National Health Service website; the remaining conditions addressed collective benefit, personal benefit, seriousness of the pandemic, and safety concerns. After online provision of vaccination information, participants completed the Oxford COVID-19 Vaccine Hesitancy Scale (outcome measure; score range 7–35) and the Oxford Vaccine Confidence and Complacency Scale (mediation measure). The primary outcome was willingness to be vaccinated. Participants were analysed in the groups they were allocated. p values were adjusted for multiple comparisons. The study was registered with ISRCTN, ISRCTN37254291. Findings From Jan 19 to Feb 5, 2021, 15 014 adults were recruited. Vaccine hesitancy had reduced from 26·9% the previous year to 16·9%, so recruitment was extended to Feb 18 to recruit 3841 additional vaccine-hesitant adults. 12 463 (66·1%) participants were classified as willing, 2932 (15·6%) as doubtful, and 3460 (18·4%) as strongly hesitant (ie, report that they will avoid being vaccinated for as long as possible or will never get vaccinated). Information conditions did not alter COVID-19 vaccine hesitancy in those willing or doubtful (adjusted p values >0·70). In those strongly hesitant, COVID-19 vaccine hesitancy was reduced, in comparison to the control condition, by personal benefit information (mean difference –1·49, 95% CI –2·16 to –0·82; adjusted p=0·0015), directly addressing safety concerns about speed of development (−0·91, –1·58 to –0·23; adjusted p=0·0261), and a combination of all information (−0·86, –1·53 to –0·18; adjusted p=0·0313). In those strongly hesitant, provision of personal benefit information reduced hesitancy to a greater extent than provision of information on the collective benefit of not personally getting ill (−0·97, 95% CI –1·64 to –0·30; adjusted p=0·0165) or the collective benefit of not transmitting the virus (−1·01, –1·68 to –0·35; adjusted p=0·0150). Ethnicity and gender were found to moderate information condition outcomes. Interpretation In the approximately 10% of the population who are strongly hesitant ...

Interim Estimates of COVID-19 Vaccine Effectiveness in a Mass Vaccination Setting: Data from an Italian Province

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“…However, some large surveys from the UK suggested that the chances of vaccination increased, even among the more reluctant subgroups, once it was acknowledged that the immunization significantly reduced the risk of severe disease [40,43]. Similarly, the probability of being vaccinated was substantially increased after clear information upon the safety profile of a vaccine was provided [43]. In this scenario, our study, based upon real-world data, may have important practical implications for public health policy, as it may help reassure the general population on both the effectiveness and the safety of the most widely used COVID-19 vaccines.…”

Vaccine for yourself, your community, or your country? Examining audiences’ response to distance framing of COVID-19 vaccine messages

“…To untangle the complex interplay of vaccine benefits in shaping the U.S. public’s vaccination behavior, we focused on three aspects of vaccine benefits individual, community, and country benefits. First, the individual or personal benefits such as protecting personal health and gaining access to public facilities have long been identified as important motivators of vaccination [8] , [9] . Second, research indicates that people vaccinate themselves or their children not only for personal gains, but also to safeguard the wellbeing of their community [10] .…”

Injection fears and COVID-19 vaccine hesitancy

“…Oxford Coronavirus Explanations, Attitudes, and Narratives Survey (OCEANS) III (Freeman et al, 2021 ) is an online survey with a quota sampled UK participant group of 15 014 adults (18+ years old), conducted from 19 January 2021 to the 5 February 2021 via a market research company, Lucid. The quotas were based on UK Office for National Statistics population estimate data for gender, age, ethnicity, income and region.…”

“…A fear of fainting may cause great reluctance to join a line of people waiting for a vaccine injection. In our latest UK survey (Freeman et al, 2021 ), we therefore included assessment of blood-injection-injury fears in order to determine the degree to which they may be a factor in hesitancy about COVID-19 vaccination, which currently depends on injection.…”