Factors Associated with COVID-19 Vaccine Hesitancy after Implementation of a Mass Vaccination Campaign

Abstract

An online cross-sectional study on COVID-19 vaccination adhesion was conducted in Portugal nine months after vaccination rollout (September–November 2021). Logistic regression was used to identify factors associated with hesitancy to take the COVID-19 vaccine in the community-based survey, “COVID-19 Barometer: Social Opinion”. Hesitancy was 11%; however, of those, 60.5% stated that they intended to take the vaccine. Hesitancy was associated with factors such as lower monthly household income; no intention of taking the flu vaccine this year; perceived reasonable health status; having two or more diseases; low confidence in the health service response; worse perception of the adequacy of anti-COVID-19 government measures; low or no perceived risk of getting COVID-19; feeling agitated, anxious or sad some days; and lack of trust in the safety and efficacy of the vaccines. Confidence in vaccines, namely against COVID-19, is paramount for public health and should be monitored during vaccination rollout. Clear communication of the risks and benefits of vaccination needs improvement to increase adherence and public confidence.

SARS-CoV-2 Seroprevalence Following a Large-Scale Vaccination Campaign in Portugal: Results of the National Serological Survey, September - November 2021

“…21 These results are in line with a study on COVID-19 vaccination adherence conducted in Portugal, which found lower odds of vaccine hesitancy for women, which may, reflect higher engagement of women in preventive behaviors. 22 A higher seroprevalence rate was also found in those with high education (96.0%; 95% CI: 94.3% to 97.3%), which was also the group with the lowest post-infection seroprevalence (6.1%; 95% CI: 4.4% to 8.4%) rate. A similar result was observed in a population-based serological survey in Switzerland.…”

“…In a Portuguese study, higher odds of vaccine hesitancy were found within individuals with no education/basic education and secondary education, when compared to those with a university degree, hence corroborating this hypothesis. 22 In addition, during the COVID-19 pandemic, Portugal experienced a significant shift to digital technology in the health sector. A web-based appointment system for vaccination was implemented and the European Union (EU) digital vaccination certificate was introduced.…”

COVID-19 vaccine hesitancy: A Systematic review of cognitive determinants

“… 37 According to Xu et al, parents with psychological distress are more likely to hesitate to vaccinate for themselves, their spouses, and their children. 94 Feeling agitated, sad, or anxious were other factors that were shown to be associated with vaccine hesitancy in a survey conducted by Gomes et al 47 …”