Underlying factors that influence the acceptance of COVID-19 vaccine in a country with a high vaccination rate

Abstract

Control of the COVID-19 pandemic largely depends on the effectiveness of the vaccination. Several factors including vaccine hesitancy can affect the vaccination process. Understanding the factors that underlie the willingness to accept vaccination brings pivotal information to control the pandemic. We analyzed the association between the willingness level to accept the COVID-19 vaccine, and vaccine determinants amidst the Chilean vaccination process. Individual-level survey data was collected from nationally representative samples of 744 respondents, and multivariate regression models used to estimate the association between outcome and explanatory variables. We found that trust in the COVID-19 vaccine, scientists, and medical professionals increased the willingness to: accept the vaccine, a booster dose, annual vaccination, and children vaccination. Our results are critical to understand the acceptance of COVID-19 vaccines in the context of a country with one of the world’s highest vaccination rates. We provide information for decision-making, policy design and communication of vaccination programs.

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

“…We also found higher odds of hesitancy for participants with low confidence in the health services response to COVID-19 and non-COVID-19 and who perceived the measures implemented by the government as inadequate, matching prior publications on this topic [15,46]. Higher odds of hesitancy were also found for participants who perceived their risk of getting COVID-19 as low or non-existent, which was in agreement with the literature [5,8,10,[14][15][16][17][18]22,25,27,30,31,33,37,46]. Risk perception and trust in the authorities and health institutions can vary according to a country's pandemic context during a specific period [51].…”

“…Negative perceptions towards the efficacy [5,8,13,14,17,19,21,25,31,34,37] and safety [5,8,10,13,14,[16][17][18][19]21,25,27,[29][30][31]33,37,40] of COVID-19 vaccines were highly linked to vaccine hesitancy. Given the complexity of this topic, aligned with the growing misinformation present in several media regarding the development process of vaccines, concerns about the safety and efficacy of the vaccines are understandable [2,15].…”

“…Several cross-sectional studies have since explored COVID-19 vaccine acceptance and hesitancy and their determinants after the respective countries' vaccination program implementation, namely in European countries [2], such as the United Kingdom [15,16,20,21], Germany [15,22], Denmark [15,23], France [15], Hungary [15], Sweden [15], Italy [15], Norway [21], Poland [24], the Netherlands [25], Spain [26] and Greece [27]. Additional studies were also conducted in Saudi Arabia [28], the United States of America [13,17,21,29], South Africa [21,30], Jordan [31], Israel [32], Chile [33], China [18,21,34,35], Japan [21,36] and Australia [21], among others [21]. These studies have not only reported variation in the refusal rate of COVID-19 vaccination over sequential waves [13][14][15]18], but also on the characteristics of the individuals that reported hesitancy in getting vaccinated [13,14,18] and on the reasons behind this refusal…”

“…In these studies, COVID-19 vaccination acceptance or hesitancy varied according to age [2][3][4]6,[8][9][10]13,14,[16][17][18][20][21][22]24,30,[32][33][34][35][36][37][38], gender [3,6,10,13,14,16,18,[20][21][22]24,26,28,30,31,36], education [4,6,[8][9][10]13,14,17,18,21,22,24,…”

“…Negative perceptions on the safety [5,8,10,13,14,[16][17][18][19]21,25,27,[29][30][31]33,37] or efficacy/effectiveness [5,8,13,14,16,17,19,21,25,31,34,37] of these vaccines and misinformation on this topic [2,15] were described in individuals hesitant about COVID-19 vaccination. Additionally, a perception of COVID-19 as not a risk to self [5,8,10,[14][15][16][17][18]22,25,27,[30][31][32][33]37,38], as well as general distrust of COVID-19 vaccines [14,17], the go...…”