Vaccination hesitancy: To be vaccinated, or not to be vaccinated, that is the question in the era of COVID‐19

Abstract

COVID‐19 vaccine hesitancy poses serious challenges in achieving adequate vaccine coverage in the general population. While most studies on vaccine hesitance determinants during the COVID‐19 pandemic were quantitative, qualitative research on the reasons for vaccine resistance is still lacking. To fill this gap, this study aims to qualitatively investigate cognitive and emotional factors associated with COVID‐19 vaccine hesitancy. This qualitative pilot study was conducted between October and November 2021 in Italy. A total of 40 COVID‐19 vaccine‐hesitant (“hesitant not vaccinated” or “hesitant but vaccinated”) individuals completed anonymous questionnaires with open‐ended questions. Data were analysed using the Interpretive Description approach. The central theme that emerged about vaccine hesitancy was the lack of control. This construct included four different sub‐categories: distrust of the government, infodemic, influence of family, and general anti‐vaccine opinions. The results also showed that the most important emotional and cognitive factors associated with hesitancy were anger related to a perceived sense of oppression; emotional avoidance to minimize risk; anxiety related to potential vaccine side effects. Identifying and understanding factors influencing COVID‐19 vaccination hesitancy is crucial to improving communication strategies that will ultimately result in increased confidence and vaccine acceptance.

Attitude towards Intranasal Vaccines and Psychological Determinants: Effects on the General Population in Northern Italy

“…So, the more an individual feels to possess this ability, the more confident and calm he or she will be in dealing with vaccination. These results are in line with the qualitative study by Perrone et al who suggested that the main theme of hesitancy was the perceived lack of control [ 32 ]. Perceived control over events in this study also exerted a significant direct effect on attitude toward intranasal vaccine.…”

“…Individuals with high levels of IU may perceive a weak control exerted over ambiguous and threatening situations and consequently may avoid them to enhance subjectively perceived control over uncertain-threatening environments [ 31 ]. In addition, Perrone et al (2022) demonstrated that the main psychological factor affecting vaccine hesitancy was the perceived lack of control, including the inability to tolerate information that was perceived as ambiguous and uncertain (e.g., potential vaccine side effects) [ 32 ]. It is reasonable that individuals with high IU may perceive low control over uncertain external events (i.e., vaccination) and refuse vaccines that are delivered by IM.…”

Learning from the Past to Improve the Future—Vaccine Hesitancy Determinants in the Italian Population: A Systematic Review

“…The most common predisposing factor for VH found in the included studies and related to vaccination is the fear of developing adverse reactions [ 19 , 23 , 24 , 25 , 29 , 34 , 37 , 38 , 39 , 43 , 45 , 49 ]. Another significant aspect is the distrust or doubts about vaccination against COVID-19 and its efficacy [ 20 , 21 , 24 , 27 , 34 , 38 , 44 , 49 , 51 , 52 , 53 ].…”

“…Another significant aspect is the distrust or doubts about vaccination against COVID-19 and its efficacy [ 20 , 21 , 24 , 27 , 34 , 38 , 44 , 49 , 51 , 52 , 53 ]. As easily expected, the attitude of refusal towards vaccinations or the adoption of poorly protective behaviours constitutes a further preponderant element predisposing to VH against COVID-19 [ 24 , 26 , 27 , 28 , 30 , 37 , 39 , 40 , 42 , 48 , 51 ]. Another predisposing element is the lack of awareness of contracting the infection [ 18 , 31 , 33 , 34 , 37 , 42 , 44 , 46 , 49 ].…”

“…As easily expected, the attitude of refusal towards vaccinations or the adoption of poorly protective behaviours constitutes a further preponderant element predisposing to VH against COVID-19 [ 24 , 26 , 27 , 28 , 30 , 37 , 39 , 40 , 42 , 48 , 51 ]. Another predisposing element is the lack of awareness of contracting the infection [ 18 , 31 , 33 , 34 , 37 , 42 , 44 , 46 , 49 ]. Furthermore, four studies found that knowing people who have contracted the COVID-19 disease affects the decision to undergo the vaccination [ 26 , 30 , 33 , 42 ].…”