As many as four in 10 adults would refuse or hesitate to get a COVID-19 vaccine, according to participants in a national survey conducted during the coronavirus pandemic. The findings from the Meyers Primary Care Institute, in collaboration with UMass Medical School, indicate that health education outreach would be necessary to achieve widespread uptake of a safe and effective vaccine when one becomes available.
The survey explored factors associated with vaccine hesitancy to identify predictors of intent to decline or delay acceptance of a vaccine and reasons for doing so to target and inform efforts to encourage vaccine uptake.
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“Who are the people saying, ‘No, I don't want to be vaccinated,’ or ‘I'm not sure I'd be vaccinated,’ and how do they differ from the people who say they will get vaccinated?” said study co-author Kimberly Fisher, MD, associate professor of medicine. “The crux of our analysis was comparing those three groups of respondents based on their demographic and other characteristics.”
Dr. Fisher and Kathleen Mazor, EdD, professor of medicine, led the study published Sept. 7 by the Annals of Internal Medicine.
The research question, “When a vaccine for the coronavirus becomes available, will you get vaccinated?” was included in an April 2020 AmeriSpeak omnibus survey. Response options were “yes,” “no,” and “not sure.” Participants who responded “no” or “not sure” were asked to provide a reason.
Funded and operated by the nonpartisan and objective research organization NORC at the University of Chicago, AmeriSpeak is a probability-based panel representative of the U.S. household population, covering approximately 97 percent of adults residing in the United States. Nearly 1,000 panel members responded to the COVID-19 vaccine question.
While more than half overall intended to be vaccinated, nearly a third were not sure, and one in 10 did not intend to be vaccinated.
“The most common reasons cited by the ‘not sure’ group were specific concerns about safety, efficacy and the ‘newness of a vaccine,’ a reasonable response to being asked a hypothetical question about it. We think that many in this group will agree to be vaccinated if they're provided clear, understandable facts,” said Fisher. “By comparison, the most common reason given by the ‘no’ group included anti-vaccine attitudes, beliefs and emotions. A focused communication strategy targeting those who are not sure may be more productive than trying to convince people who hold negative views.”
“Factors independently associated with vaccine hesitancy (a response of “no” or “not sure”) included younger age, Black race, lower educational attainment and not having received the influenza vaccine in the prior year,” co-authors wrote.
“It is especially concerning that Black race is associated with vaccine hesitancy given the disproportionate impact COVID-19 has already had among African American communities and the potential for decreased vaccination to magnify health-related disparities,” Fisher said. “Concerted efforts will be needed to ensure equitable access and uptake.”
Prior research by Mazor and Fisher has focused on improving communication between patients and health care providers. They are developing research that will create and test messages related to both COVID and influenza vaccination to identify which messages are most effective at increasing the number of patients who will get vaccinated.
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