Dataset Information

Deliberation, Dissent, and Distrust: Understanding distinct drivers of COVID-19 vaccine hesitancy in the United States.

ABSTRACT:

Background

Despite the availability of safe and efficacious COVID-19 vaccines, a significant proportion of the American public remains unvaccinated and does not appear immediately interested in receiving the vaccine.

Methods

In this study, we analyzed data from the U.S. Census Bureau's Household Pulse Survey, a biweekly cross-sectional survey of U.S. households. We estimated the prevalence of vaccine hesitancy across states and nationally and assessed the predictors of vaccine hesitancy and vaccine rejection. Additionally, we examined the underlying reasons for vaccine hesitancy, grouped into thematic categories.

Results

A total of 459,235 participants were surveyed from January 6 to March 29, 2021. While vaccine uptake increased from 7.7 to 47 percent, vaccine hesitancy rates remained relatively fixed: overall, 10.2 percent reported that they would probably not get a vaccine, and 8.2 percent would definitely not get a vaccine. Income, education, and state political leaning strongly predicted vaccine hesitancy. However, while both female sex and Black race were factors predicting hesitancy, among those who were hesitant, these same characteristics predicted vaccine reluctance rather than rejection. Those who expressed reluctance invoked mostly "deliberative" reasons while those who rejected the vaccine were also likely to invoke reasons of "dissent" and "distrust".

Conclusion

Vaccine hesitancy comprises a sizable proportion of the population and is large enough to threaten achieving herd immunity. Distinct subgroups of hesitancy have distinctive socio-demographic associations as well as cognitive and affective predilections. Segmented public health solutions are needed to target interventions and optimize vaccine uptake.

SUBMITTER: Tram KH

PROVIDER: S-EPMC8406882 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Publications

Deliberation, Dissent, and Distrust: Understanding Distinct Drivers of Coronavirus Disease 2019 Vaccine Hesitancy in the United States.

Tram Khai Hoan KH Saeed Sahar S Bradley Cory C Fox Branson B Eshun-Wilson Ingrid I Mody Aaloke A Geng Elvin E

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20220401 8

<h4>Background</h4>Despite the availability of safe and efficacious coronavirus disease 2019 vaccines, a significant proportion of the American public remains unvaccinated and does not appear to be immediately interested in receiving the vaccine.<h4>Methods</h4>In this study, we analyzed data from the US Census Bureau's Household Pulse Survey, a biweekly cross-sectional survey of US households. We estimated the prevalence of vaccine hesitancy across states and nationally and assessed the predict ...[more]

PMID: 34272559

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Project description:IntroductionGiven that the success of vaccines against coronavirus disease 2019 (COVID-19) relies on herd immunity, identifying patients at risk for vaccine hesitancy is imperative-particularly for those at high risk for severe COVID-19 (i.e., minorities and patients with neurological disorders).MethodsAmong patients from a large neuroscience institute in Hawaii, vaccine hesitancy was investigated in relation to over 30 sociodemographic variables and medical comorbidities, via a telephone quality improvement survey conducted between 23 January 2021 and 13 February 2021.ResultsVaccine willingness (n = 363) was 81.3%. Univariate analysis identified that the odds of vaccine acceptance reduced for patients who do not regard COVID-19 as a severe illness, are of younger age, have a lower Charlson Comorbidity Index, use illicit drugs, or carry Medicaid insurance. Multivariable logistic regression identified the best predictors of vaccine hesitancy to be: social media use to obtain COVID-19 information, concerns regarding vaccine safety, self-perception of a preexisting medical condition contraindicated with vaccination, not having received the annual influenza vaccine, having some high school education only, being a current smoker, and not having a prior cerebrovascular accident. Unique amongst males, a conservative political view strongly predicted vaccine hesitancy. Specifically for Asians, a higher body mass index, while for Native Hawaiians and other Pacific Islanders (NHPI), a positive depression screen, both reduced the odds of vaccine acceptance.ConclusionUpon identifying the variables associated with vaccine hesitancy amongst patients with neurological disorders, our clinic is now able to efficiently provide ancillary COVID-19 education to sub-populations at risk for vaccine hesitancy. While our results may be limited to the sub-population of patients with neurological disorders, the findings nonetheless provide valuable insight to understanding vaccine hesitancy.