No abstract

Vaccine hesitancy could become a significant impediment to addressing the COVID-19 pandemic. The current study examined the prevalence of COVID-19 vaccine hesitancy and factors associated with vaccine intentions. A national panel survey by the National Opinion Research Center (NORC) was designed to be representative of the US household population. Sampled respondents were invited to complete the survey between May 14 and 18, 2020 in English or Spanish. 1,056 respondents completed the survey—942 via the web and 114 via telephone. The dependent variable was assessed by the item “If a vaccine against the coronavirus becomes available, do you plan to get vaccinated, or not?” Approximately half (53.6%) reported intending to be vaccinated, 16.7% did not intend, and 29.7% were unsure. In the adjusted stepwise multinominal logistic regression, Black and Hispanic respondents were significantly less likely to report intending to be vaccinated as were respondents who were females, younger, and those who were more politically conservative. Compared to those who reported positive vaccine intentions, respondents with negative vaccine intentions were significantly less likely to report that they engaged in the COVID-19 prevention behaviors of wearing masks (aOR = 0.53, CI = 0.37–0.76) and social distancing (aOR = 0.22, CI = 0.12–0.42). In a sub-analysis of reasons not to be vaccinated, significant race/ethnic differences were observed. This national survey indicated a modest level of COVID-19 vaccine intention. These data suggest that public health campaigns for vaccine uptake should assess in greater detail the vaccine concerns of Blacks, Hispanics, and women to tailor programs.

Background COVID-19 vaccine hesitancy is a major obstacle for pandemic mitigation. As vaccine hesitancy occurs along multiple dimensions, we used a social-ecological framework to guide the examination of COVID-19 vaccine intentions. Methods Using an online survey in the US conducted in July 2020, we examined intentions to obtain a COVID-19 vaccine, once available. 592 respondents provided data, including measures of demographics, vaccine history, social norms, perceived risk, and trust in sources of COVID-19 information. Bivariate and multivariate multinomial models were used to compare respondents who did not intend to get or were ambivalent about COVID-19 vaccination and to those who intended to be vaccinated against COVID-19. Results Only 59.1% of the sample reported that they intended to obtain a COVID-19 vaccine. In the multivariate multinomial model, those respondents who did not intend to be vaccinated, as compared to those who did, had significantly lower levels of trust in the CDC as a source of COVID-19 information (aOR= 0.29, CI=0.17-0.50), reported lower social norms of COVID-19 preventive behaviors (aOR=0.6, CI 0.51-0.88), scored higher on COVID-19 Skepticism (aOR=1.44, CI=1.28-1.61), identified as more politically conservative (aOR=1.23, CI=1.05-1.45), were less likely to have obtained a flu vaccine in the prior year (aOR=0.21, CI= 0.11-0.39), were less likely to be female (aOR=0.51, CI=0.29-0.87), and were much more likely to be Black compared to White (aOR=10.7, CI=4.09-28.1). A highly similar pattern was observed among those who were ambivalent about receiving a COVID-19 vaccine compared to those who intended to receive one. Conclusion The results of this study suggest several avenues for COVID-19 vaccine promotion campaigns, including social network diffusion strategies and cross-partisan messaging, to promote vaccine trust. The racial and gender differences in vaccine intentions also suggest the need to tailor campaigns based on gender and race.