An assessment of Veterans attitudes and willingness to receiving the COVID-19 vaccine: a mixed methods study

Abstract

Background While several safe and effective COVID-19 vaccines have been available since December 2020, many eligible individuals choose to remain unvaccinated. This vaccine hesitancy is an important factor affecting our ability to combat the COVID-19 pandemic. Methods The objective of the study was to examine the attitudes and willingness among US Veterans toward receiving COVID-19 vaccination. The study used a quantitative qualitative mixed methods design with a telephone survey and then in-depth interviews in a subset of those surveyed. Participants were unvaccinated Veterans (N = 184) selected randomly from a registry of patients who had received VA healthcare during the pandemic and had a diagnostic test for COVID-19. The primary outcome was willingness to accept COVID-19 vaccination. Survey data collection and in-depth interviews were conducted by telephone. Analyses of the survey data compared the primary outcome with demographics, clinical data, and survey responses using bivariate and multiple regression analyses. A subset (N = 10) of those surveyed, participated in an in-depth interview. Interview transcripts were analyzed to derive themes using qualitative content analysis. Results Almost 40% of participants disagreed they would receive a COVID-19 vaccine. Participants who were younger, female, and had fewer comorbid conditions were more likely (P < 0.05) to disagree with COVID-19 vaccination. In multiple regression analysis, willingness to accept vaccination was associated with reliance on a doctor or family member’s recommendation and with a belief that vaccines are effective. In-depth interviews revealed several barriers to COVID-19 vaccination, including lack of trust in the government and vaccine manufacturers, concerns about the speed of vaccine development, fear of side effects, and fear the vaccine was a tool of racism. Conclusions This study illustrates the complexity of patients’ deliberation about COVID-19 vaccination and may help physicians and other health care providers understand patients’ perspectives about COVID-19 vaccination. The results highlight the importance of patients’ trust in physicians, healthcare organizations, pharmaceutical manufacturers and the government when making health decisions.

Updated beliefs and shaken confidence: Evidence from vaccine hesitancy caused by experiencing "COVID arm"

“…Using data from the UK, Freeman et al and Veli et al found that the exposure to information about vaccine efficacy reduces vaccine hesitancy [18,19]. Denford et al from interviews in the UK and Gardner et al from the US found that vaccine hesitancy was associated with lower trust in the government [20,21]. By Southeast Asian data, Duong and Antriyandarti also found that respondents who were more informed about efficacy were less vaccinehesitant [22].…”

Updated beliefs and shaken confidence: evidence from vaccine hesitancy caused by experiencing “COVID arm”

“…Using Southeast Asian data, Duong and Antriyandarti found that respondents who were more informed about vaccine efficacy were less vaccine hesitant [ 32 ]. Denford et al found from interviews in the UK and Gardner et al found from a survey in the US that vaccine hesitancy was associated with lower trust in the government [ 33 , 34 ]. Using extensive panel data from 12 countries, Algan et al found that confidence in science is significantly associated with attitudes toward vaccinations [ 35 ].…”

Freedom of Expression Across Borders: Communication, Culture, and Language

“…The mistrust of military-connected populations was again highlighted throughout the COVID-19 pandemic when mistrust was prevalent among the broader American population (Gardner et al, 2022). In a 2022 survey of Veterans, almost 40% of participants stated that they would not receive the COVID-19 vaccine (Gardner et al, 2022).…”

“…Trust is an important part of the patient experience and patient-provider relationship; it is because of trust in the collective health care professions that patients seek care from these experts during their most vulnerable moments (e.g., Eagan, 2019). However, there has been a trust crisis in the United Statesone that came into clear focus during the COVID-19 pandemic, when many Americans expressed distrust in government, science, health care providers, news media, and even in facts or truth (e.g., Gardner et al, 2022). According to a recent poll, fewer than one in three Americans think that government officials are credible, and the majority of Americans find it difficult to assess what is real versus fake news (Edelman Intelligence, 2018).…”