COVID-19 vaccination attitudes, values and intentions among United States adults prior to emergency use authorization

Abstract

Introduction Safe and effective vaccines against Coronavirus Disease 2019 (COVID-19) provide the best opportunity to control the pandemic. Having safe and efficacious vaccines available is only half the equation; people must also take them. We describe a study to identify COVID-19 vaccine attitudes, values and intentions immediately preceding authorization of COVID-19 vaccines in the US. Methods A national panel survey was conducted to measure intent to receive COVID-19 vaccines as well as disease and vaccine attitudes, values and trust in local, state and federal public health authorities. Results Greater than 80% of respondents reported confidence they could adhere to COVID recommendations such as mask wearing, social distancing and hand washing. The majority of respondents (70%) reported believing that current drugs were somewhat or very good at treating COVID-19 infection. Vaccine intent fell into three groups: Intenders (50%), Wait and Learn (40%), and Unlikelys (10%). Intent to get vaccinated was substantially lower among African American (32%), and higher among men (56%), those over 60 years of age (61%), those with a Bachelor’s degree or higher (63%), and Democrats (63%). The Wait and Learn group, compared to the Intenders, were less likely to report being diagnosed with a high risk condition for COVID-19, receiving an influenza vaccine in the past 12 months, discussing COVID-19 vaccine with their healthcare provider, perceiving COVID-19 as severe, considering a COVID-19 vaccine important to stop the spread of infection, and wering a mask usually or almost always. Conclusion Only half of US adults intend to accept COVID-19 vaccines; most others (40%) are uncertain. Levels of immunity associated with community protection will not be achieved without reaching those who are currently uncertain. Characterizing COVID-19 vaccine attitudes and intentions and ascertaining values and trust in local, state, and federal public health authorities that impact vaccine decision-making are essential.

Differences in the Protection Motivation Theory Constructs between People with Various Latent Classes of Motivation for Vaccination and Preventive Behaviors against COVID-19 in Taiwan

“…Research has demonstrated a significant association between the adoption of preventive behaviors against COVID-19 and motivation to receive a COVID-19 vaccination. However, adopting preventive behaviors did not guarantee a high motivation to receive a COVID-19 vaccination [ 30 , 31 ]. Most of the recommended preventive behaviors against COVID-19 are well-known measures to prevent the spread of respiratory infectious diseases with proven benefits; however, the COVID-19 vaccines have been developed in a short period, causing some individuals to be skeptical.…”

“…The result of a review study supported the effectiveness of Protection Motivation Theory, Health Belief Model, and Theory of Planned Behavior on informing infectious disease modelling, research, and public health practice [ 39 ]. Because knowledge regarding COVID-19 and protective behaviors [ 40 , 41 ] and previous experiences regarding adopting protective behaviors [ 31 ] also predict further adoption of protective behaviors against respiratory infectious diseases, they are included in the extended PMT.…”

“…PMT has been applied to explain the motivation to adopt preventive behaviors [ 41 , 42 , 43 , 44 , 45 , 46 ] and to get vaccinated against COVID-19 [ 31 , 44 , 47 , 48 ]. Cross-sectional studies have revealed that perceived severity of and vulnerability to COVID-19, self-efficacy to adopt preventive behaviors, and response efficacy of preventive behaviors are positively associated with the intention to adhere to recommended protective behaviors against COVID-19 [ 41 , 42 , 43 , 44 , 45 ].…”

“…A follow-up study demonstrated that perceived severity and response efficacy can predict the adoption of preventive behaviors against COVID-19 [ 44 ]. Moreover, research has revealed that the perceived severity of COVID-19 [ 46 ], response and cost efficacy of vaccination [ 44 , 48 ], and receiving an influenza vaccine [ 31 ] are associated with the motivation to receive COVID-19 vaccination. However, no study has examined whether the cognitive constructs of PMT differ between individuals with various classes of motivations to get vaccinated and to adopt preventive behaviors against COVID-19.…”

“…We proposed two hypotheses. First, because adopting preventive behaviors did not guarantee high motivation to receive COVID-19 vaccination [ 30 , 31 ], we hypothesized that the individuals could be categorized into various latent classes according to their motivations of getting vaccinated and adopting preventive behaviors against COVID-19. Second, we hypothesized that the cognitive constructs of PMT differ between individuals with various classes of motivations to get vaccinated and to adopt preventive behaviors against COVID-19.…”