COVID-19 Vaccine Hesitancy among Behavioral Risk Takers

Abstract

The COVID-19 pandemic has emerged as a major public health issue, with vaccines serving as a vital preventive strategy to lower the global burden. Yet, despite national and local mandates, key sectors of the population continue to demonstrate lower compliance rates. In the United States, young adults have the lowest vaccination rates among the adult population. The goal of our study was to utilize the largest state-health survey to assess the key determinants of such hesitancy in order to create targeted interventions for the most at-risk groups to ensure equitable outcomes in disease prevention. We utilized the latest available California Health Interview Survey, a population-based complex probability survey, to evaluate determinants of vaccine hesitancy among young adults. Survey-weighted descriptive statistics, bivariate statistics, and multivariable logistic regression analyses were conducted. All statistical tests used p less than 0.05 to determine statistical significance. A total of 1203 respondents, representative of 4,027,462 young adults (ages 18–25 years) were included in our study. Our primary findings note that 24% of participants reported they would not be willing to take the COVID-19 vaccination. Prevalence of vaccine hesitancy was also significantly higher among young adults who were current smokers (including electronic cigarettes), when compared to non-current smokers (36% vs. 22%). Further, the highest prevalence was also noted among young adults who identified as African-American (51%), had a high school degree or less (34%), those who were overweight or obese (28%), and reported a poor health status (22%). Multivariable regression analysis demonstrated that current smokers, as compared to non-current smokers, had more than double the odds of reporting COVID-19 vaccine hesitancy. African-American young adults or young adults with a high school degree or less were both independently associated with at least a three-fold increase in vaccine hesitancy. Participants with psychological distress, however, were more likely to be accepting of the vaccine. Public health efforts to improve vaccine compliance need targeted efforts, including building trust in the healthcare system for African-Americans and promoting easier access and knowledge of vaccines among those with a high school degree or less, as well as young-adults who are currently smoking, with such efforts targeting behavioral interventions focused on risk aversion.

Durability of the Single-Dose Ad26.COV2.S Vaccine in the Prevention of COVID-19 Infections and Hospitalizations in the US Before and During the Delta Variant Surge

“…35,36 As a result of mass vaccination efforts by a range of public and private organizations, where health insurance information may not have been required, collected, or submitted, a substantial fraction of COVID-19 vaccine administrations were not recorded in insurance data. 37 Given the underrecording of COVID-19 vaccinations in insurance claims data, which leads to an underestimation of the true effect size, we empirically estimated the level of underrecording by calibrating against national and state vaccine registry data (eMethods 4 in the Supplement) and applied standard correction methods to all VE estimates. 38 Even if one would falsely assume no (0%) underrecording and completely disregard the necessary correction, the VE estimates would decline by about 10 percentage points, as illustrated in Table 2, eTable 5, and eTable 6 in the Supplement.…”

Healthcare workers’ attitudes on mandates, incentives, and strategies to improve COVID-19 vaccine uptake: A mixed methods study

“… 39 In the United States, Texas has banned healthcare worker mandates, however the state still has difficulty obtaining enough nurses to cover their patients. 40 Another study using data from the California Health Interview Survey evaluating COVID-19 vaccine hesitancy observed that initiatives such as mandates may not support vaccine uptake, citing that community level outreach should be prioritized, 41 a finding echoed by a further study finding that public health efforts to improve access to vaccines should be prioritized over mandates. 11 Similar to our findings, a survey study evaluating attitudes of healthcare workers in the UK reported that a large proportion of the sample favored education and building public trust over vaccine mandates.…”

Knowledge and attitudes towards COVID-19 vaccination among medical and paramedical students

“…Therefore, it is crucial to implement practical, evidence based approaches to combat vaccine hesitancy among our students. More over, vaccine hesitancy represents a significant barrier to effectively managing and controlling the COVID-19 pandemic (Becerra & Becerra et al, 2022). A notion that has been confirmed by a computational based mathematical model that was performed by (Bartsch et al, 2020) and showed that the COVID-19 vaccine must have a coverage efficacy of at least 70% to effectively extinguish an ongoing pandemic by at least 80% without any other measures (Bartsch et al, 2020).…”