COVID-19 vaccine hesitancy: the five Cs to tackle behavioural and sociodemographic factors

Razai, Mohammad S; Oakeshott, Pippa; Esmail, Aneez; Wiysonge, Charles Shey; Viswanath, Kasisomayajula; Mills, Melinda

doi:10.1177/01410768211018951

Cited by 112 publications

(129 citation statements)

References 16 publications

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“…However, this is overly simplistic, especially when considering the complexities of healthcare and existing inequity. Other models further elaborate on the “5 Cs” and include Communication, a person’s sources for information, and Context, a person’s community structure, sociodemographics, and environment [ 71 ]. Further, Constraint is a more complex concept that describes structural and psychological barriers to vaccination, including (but not limited to) the physical availability, affordability, or geographical accessibility of the vaccine and limitations to the ability to understand (language and health literacy) vaccine information [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

Correlates of COVID-19 Vaccine Hesitancy among a Community Sample of African Americans Living in the Southern United States

et al. 2021

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In the United States, African Americans (AAs) have been disproportionately affected by COVID-19 mortality. However, AAs are more likely to be hesitant in receiving COVID-19 vaccinations when compared to non-Hispanic Whites. We examined factors associated with vaccine hesitancy among a predominant AA community sample. We performed a cross-sectional analysis on data collected from a convenience sample of 257 community-dwelling participants in the Central Savannah River Area from 5 December 2020, through 17 April 2021. Vaccine hesitancy was categorized as resistant, hesitant, and acceptant. We estimated relative odds of vaccine resistance and vaccine hesitancy using polytomous logistic regression models. Nearly one-third of the participants were either hesitant (n = 40, 15.6%) or resistant (n = 42, 16.3%) to receiving a COVID-19 vaccination. Vaccine-resistant participants were more likely to be younger and were more likely to have experienced housing insecurity due to COVID-19 when compared to both acceptant and hesitant participants, respectively. Age accounted for nearly 25% of the variation in vaccine resistance, with 21-fold increased odds (OR: 21.93, 95% CI: 8.97–5.26–91.43) of vaccine resistance in participants aged 18 to 29 compared to 50 and older adults. Housing insecurity accounted for 8% of the variation in vaccine resistance and was associated with 7-fold increased odds of vaccine resistance (AOR: 7.35, 95% CI: 1.99–27.10). In this sample, AAs under the age of 30 and those experiencing housing insecurity because of the COVID-19 pandemic were more likely to be resistant to receiving a free COVID-19 vaccination.

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Section: Discussionmentioning

confidence: 99%

Correlates of COVID-19 Vaccine Hesitancy among a Community Sample of African Americans Living in the Southern United States

et al. 2021

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“…The respondents were also asked to report reasons that guided their decision to receive or decline vaccination. The survey questionnaires (Appendix A) were developed based on previous research on vaccination behavior and factors affecting vaccination acceptance in the US [3] , [8] , [9] , [10] .…”

Section: Methodsmentioning

confidence: 99%

Changes in COVID-19 vaccine acceptance rate among recovered critically Ill patients: A 12-month follow-up study

Olanipekun

Abe

Effoe

et al. 2021

Vaccine

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Introduction We surveyed a cohort of patients who recovered from severe SARS-CoV-2 infection to determine the COVID-19 vaccination rate. We also compared the willingness to accept the vaccine before and after its availability to assess changes in perception and attitude towards vaccination. Materials and Methods Recovered patients with severe hypoxemic respiratory failure from SARS-CoV-2 infection treated in the ICU at Grady Memorial Hospital, Atlanta, Georgia between April 1, 2020, and June 30, 2020 were followed up over a 1-year period to assess vaccine acceptability and acceptance rates, and changes in perception towards COVID-19 vaccination before and after vaccine availability. Results A total of 98 and 93 patients completed the initial and follow up surveys respectively. During the initial survey , 41% of the patients intended to receive vaccination, 46% responded they would not accept a vaccine against COVID-19 even if it were proven to be ‘safe and effective ‘and 13% undecided. During the follow up survey, 44% of the study cohort had received at least one dose of a COVID-19 vaccine. Major reasons provided by respondents for not accepting COVID-19 vaccine were lack of trust in the effectiveness of the vaccine, pharmaceutical companies, government, vaccine technology, fear of side effects and perceived immunity against COVID-19. Respondents were more likely to be vaccinated if recommended by their physicians (OR 6.4, 95% CI 2.8 – 8.3), employers (OR 2.5, 95% CI 1.9 – 5.8), and family and friends (OR 1.6, 95% CI 1.1 – 4.5) Conclusion We found a suboptimal COVID-19 vaccination rate in a cohort of patients who recovered from severe infection. COVID-19 vaccine information and recommendation by healthcare providers, employers and family and friends may improve vaccination uptake.

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“…As of September 2021, the proportion of those who report that they will definitely not get vaccinated or only when required was 19% for Black persons and 14% for Latinx persons compared to 17% for White persons [ 28 ]. Therefore, upstream social determinants of health are accounting for the vaccine disparity, including disproportionate easy access to vaccines in wealthier neighborhoods, inability to skip work to receive a vaccine, lack of access to culturally and linguistically tailored information, and fear of deportation among some immigrant groups [ 29 – 32 ]. This is evident in previous vaccination programs such as the annual influenza vaccinations in which people from racial and ethnic minority groups have persistently low vaccination rates compared to White persons.…”

Section: Covid-19 Disparities In Vaccinationsmentioning

confidence: 99%

Disproportionate Impact of COVID-19 on Racial and Ethnic Minority Groups in the United States: a 2021 Update

Tai

Sia

Doubeni

et al. 2021

J. Racial and Ethnic Health Disparities

124

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The COVID-19 pandemic’s disproportionate impact on people from some racial and ethnic groups in the U.S. persisted throughout 2021. Black, Latinx, and American Indian persons have been hospitalized and died at a higher rate than White persons consistently from the start of the pandemic. Early data show that hospitalization and mortality rates for Black, Latinx, and American Indian children are higher than White children in a worrying trend. The pandemic has likely worsened the gaps in wealth, employment, housing, and access to health care: the social determinants of health that caused the disparities in the first place. School closures will have a long-lasting impact on the widening achievement gaps between Black and Latinx students and White students. In the earlier vaccination phase, Black and Latinx persons were being vaccinated at a lower rate than their proportion of cases due to vaccine hesitancy, misinformation, and barriers to access. Vaccine hesitancy rates among these groups have since decreased and are now comparable to White persons. Aggregated data make it challenging to paint a picture of the actual impact of COVID-19 on Asian Americans as they are a diverse group with significant disparities. All of this highlights that we have much work to do in dismantling systemic racism, engaging communities we serve, and advancing health equity to prepare us for future pandemics and a more just healthcare system.

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COVID-19 vaccine hesitancy: the five Cs to tackle behavioural and sociodemographic factors

Cited by 112 publications

References 16 publications

Correlates of COVID-19 Vaccine Hesitancy among a Community Sample of African Americans Living in the Southern United States

Correlates of COVID-19 Vaccine Hesitancy among a Community Sample of African Americans Living in the Southern United States

Changes in COVID-19 vaccine acceptance rate among recovered critically Ill patients: A 12-month follow-up study

Disproportionate Impact of COVID-19 on Racial and Ethnic Minority Groups in the United States: a 2021 Update

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