Does a major change to a COVID-19 vaccine program alter vaccine intention? A qualitative investigation

Abstract

Background On 8 th April 2021, the Australian Technical Advisory Group on Immunisation (ATAGI) made the Pfizer-BioNtech (Comirnaty) vaccine the “preferred” vaccine for adults in Australia aged <50 years due to a risk of thrombosis with thrombocytopenia syndrome (TTS) following AstraZeneca vaccination. We sought to understand whether this impacted COVID-19 vaccine intentions. Method we undertook qualitative interviews from February – April 2021 before and after the program change with 28 adults in Perth, Western Australia. Using our COVID-19 vaccine intentions model, we assessed changes in participants’ COVID-19 vaccine intention before and after the program change. Participants were classified as 1) ‘acceptors’: no concerns about COVID-19 vaccine safety, efficacy, access and would accept whatever vaccine is offered, 2) ‘cautious acceptors’: some concerns and would prefer a particular vaccine brand but would accept whatever is offered, 3) ‘Wait awhile’: for more data, easier access, for another vaccine brand, or a greater perceived COVID-19 threat or 4) ‘refuser’: no intention to vaccinate due to concerns about safety and/or efficacy. Results before the change, 7/18 of those aged <50 years were ‘acceptors,’ 10/18 were ‘cautious acceptors’ and 1/18 was ‘wait awhile.’ Overall, 14/18 participants had the same COVID-19 vaccine intention after the change; 4/18 became more concerned. For those aged ≥50 years and before the change, 5/10 were ‘acceptors’ and 5/10 were ‘cautious acceptors.’ After the change, 8/10 still had the same COVID-19 vaccine intention; 2/10 became more cautious. The major concern before the program change was COVID-19 vaccines having different vaccine efficacy; the concern pivoted to safety. Conclusion the majority of participants were ‘cautious acceptors’ who intended on being vaccinated; many had this intention before and after the program change. The Australian government, health care providers and media need to better address COVID-19 vaccine concerns to assist those with COVID-19 vaccine intentions receive a vaccine.

A Global Survey of COVID-19 Vaccine Acceptance Among Healthcare Workers

“…Our results represent the attitudes of HCWs at a particular point in time and is expected to change as the vaccination campaigns gather pace, depending on several factors, including rate of disease transmission and mortality, first-hand information from vaccinated friends and relatives, change in perception of disease severity and trust in authorities, etc. ( 35 , 36 ). Therefore, more studies are necessary to collect snapshots at different points in time to capture changes in mass behavior and prioritize vulnerable populations accordingly.…”

Understandings and practices related to risk, immunity and vaccination during the Delta variant COVID-19 outbreak in Australia: An interview study

“…Australians’ willingness to accept a potential COVID vaccine during the early months of the pandemic, when no vaccines had yet been developed, was high [57] , [58] , [59] , [60] , [61] , [62] , [63] . Yet in early 2021, when Australia seemed to have largely controlled the spread of the virus, a combination of complacency, concern about side effects and problems with supply resulted in a diminishing of interest in accepting vaccines [64] , [65] , [66] . By mid-2021, there was evidence of increased confusion, hesitation and uncertainty among some social groups in Australia [67] , [68] .…”

Western Australian health care workers’ views on mandatory COVID-19 vaccination for the workplace

“…We classified these six plus the vaccinated participants as “COVID-19 vaccine acceptors” based on their confident and emphatic support for being vaccinated. However, two of our participants – both of whom had not yet been vaccinated – had unresolved hesitancy about the vaccines that led us to classify them as “Wait Awhiles” [46] .…”

“…Deductive analytical methods were used to categorise participants’ attitudes towards being vaccinated and their perspectives on COVID-19 vaccine mandates. We used theoretical frameworks for both exercises that we had developed for earlier Coronavax studies – one on individuals’ COVID-19 vaccine intentions [46] , and an earlier publication on publics’ attitudes to widespread societal mandates [17] . We used these frameworks to categorise participants as either COVID-19 vaccine acceptors, cautious acceptors, “wait awhiles” or refusers.…”