Factors Associated With US Adults’ Likelihood of Accepting COVID-19 Vaccination

Abstract

IMPORTANCE The development of a coronavirus disease 2019 (COVID-19) vaccine has progressed at unprecedented speed. Widespread public uptake of the vaccine is crucial to stem the pandemic. OBJECTIVE To examine the factors associated with survey participants' self-reported likelihood of selecting and receiving a hypothetical COVID-19 vaccine. DESIGN, SETTING, AND PARTICIPANTS A survey study of a nonprobability convenience sample of 2000 recruited participants including a choice-based conjoint analysis was conducted to estimate respondents' probability of choosing a vaccine and willingness to receive vaccination. Participants were asked to evaluate their willingness to receive each hypothetical vaccine individually. The survey presented respondents with 5 choice tasks. In each, participants evaluated 2 hypothetical COVID-19 vaccines and were asked whether they would choose vaccine A, vaccine B, or neither vaccine. Vaccine attributes included efficacy, protection duration, major adverse effects, minor adverse effects, US Food and Drug Administration (FDA) approval process, national origin of vaccine, and endorsement. Levels of each attribute for each vaccine were randomly assigned, and attribute order was randomized across participants. Survey data were collected on July 9, 2020. MAIN OUTCOMES AND MEASURES Average marginal component effect sizes and marginal means were calculated to estimate the relationship between each vaccine attribute level and the probability of the respondent choosing a vaccine and self-reported willingness to receive vaccination. RESULTS A total of 1971 US adults responded to the survey (median age, 43 [interquartile range, 30-58] years); 999 (51%) were women, 1432 (73%) White, 277 (14%) were Black, and 190 (10%) were Latinx. An increase in efficacy from 50% to 70% was associated with a higher probability of choosing a vaccine (coefficient, 0.07; 95% CI, 0.06-0.09), and an increase from 50% to 90% was associated with a higher probability of choosing a vaccine (coefficient, 0.16; 95% CI, 0.15-0.18).

Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review

“…Vaccine attributes posed prevalent concerns, particularly due to the newness of COVID-19 vaccines [22,48]. The most commonly cited reasons for hesitation or refusal were fear of side effects [1,22,47,49,50], safety [5,34,37,51], and effectiveness [2,5,24,[52][53][54]. Belief that vaccines are unnecessary [43,50,52,55], inadequate information [34,47,50], unknown/short duration of immunity [2,5,50,53], and a general anti-vaccine stand [1,10,55] were associated with lower acceptance.…”

“…One survey reported that 17.1% would get the vaccine only if covered by insurance [54] and another found 49% expected it to be free (paid by insurance or government) [56]. In America, US-made vaccines were more trusted than China-made [53,57] or foreign-developed [5,53]. Most Chinese (64%) expressed no preference for domestic or foreign-made [34].…”

Adenovirus and RNA-based COVID-19 vaccines: perceptions and acceptance among healthcare workers

“…A previous study found that 50% vaccine efficacy was associated with a 51% rate of acceptance. [38] The manufacturing country was another reason given for accepting the vaccine (in 28.6% of respondents). This finding is similar to results from a US survey related to hypothetical vaccines.…”

“…The surveyed individuals had lower acceptance of the vaccine if it originated from a country outside the United States. [38] Other contributing factors, such as fewer adverse effects,…”

“…were also reported in this study. [38] Understanding these factors is important to build strategies for vaccine acceptance in any community. Strategies should address concerns, contributing factors, and misconceptions.…”