Preferences for COVID-19 vaccine distribution strategies in the US: A discrete choice survey

Abstract

Background The COVID-19 vaccination campaign in the US has been immensely successful in vaccinating those who are receptive, further increases in vaccination rates however will require more innovative approaches to reach those who remain hesitant. Developing vaccination strategies that are modelled on what people want could further increase uptake. Methods and findings To inform COVID-19 vaccine distribution strategies that are aligned with public preferences we conducted a discrete choice experiment among the US public (N = 2,895) between March 15 to March 22, 2021. We applied sampling weights, evaluated mean preferences using mixed logit models, and identified latent class preference subgroups. On average, the public prioritized ease, preferring single to two dose vaccinations (mean preference: -0.29; 95%CI: -0.37 to -0.20), vaccinating once rather than annually (mean preference: -0.79; 95%CI: -0.89 to -0.70) and reducing waiting times at vaccination sites. Vaccine enforcement reduced overall vaccine acceptance (mean preference -0.20; 95%CI: -0.30 to -0.10), with a trend of increasing resistance to enforcement with increasing vaccine hesitancy. Latent class analysis identified four distinct preference phenotypes: the first prioritized inherent “vaccine features” (46.1%), the second were concerned about vaccine “service delivery” (8.8%), a third group desired “social proof” of vaccine safety and were susceptible to enforcement (13.2%), and the fourth group were “indifferent” to vaccine and service delivery features and resisted enforcement (31.9%). Conclusions This study identifies several critical insights for the COVID-19 public health response. First, identifying preference segments is essential to ensure that vaccination services meet the needs of diverse population subgroups. Second, making vaccination easy and promoting autonomy by simplifying services and offering the public choices (where feasible) may increase uptake in those who remain deliberative. And, third vaccine mandates have the potential to increase vaccination rates in susceptible groups but may simultaneously promote control aversion and resistance in those who are most hesitant.

COVID-19 vaccine hesitancy and vaccine passports: a cross-sectional conjoint experiment in Japan

“…Furthermore, these types of passports must not be used to discriminate and eliminate the unvaccinated from society, allowing them to use alternative services, such as a certificate for a negative COVID-19 test result. Requiring these types of passports to re-engage in social activities may essentially violate the freedom of choice,31 which could be why some studies suggest that this type of scheme was viewed as negative 33 34. Given the potential health risks of vaccination, it may not be feasible to mandate vaccination.…”

“…Requiring these types of passports to re-engage in social activities may essentially violate the freedom of choice, 31 which could be why some studies suggest that this type of scheme was viewed as negative. 33 34 Given the potential health risks of vaccination, it may not be feasible to mandate vaccination. In Japan, there is no vaccine mandate, not only for COVID-19 but for other diseases, while some of these are determined by law as non-binding obligations of the citizens.…”

“… 31 While only a limited number of related studies are available, the freedom allowed by vaccine passports can affect vaccine acceptance and preference both positively and negatively: A study found that more freedom allowed by vaccination can increase vaccination uptake. 29 32 In contrast, some studies suggest that people do not prefer vaccination used as permission to engage in social activities, 33 34 and thereby vaccine passports could be viewed negatively among some sociodemographic groups. 32 Despite the concern about ‘breakthrough infections’, it would be worth considering the applicability of vaccine passports if and only if the passports largely contribute to achieving herd immunity against COVID-19 by increasing vaccine acceptance.…”

Repeated information of benefits reduces COVID-19 vaccination hesitancy: Experimental evidence from Germany

“…To assess whether information campaigns reduce hesitancy, studies are needed that examine their impact on vaccination intention and vaccination actions over time. Beyond these interventions, the convenience of vaccination—such as ease of access and availability—is suggested to reduce hesitancy as well [ 46 , 47 ]. Moreover, vaccination reminders have been shown to increase COVID-19 vaccination rates [ 42 ].…”

COVID-19 Vaccine Acceptability and Financial Incentives among Unhoused People in Los Angeles County: a Three-Stage Field Survey

“…While vaccine brand preference has not been considered among unhoused people, a study of American adults found that vaccine brand was not associated with willingness to get vaccinated [ 12 ]. However, characteristics that may be related to vaccine brand were associated with willingness to get vaccinated: vaccine efficacy, risk of side effects, FDA approval, cost, and number of doses [ 12 , 13 ].…”