Profiling vaccine believers and skeptics in nurses: A latent profile analysis

Abstract

Background A tailored immunization program is deemed more successful in encouraging vaccination. Understanding the profiles of vaccine hesitancy constructs in nurses can help policymakers in devising such programs. Encouraging vaccination in nurses is an important step in building public confidence in the upcoming COVID-19 and influenza vaccination campaigns. Objectives Using a person-centered approach, this study aimed to reveal the profiles of the 5C psychological constructs of vaccine hesitancy (confidence, complacency, constraints, calculation, and collective responsibility) among Hong Kong nurses. Design Cross-sectional online survey. Settings With the promotion of a professional nursing organization, we invited Hong Kong nurses to complete an online survey between mid-March and late April 2020 during the COVID-19 outbreak. Participants 1,193 eligible nurses (mean age = 40.82, SD = 10.49; with 90.0% being female) were included in the analyses. Methods In the online survey, we asked the invited nurses to report their demographics, COVID-19-related work demands (including the supply of personal protective equipment, work stress, and attitudes towards workplace infection control policies), the 5C vaccine hesitancy components, seasonal influenza vaccine uptake history, and the COVID-19 vaccine uptake intention. Latent profile analysis was employed to identify distinct vaccine hesitancy antecedent subgroups. Results Results revealed five profiles, including “believers” (31%; high confidence, collective responsibility; low complacency, constraint), “skeptics” (11%; opposite to the believers), “outsiders” (14%; low calculation, collective responsibility), “contradictors” (4%; high in all 5C constructs), and “middlers” (40%; middle in all 5C constructs). Believers were less educated, reported more long-term illnesses, greater work stress, higher perceived personal protective equipment sufficiency, and stronger trust in government than skeptics. They were older and had higher perceived personal protective equipment sufficiency than middlers. Also, believers were older and had greater work stress than outsiders. From the highest to the lowest on vaccination uptake and intention were believers and contradictors, then middlers and outsiders, and finally skeptics. Conclusion Different immunization programs can be devised based on the vaccine hesitancy profiles and their predictors. Despite both profiles being low in vaccination uptake and intention, our results distinguished between outsiders and skeptics regarding their different levels of information-seeking engagement. The profile structure reveals the possibilities in devising tailored interventions based on their 5C characteristics. The current data could serve as the reference for the identification of individual profile memb...

Targeting COVID-19 vaccine hesitancy among nurses in Shanghai: A latent profile analysis

“…In this study, nurses had higher median score in confidence (Median = 6.33), calculation (Median = 6.00), and collective responsibility (Median = 6.50) and lower median score in complacency (Median = 2.67) and constraints (M = 1.25). The overall distribution of the five dimensions is similar to prior research on nurses in Hong Kong ( 30 ). However, our findings contradict Betsch's ( 31 ) assumptions about the structure of the calculation.…”

“…As expected, all 5C indicators were correlated with each other and all were significantly associated with COVID-19 vaccine intention. However, a positive correlation was calculated with vaccination intention ( r = 0.118, p < 0.01), contradicting the original authors' hypothesis ( 31 ) but matching a study in the Hong Kong nurse population ( 30 ). In addition, the same pattern was detected for the frequency of paying attention to COVID-19 vaccine news.…”

“…Previous findings support the need for focused communication actions to address vaccine hesitancy among certain populations in various geographic cultures ( 27 , 28 ). Recent studies have also classified people into subgroups depending on their vaccination beliefs, such as hesitant, confident, and trade-off clusters ( 29 ), or believers, skeptics, outsiders, contradictors, and middler profiles ( 30 ). In our study, we used the 5C model to understand the psychological antecedents of vaccination among nurses ( 31 ), which includes five dimensions of confidence (trust in vaccine efficacy, safety, and necessity, as well as in the system providing the vaccine), complacency (perception of low disease risk), constraints (perception of low vaccine availability, affordability, and accessibility), the calculation (participation in information search), and collective responsibility (willingness to vaccinate to protect others through herd immunity).…”

The way forward to achieve high COVID-19 vaccination and revaccination coverage in a city amid a period of tranquility

“…Our current four profile pattern in the full sample was very similar to the one found in a survey conducted among nurses during the early epidemic phase in March 2020 except that the "contradictor" profile was missing (18). The "middler" and "outsider" profiles defined in our previous work were classified as fence-sitters and apathetics, respectively in this study.…”

Distrustful, Dissatisfied, and Conspiratorial: A Latent Profile Analysis of COVID-19 Vaccination Rejection

“…For example, five profiles have been identified among Hong Kong health workers. The analysis revealed that the profile with the highest intention to vaccinate was characterized by lower educational attainment, more long-term illness, higher work stress, and greater trust in the government, among other factors [ 26 ]. In another study, motivation to vaccinate against both COVID-19 and seasonal influenza was examined in Taiwan [ 27 ].…”