The vaccine hesitancy continuum among hesitant adopters of the COVID‐19 vaccine

Abstract

Vaccination is a strategy for mitigating the impact of coronavirus disease 2019 (COVID-19) at both the individual and population levels. Vaccine hesitancy is identified as a significant threat to global health by the World Health Organization (WHO). Vaccine hesitancy has been theorized as a continuum encompassing a range of attitudes, beliefs, emotional orientations, ideologies, and health-seeking behaviors. Individuals who received the COVID-19 vaccine but also indicated some level of hesitancy about vaccination, or "hesitant adopters," remain an understudied group. This study uses a qualitative descriptive design to understand motivations to receive the COVID-19 vaccine among hesitant adopters at various self-reported levels of hesitancy. We conducted interviews with hesitant adopters (n = 49) to analyze the elements of vaccine hesitancy corresponding to reported levels of COVID-19 vaccine hesitancy (i.e., "little hesitant," "somewhat hesitant," and "very hesitant"). Concerns about side effects are shared across the continuum but are articulated differently at each level of hesitancy. The "little hesitant" relate fears of side effects to their health and a lack of clear information to inform their health decision making, whereas the "very hesitant" articulate the risks of side effects within the frame of conspiracies related to the development, approval, and economics of the COVID-19 vaccine. Additionally, conspiracy theories generally increase in salience across the continuum, with the "very hesitant" reporting conspiracy theories as the most salient element of vaccine hesitancy. This research presents opportunities for developing targeted interventions for different levels of vaccine hesitancy. Study Highlights WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?Prior research has documented that coronavirus disease 2019 (COVID-19) vaccine hesitancy is influenced by several elements, including fears of side effects and adverse events, the speed of the development and approval process, health literacy, and misinformation/disinformation. However, no studies have explored the difference in these influences across a hesitancy continuum.

COVID-19 vaccination perspectives among patients with Long COVID: A qualitative study

“…Our findings align with prior research that has investigated differences in perspectives along the continuum of vaccine hesitancy among adults in the United States with varying degrees of hesitancy toward or refusal of COVID-19 vaccines. 18 , 19 Participants in our study reflected on how their experiences with Long COVID impacted their perceptions about COVID-19 vaccines, including individuals who were convinced to receive, or considered receiving, a COVID-19 vaccine for the first time due to their Long COVID experience, as well as individuals who received an initial COVID-19 vaccine, but were uncertain about receiving future booster doses due to the potential impact on their Long COVID symptoms. These findings demonstrate that the unique perspectives of Long COVID patients should be considered when discussing vaccination recommendations with this population.…”

Manifestation of Health Denialism in Attitudes toward COVID-19 Vaccination: A Qualitative Study

“…The first theme confirmed that hesitation about COVID-19 vaccination has various roots, spanning from health denialism through the fear of side effects to a libertarian outlook [ 27 ]. There is a growing corpus of scientific literature on denialism and vaccine hesitancy; however, more authors are interested in the determinants of refusal or hesitation to get vaccinated than in the motivation of those who have accepted vaccination [ 27 , 28 , 29 , 30 , 31 , 32 ]. Our study showed that apart from those who were simply afraid of COVID-19 infection and its consequences, several interviewees treated vaccination as their obligation.…”

“…Clearly, we observed some propensity toward conspiracy beliefs, especially associated with vaccination. We had also previously marked a high prevalence of conspiracy beliefs regarding COVID-19 in Polish society [ 10 , 32 ].…”

Hesitant adopters: COVID-19 vaccine hesitancy among diverse vaccinated adults in the United States

“…Studies of vaccine hesitancy published in highly reputable medical journals have conflated vaccination status and the attitude of hesitancy [13] . Emerging research demonstrates individuals who have been vaccinated commonly report some degree of vaccine hesitancy either months before receiving the vaccine, or even the same day as having received it [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] . Therefore, this study distinguishes vaccine hesitancy (an attitude) from vaccination status (a behavior) [22] and recognizes individuals who are “hesitant adopters” (i.e., individuals who were both hesitant and vaccinated).…”

“…Prior research on hesitant adopters has focused on small samples [ 21 , 23 ], qualitative analysis [24] , and single state geographic samples [19] . Given the past research demonstrating how common vaccine hesitancy is among the vaccinated [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , it is important to consider the presence of vaccine hesitancy and its correlates even among individuals who have received a dose of COVID-19 vaccine. To our knowledge, there are no studies examining hesitancy among vaccinated individuals in a diverse sample of US adults.…”