Time trends, factors associated with, and reasons for COVID-19 vaccine hesitancy: A massive online survey of US adults from January-May 2021

Abstract

Importance COVID-19 vaccine hesitancy has become a leading barrier to increasing the US vaccination rate. Objective To evaluate time trends in COVID-19 vaccine intent during the US vaccine rollout, and identify key factors related to and self-reported reasons for COVID-19 vaccine hesitancy in May 2021. Design, participants and setting A COVID-19 survey was offered to US adult Facebook users in several languages yielding 5,088,772 qualifying responses from January 6 to May 31, 2021. Data was aggregated by month. Survey weights matched the sample to the age, gender, and state profile of the US population. Exposure Demographics, geographic factors, political/COVID-19 environment, health status, beliefs, and behaviors. Main outcome measures “If a vaccine to prevent COVID-19 were offered to you today, would you choose to get vaccinated.” Hesitant was defined as responding probably or definitely would not choose to get vaccinated (versus probably or definitely would, or already vaccinated). Results COVID-19 vaccine hesitancy decreased by one-third from 25.4% (95%CI, 25.3, 25.5) in January to 16.6% (95% CI, 16.4, 16.7) in May, with relatively large decreases among participants with Black, Pacific Islander or Hispanic race/ethnicity and ≤high school education. Independent risk factors for vaccine hesitancy in May (N = 525,644) included younger age, non-Asian race, < 4 year college degree, living in a more rural county, living in a county with higher Trump vote share in the 2020 election, lack of worry about COVID-19, working outside the home, never intentionally avoiding contact with others, and no past-year flu vaccine. Differences in hesitancy by race/ethnicity varied by age (e.g., Black adults more hesitant than White adults <35 years old, but less hesitant among adults ≥45 years old). Differences in hesitancy by age varied by race/ethnicity. Almost half of vaccine hesitant respondents reported fear of side effects (49.2% [95%CI, 48.7, 49.7]) and not trusting the COVID-19 vaccine (48.4% [95%CI, 48.0, 48.9]); over one-third reported not trusting the government, not needing the vaccine, and waiting to see if safe. Reasons differed by degree of vaccine intent and by race/ethnicity. Conclusion COVID-19 vaccine hesitancy varied by demographics, geography, beliefs, and behaviors, indicating a need for a range of messaging and policy options to target high-hesitancy groups.

Acceptance of COVID 19 vaccine among sub-Sahara African (SSA): a comparative study of residents and diaspora dwellers

“…A recent study in the US showed a similar pattern with those with lower levels of education showing less hesitancy than those with higher. [49] This is contrary to the results obtained in other studies. [35-37,42-43] A statement by a 61 year old on Africa news may provide an insight into the mindset of those who are less educated thereby making them more likely to accept vaccination: “If in the time of our mothers, in the time we were little children if these “WhatsApp doctors” had existed (people who post unreliable medical information on social media) I think we would have all died because our mothers who did not go to school agreed to vaccinate us against smallpox, measles, polio -- all the other diseases without debate.…”

“…Local East African respondents were three times more likely to resist and almost five times more likely to be hesitant than West Africans. This may be due to misinformation about COVID-19 [48] and its vaccines [49] which was reported to be more common in East African countries such as Tanzania. The results showed that the least educated respondents were less likely to be resistant or hesitant.…”

A retrospective cross-sectional analysis of community perceptions of flu and COVID-19 vaccines at Turtle Creek Primary Care Center

“…population studies that examined COVID-19 vaccine uptake by demographic association (15,16), our study demonstrates that participants who routinely get flu vaccinations and are older in age were the most likely groups to get vaccinated against COVID-19. This is also in agreement with state-wide data from the PA Department of Health, showing highest vaccination rates among older citizens (>99% vaccinated in 65+ age groups).…”

“…While this may be due to our sample size, an important confounder to consider is the health literacy of the Turtle Creek community. Groups most likely to not pursue vaccination are also less likely to be concerned about themselves or family members contracting COVID-19 (1), more likely to believe the virus was manufactured or pandemic exaggerated, hold Republican political beliefs (4,16,17), and have decreased health literacy as demonstrated by knowing less about the safety and science of COVID-19 vaccines (14).…”

Prevalence of COVID-19 Infection among Patients with Diabetes and Their Vaccination Coverage Status in Saudi Arabia: A Cross-Sectional Analysis from a Hospital-Based Diabetes Registry

“…Vaccine hesitancy, or the belief in conspiracy theories related to COVID-19 and misinformation about the COVID-19 pandemic and vaccines on social media have been important factors that impede COVID-19 preventive efforts, including timely vaccination coverage [64,65]. Other reasons for COVID-19 vaccine hesitancy include individuals' concerns about the adverse effects of COVID-19 vaccines, lack of trust in COVID-19 vaccines, planning to wait and see if the vaccines are safe, believing that COVID-19 is not a serious disease, believing that there is no need for the vaccines or being not sure about their effectiveness [66,67]. Therefore, it is important for governments to work on educating the population against these conspiracy theories, as such theories could jeopardize the strategies to mitigate the spread of COVID-19 and prevent timely and wide vaccination coverage of the populations [64,68,69].…”