美国的 COVID-19 疫苗接种意向：一个社会生态框架。
COVID-19 vaccine intentions in the United States, a social-ecological framework.
机构信息
Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States; Division of Infectious Diseases, Johns Hopkins University School of Medicine, United States.
Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States.
出版信息
Vaccine. 2021 Apr 15;39(16):2288-2294. doi: 10.1016/j.vaccine.2021.02.058. Epub 2021 Mar 10.
BACKGROUND
COVID-19 vaccine hesitancy is a major obstacle for pandemic mitigation. As vaccine hesitancy occurs along multiple dimensions, we used a social-ecological framework to guide the examination of COVID-19 vaccine intentions.
METHODS
Using an online survey in the US conducted in July 2020, we examined intentions to obtain a COVID-19 vaccine, once available. 592 respondents provided data, including measures of demographics, vaccine history, social norms, perceived risk, and trust in sources of COVID-19 information. Bivariate and multivariate multinomial models were used to compare respondents who intended to be vaccinated against COVID-19 to respondents who did not intend or were ambivalent about COVID-19 vaccination.
RESULTS
Only 59.1% of the sample reported that they intended to obtain a COVID-19 vaccine. In the multivariate multinomial model, those respondents who did not intend to be vaccinated, as compared to those who did, had significantly lower levels of trust in the CDC as a source of COVID-19 information (aOR = 0.29, CI = 0.17-0.50), reported lower social norms of COVID-19 preventive behaviors (aOR = 0.67, CI 0.51-0.88), scored higher on COVID-19 Skepticism (aOR = 1.44, CI = 1.28-1.61), identified as more politically conservative (aOR = 1.23, CI = 1.05-1.45), were less likely to have obtained a flu vaccine in the prior year (aOR = 0.21, CI = 0.11-0.39), were less likely to be female (aOR = 0.51, CI = 0.29-0.87), and were much more likely to be Black compared to White (aOR = 10.70, CI = 4.09-28.1). A highly similar pattern was observed among those who were ambivalent about receiving a COVID-19 vaccine compared to those who intended to receive one.
CONCLUSION
The results of this study suggest several avenues for COVID-19 vaccine promotion campaigns, including social network diffusion strategies and cross-partisan messaging, to promote vaccine trust. The racial and gender differences in vaccine intentions also suggest the need to tailor campaigns based on gender and race.
背景
COVID-19 疫苗犹豫是减轻大流行的主要障碍。由于疫苗犹豫是沿着多个维度发生的，我们使用社会生态学框架来指导 COVID-19 疫苗接种意向的检查。
方法
我们使用 2020 年 7 月在美国进行的在线调查，检查了一旦有 COVID-19 疫苗，就获得 COVID-19 疫苗的意愿。592 名受访者提供了数据，包括人口统计学、疫苗接种史、社会规范、感知风险和对 COVID-19 信息来源的信任度。使用双变量和多变量多项逻辑回归模型比较了打算接种 COVID-19 疫苗的受访者与不打算或对 COVID-19 疫苗接种犹豫不决的受访者。
结果
只有 59.1%的样本报告打算接种 COVID-19 疫苗。在多变量多项逻辑回归模型中，与打算接种疫苗的受访者相比，不打算接种疫苗的受访者对疾病预防控制中心作为 COVID-19 信息来源的信任度明显较低（优势比[OR]为 0.29，95%置信区间[CI]为 0.17-0.50），报告 COVID-19 预防行为的社会规范较低（OR 为 0.67，CI 为 0.51-0.88），COVID-19 怀疑程度较高（OR 为 1.44，CI 为 1.28-1.61），政治立场更为保守（OR 为 1.23，CI 为 1.05-1.45），在过去一年中不太可能接种流感疫苗（OR 为 0.21，CI 为 0.11-0.39），不太可能为女性（OR 为 0.51，CI 为 0.29-0.87），与白人相比，黑人更有可能（OR 为 10.70，CI 为 4.09-28.1）。对于那些对接受 COVID-19 疫苗犹豫不决的人，与那些打算接受疫苗的人相比，观察到类似的模式。
结论
本研究结果表明，COVID-19 疫苗推广活动有几个途径，包括社交网络扩散策略和跨党派信息传递，以促进疫苗信任。疫苗接种意愿方面的种族和性别差异也表明，需要根据性别和种族调整宣传活动。
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