CARTaGENE, Research Center, CHU Sainte-Justine, Montreal, QC, Canada.
Université de Montréal, Montreal, QC, Canada.
Front Public Health. 2022 Mar 18;10:756037. doi: 10.3389/fpubh.2022.756037. eCollection 2022.
The objective of this study was to characterize the combinations of demographic and socioeconomic characteristics associated to the unwillingness to receive the COVID-19 vaccines during the 2021 Quebec's vaccination campaign.
In March-June 2021, we conducted an online survey of the participants of the CARTaGENE population-based cohort, composed of middle-aged and older adults. After comparing the vaccinated and unvaccinated participants, we investigated vaccine hesitancy among participants who were unvaccinated. For identifying homogeneous groups of individuals with respect to vaccine hesitancy, we used a machine learning approach based on a hybrid tree-based model.
Among the 6,105 participants of the vaccine cohort, 3,553 (58.2%) had at least one dose of COVID-19 vaccine. Among the 2,552 participants, 221 (8.7%) did not want to be vaccinated (91) or were uncertain (130). The median age for the unvaccinated participants was 59.3 years [IQR 54.7-63.9]. The optimal hybrid tree-based model identified seven groups. Individuals having a household income lower than $100,000 and being born outside of Canada had the highest rate of vaccine hesitancy (28% [95% CI 19.8-36.3]). For those born in Canada, the vaccine hesitancy rate among the individuals who have a household income below $50,000 before the pandemic or are Non-retired was of 12.1% [95% CI 8.7-15.5] and 10.6% [95% CI 7.6-13.7], respectively. For the participants with a high household income before the pandemic (more than $100,000) and a low level of education, those who experienced a loss of income during the pandemic had a high level of hesitancy (19.2% [8.5-29.9]) whereas others who did not experience a loss of income had a lower level of hesitancy (6.0% [2.8-9.2]). For the other groups, the level of hesitancy was low of around 3% (3.2% [95% CI 1.9-4.4] and 3.4% [95% CI 1.5-5.2]).
Public health initiatives to tackle vaccine hesitancy should take into account these socio-economic determinants and deliver personalized messages toward people having socio-economic difficulties and/or being part of socio-cultural minorities.
本研究旨在描述与 2021 年魁北克疫苗接种活动期间不愿接种 COVID-19 疫苗相关的人口统计学和社会经济特征的组合。
2021 年 3 月至 6 月，我们对基于人群的 CARTaGENE 队列的参与者进行了一项在线调查，该队列由中年和老年人组成。在比较已接种和未接种疫苗的参与者后，我们调查了未接种疫苗的参与者中的疫苗犹豫情况。为了确定在疫苗犹豫方面具有相似特征的同质人群，我们使用了一种基于混合树基模型的机器学习方法。
在疫苗队列的 6105 名参与者中，有 3553 名（58.2%）至少接种了一剂 COVID-19 疫苗。在 2552 名参与者中，有 221 名（91 名）或不确定（130 名）不愿接种疫苗。未接种疫苗参与者的中位年龄为 59.3 岁[IQR 54.7-63.9]。最佳的混合树基模型确定了七个群体。家庭收入低于 100000 加元且在加拿大境外出生的个体疫苗犹豫率最高（28%[95%CI 19.8-36.3]）。对于在加拿大出生的个体，在大流行前家庭收入低于 50000 加元或非退休人员中，疫苗犹豫率为 12.1%[95%CI 8.7-15.5]和 10.6%[95%CI 7.6-13.7]。对于大流行前家庭收入较高（超过 100000 加元）和教育程度较低的参与者，在大流行期间经历收入损失的个体具有较高的犹豫水平（19.2%[8.5-29.9]），而其他没有经历收入损失的个体具有较低的犹豫水平（6.0%[2.8-9.2]）。对于其他群体，犹豫水平较低，约为 3%（3.2%[95%CI 1.9-4.4]和 3.4%[95%CI 1.5-5.2]）。
解决疫苗犹豫的公共卫生措施应考虑这些社会经济决定因素，并针对经济困难和/或属于社会文化少数群体的人群提供个性化信息。
