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深思熟虑、背景、情感和信任——理解德国成年人 COVID-19 疫苗接种决策的动态。

Deliberation, context, emotion and trust - understanding the dynamics of adults' COVID-19 vaccination decisions in Germany.

机构信息

Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA.

出版信息

BMC Public Health. 2023 Jan 19;23(1):136. doi: 10.1186/s12889-022-14587-7.


DOI:10.1186/s12889-022-14587-7
PMID:36658504
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9850339/
Abstract

BACKGROUND: Willingness to vaccinate against coronavirus disease 2019 (COVID-19), which is vital to successful vaccination campaigns, is wavering and suboptimal. In Germany, quantitative research highlighted concerns regarding the safety and efficacy of COVID-19 vaccines as barriers to uptake, but qualitative insights regarding individuals' decisions about COVID-19 vaccines and how personal perceptions reflect or refute existing behavioral theories are lacking. METHODS: To identify how individuals make COVID-19 vaccination decisions within real-life contexts, we conducted 33 semi-structured, in-depth qualitative interviews with individuals in Germany between March and April 2021 using maximum variation sampling, focusing on perceptions of COVID-19 vaccines. Analysis, informed by a framework approach, began in the field via debriefings and was amplified upon the conclusion of data collection. RESULTS: Four interconnected themes (deliberation, context, emotion, trust) shaped respondents' decisions about vaccination. Personal deliberation regarding benefits and risks of vaccines and perceptions of the broader social and political context sparked a spectrum of emotions that underpinned vaccination decisions. Trust in science and researchers emerged as a powerful protective factor facilitating the decision to get vaccinated even amidst a rapidly changing context and disconcerting information. CONCLUSIONS: Our findings add to ongoing debates about the breadth of vaccination decisions by highlighting how respondents are influenced by their perceptions of the political context and the emotional heft of their decisions. The role of cognitive evaluation, context, and emotions mirrors other decision-making frameworks, particularly the Risk as Feelings Theory. We extend on the elements of this theory by highlighting trust as a protective factor when making decisions particularly in highly uncertain contexts. Success of vaccination campaigns, more important than ever as new variants of COVID-19 emerge, is interwoven with an ability to bolster trust in science. Communicating public-health decisions and information about vaccines transparently without instilling fear offers promising chances to strengthen public trust in COVID-19 vaccines. TRIAL REGISTRATION: German Clinical Trials Register ( DRKS00024505 ).

摘要

背景:接种 2019 年冠状病毒病(COVID-19)疫苗的意愿对于成功的疫苗接种活动至关重要,但目前这种意愿正在动摇,并且并不理想。在德国,定量研究强调了人们对接种 COVID-19 疫苗的安全性和有效性的担忧,这些担忧是疫苗接种的障碍,但缺乏关于个人对 COVID-19 疫苗的决定以及个人看法如何反映或反驳现有行为理论的定性见解。

方法:为了确定个人如何在现实环境中做出 COVID-19 疫苗接种决策,我们于 2021 年 3 月至 4 月期间在德国进行了 33 次半结构化深入定性访谈,使用最大变化抽样法,重点关注对 COVID-19 疫苗的看法。分析是通过框架方法进行的,在实地通过汇报开始,并在数据收集结束后进行了扩充。

结果:有四个相互关联的主题(考虑、背景、情绪、信任)塑造了受访者对疫苗接种的决定。个人对疫苗的利弊的思考以及对更广泛的社会和政治背景的看法引发了一系列情绪,这些情绪构成了疫苗接种决策的基础。对科学和研究人员的信任是一个强大的保护因素,即使在瞬息万变的背景和令人不安的信息中,也有助于做出接种疫苗的决定。

结论:我们的研究结果通过强调受访者如何受到他们对政治背景的看法和他们决策的情感重要性的影响,为关于疫苗接种决定的广泛讨论增添了新的内容。认知评估、背景和情绪的作用反映了其他决策框架,特别是风险即感觉理论。我们通过强调在做出决策时信任是一个保护因素,尤其是在高度不确定的情况下,扩展了该理论的要素。随着 COVID-19 的新变种不断出现,疫苗接种活动的成功比以往任何时候都更加重要,这与增强对科学的信任息息相关。透明地传达公共卫生决策和疫苗信息而不引起恐惧,为加强公众对 COVID-19 疫苗的信任提供了有希望的机会。

试验注册:德国临床试验注册处(DRKS00024505)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fa8/9850676/580ad72e9283/12889_2022_14587_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fa8/9850676/e3bb8055afff/12889_2022_14587_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fa8/9850676/580ad72e9283/12889_2022_14587_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fa8/9850676/e3bb8055afff/12889_2022_14587_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fa8/9850676/580ad72e9283/12889_2022_14587_Fig2_HTML.jpg

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本文引用的文献

[1]
The COVID-19 Vaccine: Trust, doubt, and hope for a future beyond the pandemic in Germany.

PLoS One. 2022

[2]
Factors Predicting Progression to Severe COVID-19: A Competing Risk Survival Analysis of 1753 Patients in Community Isolation in Wuhan, China.

Engineering (Beijing). 2022-6

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Soc Sci Med. 2022-1

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Nat Med. 2021-8

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JAMA Netw Open. 2021-7-1

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BMC Public Health. 2021-6-12

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Soc Sci Med. 2021-7

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Nat Hum Behav. 2021-11

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Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study.

BMJ. 2021-5-13

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