Center for Interdisciplinary Population Health Research (CIPHR), Portland, Maine, USA.
Department of Medicine, Maine Medical Center, Portland, Maine, USA.
Health Expect. 2023 Jun;26(3):1052-1064. doi: 10.1111/hex.13714. Epub 2023 Mar 2.
Many people, especially in rural areas of the United States, choose not to receive novel COVID-19 vaccinations despite public health recommendations. Understanding how people describe decisions to get vaccinated or not may help to address hesitancy.
We conducted semistructured interviews with 17 rural inhabitants of Maine, a sparsely populated state in the northeastern US, about COVID-19 vaccine decisions during the early rollout (March-May 2021). We used the framework method to compare responses, including between vaccine Adopters and Non-adopters.
Adopters framed COVID-19 as unequivocally dangerous, if not personally, then to other people. Describing their COVID concerns, Adopters emphasized disease morbidities. By contrast, Non-adopters never mentioned morbidities, referencing instead mortality risk, which they perceived as minimal. Instead of risks associated with the disease, Non-adopters emphasized risks associated with vaccination. Uncertainty about the vaccine development process, augmented by social media, bolstered concerns about the long-term unknown risks of vaccines. Vaccine Adopters ultimately described trusting the process, while Non-adopters expressed distrust.
Many respondents framed their COVID vaccination decision by comparing the risks between the disease and the vaccine. Associating morbidity risks with COVID-19 diminishes the relevance of vaccine risks, whereas focusing on low perceived mortality risks heightens their relevance. Results could inform efforts to address COVID-19 vaccine hesitancy in the rural US and elsewhere.
Members of Maine rural communities were involved throughout the study. Leaders of community health groups provided feedback on the study design, were actively involved in recruitment, and reviewed findings after analysis. All data produced and used in this study were co-constructed through the participation of community members with lived experience.
尽管有公共卫生建议，但仍有许多人，尤其是美国农村地区的人，选择不接种新型 COVID-19 疫苗。了解人们如何描述接种疫苗或不接种疫苗的决定可能有助于解决犹豫不决的问题。
我们对美国东北部人口稀少的缅因州的 17 名农村居民进行了半结构化访谈，了解他们在 COVID-19 疫苗早期推出期间（2021 年 3 月至 5 月）的疫苗接种决定。我们使用框架方法比较了受访者的回答，包括接种者和非接种者的回答。
接种者认为 COVID-19 是非常危险的，即使不是对个人，也会对其他人造成危险。在描述他们对 COVID 的担忧时，接种者强调了疾病的发病率。相比之下，非接种者从未提到过发病率，而是提到了他们认为风险极小的死亡率。非接种者强调的是与疫苗接种相关的风险，而不是与疾病相关的风险。对疫苗开发过程的不确定性，加上社交媒体的影响，增加了人们对疫苗长期未知风险的担忧。接种者最终描述了他们对该过程的信任，而非接种者则表达了不信任。
许多受访者通过比较疾病和疫苗之间的风险来框定他们的 COVID 疫苗接种决定。将发病率风险与 COVID-19 相关联会降低疫苗风险的相关性，而关注低死亡率风险则会提高其相关性。研究结果可为解决美国农村和其他地区 COVID-19 疫苗犹豫问题提供信息。
缅因州农村社区的成员参与了整个研究过程。社区卫生组织的领导人对研究设计提供了反馈，积极参与了招募工作，并在分析后审查了研究结果。本研究中产生和使用的所有数据都是通过具有亲身经验的社区成员的参与共同构建的。
