Nguyen Vu-Thuy Thi, Huang Yuan, Huang Minda, Tsai Jack
Health Services Research & Development, VA Connecticut Healthcare System, West Haven, Connecticut, USA
Biostatistics, Yale University, New Haven, Connecticut, USA.
J Epidemiol Community Health. 2023 May;77(5):328-335. doi: 10.1136/jech-2021-218535. Epub 2023 Mar 8.
Vaccine hesitancy has been an ongoing challenge in campaigns, especially the rapid development and approval of the COVID-19 vaccines. The goal of this study was to understand the characteristics, perceptions and beliefs of COVID-19 vaccination prior to its widespread rollout among middle-income and low-income US adults.
Using a national sample of 2101 adults who completed an online assessment in 2021, this study examines the association of demographics, attitudes and behaviours related to COVID-19 vaccination intentions. Adaptive least absolute shrinkage and selection operator models were used to select these specific covariate and participant responses. Poststratification weights were generated using raking procedures and applied to improve generalisability.
Vaccine acceptance was high at 76% with 66.9% reporting intent to receive the COVID-19 vaccine when available. Only 8.8% of vaccine supporters screened positive for COVID-19-related stress compared with 9.3% among the vaccine hesitant. However, there were more people with vaccine hesitancy who screened positive for poor mental health and alcohol and substance misuse. The three main vaccine concerns were side effects (50.4%), safety (29.7%) and mistrust of vaccine distribution (14.8%).Factors influencing vaccine acceptance included age, education, children, region, mental health and social support, threat perception, opinion of governmental response, risk exposure and prevention activities and rejecting COVID-19 vaccine concerns. The results indicated acceptance was more strongly associated with beliefs and attitudes about the vaccine than sociodemographics, which are noteworthy and may lead to targeted interventions to increase COVID-19 vaccine acceptance among subgroups who are vaccine hesitant.
疫苗犹豫一直是疫苗接种运动中持续存在的挑战，尤其是在新冠疫苗的快速研发和获批过程中。本研究的目的是在美国中低收入成年人广泛接种新冠疫苗之前，了解他们对新冠疫苗接种的特征、认知和信念。
本研究采用2021年完成在线评估的2101名成年人的全国样本，考察与新冠疫苗接种意愿相关的人口统计学、态度和行为之间的关联。使用自适应最小绝对收缩和选择算子模型来选择这些特定的协变量和参与者反应。通过加权程序生成事后分层权重，并应用于提高普遍性。
疫苗接受率较高，为76%，其中66.9%的人表示愿意在有新冠疫苗时接种。在疫苗支持者中，只有8.8%的人新冠相关应激筛查呈阳性，而在犹豫接种疫苗者中这一比例为9.3%。然而，更多犹豫接种疫苗者心理健康不佳、存在酒精和药物滥用问题的筛查呈阳性。对疫苗的三大主要担忧是副作用（50.4%）、安全性（29.7%）和对疫苗分发的不信任（14.8%）。影响疫苗接受度的因素包括年龄、教育程度、子女情况、地区、心理健康和社会支持、威胁感知、对政府应对措施的看法、风险暴露和预防活动以及对新冠疫苗担忧的排斥。结果表明，接受度与对疫苗的信念和态度的关联比与社会人口统计学的关联更强，这一点值得注意，可能会促使针对性地采取干预措施，以提高犹豫接种疫苗的亚群体对新冠疫苗的接受度。
