Southern Africa Labour and Development Research Unit, University of Cape Town, Cape Town, South Africa
Southern Africa Labour and Development Research Unit, School of Economics, University of Cape Town, Cape Town, South Africa.
BMJ Glob Health. 2023 Aug;8(8). doi: 10.1136/bmjgh-2023-012433.
COVID-19 vaccine coverage remains low in many low and middle-income countries despite widespread access. To understand the dynamic decision-making process around vaccination and provide evidence for future vaccine promotion campaigns, we identified predictors of COVID-19 vaccine uptake among South African adults, including those who did not believe in the vaccine's safety or efficacy.
Data from two longitudinal telephone surveys in late 2021 and early 2022 of unvaccinated South African adults were used to model COVID-19 uptake. Predictors of interest informed by the theory of planned behaviour included vaccine attitudes and beliefs, social norms, perceived behavioural control and vaccine intentions. Responses to open-ended questions provided insights into key reasons for getting vaccinated.
Among panel participants (n=1772), 19% reported being vaccinated between Survey 1 and Survey 2. Vaccine uptake was greater among participants who reported wanting to get vaccinated 'as soon as possible' (+27 percentage points, p<0.01). Vaccine uptake was greater among participants who believed that the vaccine is effective in preventing COVID-19 infection and/or death (+12 percentage points, p<0.01) and lower among those who believed that the vaccine is unsafe (-9 percentage points, p<0.01). Among participants who did not believe the vaccine is safe, living with someone already vaccinated against COVID-19 increased vaccine uptake (+6 percentage points, p<0.05). At Survey 1, the intention to get vaccinated as soon as possible was positively associated with perceived risk of illness from COVID-19 (+9.2 percentage points, p<0.05), the belief that most people in their area had been vaccinated (+7.0 percentage points, p<0.05) and living with someone already vaccinated against COVID-19 (+6.6 percentage points, p<0.05).
Study findings underscore the predictive power of intentions and of beliefs about disease risk, vaccine safety and vaccine efficacy. Social proof interventions hold promise for increasing vaccination intentions and overcoming concerns about vaccine safety.
尽管许多低收入和中等收入国家都能广泛获得新冠疫苗，但疫苗接种率仍然很低。为了了解围绕疫苗接种的动态决策过程，并为未来的疫苗推广活动提供证据，我们确定了南非成年人接种新冠疫苗的预测因素，包括那些不相信疫苗安全性或有效性的人。
使用 2021 年底和 2022 年初对未接种南非成年人进行的两项纵向电话调查的数据来建立新冠疫苗接种模型。以计划行为理论为指导的感兴趣的预测因素包括疫苗态度和信念、社会规范、感知行为控制和疫苗意图。对开放式问题的回答提供了对接种疫苗的关键原因的深入了解。
在小组参与者（n=1772）中，19%的人报告在调查 1 和调查 2 之间接种了疫苗。报告“尽快”想要接种疫苗的参与者疫苗接种率更高（增加 27 个百分点，p<0.01）。相信疫苗能有效预防新冠病毒感染和/或死亡的参与者疫苗接种率更高（增加 12 个百分点，p<0.01），而认为疫苗不安全的参与者疫苗接种率更低（减少 9 个百分点，p<0.01）。对于那些不相信疫苗安全的人来说，与已经接种新冠疫苗的人同住会增加疫苗接种率（增加 6 个百分点，p<0.05）。在调查 1 时，尽快接种疫苗的意愿与对新冠病毒疾病风险的感知（增加 9.2 个百分点，p<0.05）、相信他们所在地区的大多数人都已接种疫苗（增加 7.0 个百分点，p<0.05）以及与已经接种新冠疫苗的人同住（增加 6.6 个百分点，p<0.05）呈正相关。
研究结果强调了意图和对疾病风险、疫苗安全性和疫苗有效性的信念的预测能力。社会证明干预措施有望增加疫苗接种意愿并克服对疫苗安全性的担忧。
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