Kranzler Elissa C, Luchman Joseph N, Margolis Katherine A, Ihongbe Timothy O, Kim Jae-Eun C, Denison Benjamin, Vuong Victor, Hoffman Blake, Dahlen Heather, Yu Kathleen, Dupervil Daphney, Hoffman Leah
Fors Marsh, Arlington, VA, United States.
U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States.
Vaccine X. 2024 Feb 8;17:100458. doi: 10.1016/j.jvacx.2024.100458. eCollection 2024 Mar.
COVID-19 vaccine hesitancy has been a major limiting factor to the widespread uptake of COVID-19 vaccination in the United States. A range of interventions, including mass media campaigns, have been implemented to encourage COVID-19 vaccine confidence and uptake. Such interventions are often guided by theories of behavior change, which posit that behavioral factors, including beliefs, influence behaviors such as vaccination. Although previous studies have examined relationships between vaccination beliefs and COVID-19 vaccination behavior, they come with limitations, such as the use of cross-sectional study designs and, for longitudinal studies, few survey waves. To account for these limitations, we examined associations between vaccination beliefs and COVID-19 vaccine uptake using data from six waves of a nationally representative, longitudinal survey of U.S. adults ( = 3,524) administered over a nearly 2-year period (January 2021-November 2022). Survey-weighted lagged logistic regression models were used to examine the association between lagged reports of vaccination belief change and COVID-19 vaccine uptake, using five belief scales: (1) importance of COVID-19 vaccines, (2) perceived benefits of COVID-19 vaccination, (3) COVID-19 vaccine concerns and risks, (4) normative beliefs about COVID-19 vaccination, and (5) perceptions of general vaccine safety and effectiveness. Analyses controlled for confounding factors and accounted for within-respondent dependence due to repeated measures. In individual models, all vaccination belief scales were significantly associated with increased COVID-19 vaccine uptake. In a combined model, all belief scales except the benefits of COVID-19 vaccination were significant predictors of vaccine uptake. Overall, belief scales indicating the importance of COVID-19 vaccines and normative beliefs about COVID-19 vaccination were the strongest predictors of COVID-19 vaccine uptake. Findings demonstrate that changes in vaccination beliefs influence subsequent COVID-19 vaccine uptake, with implications for the development of future interventions to increase COVID-19 vaccination.
对新冠疫苗的犹豫态度一直是美国广泛接种新冠疫苗的一个主要限制因素。一系列干预措施，包括大众媒体宣传活动，已被实施以鼓励人们对新冠疫苗的信心并提高接种率。此类干预措施通常以行为改变理论为指导，这些理论认为包括信念在内的行为因素会影响诸如接种疫苗等行为。尽管先前的研究已经考察了接种信念与新冠疫苗接种行为之间的关系，但它们存在局限性，比如采用横断面研究设计，而且对于纵向研究来说，调查波次较少。为了克服这些局限性，我们使用了来自一项对美国成年人进行的具有全国代表性的纵向调查的六波数据（(n = 3524)），该调查在近2年时间（2021年1月至2022年11月）内进行，以考察接种信念与新冠疫苗接种情况之间的关联。使用调查加权滞后逻辑回归模型，利用五个信念量表来考察接种信念变化的滞后报告与新冠疫苗接种情况之间的关联：（1）新冠疫苗的重要性，（2）对新冠疫苗接种的感知益处，（3）对新冠疫苗的担忧和风险，（4）关于新冠疫苗接种的规范信念，以及（5）对一般疫苗安全性和有效性的看法。分析对混杂因素进行了控制，并考虑了由于重复测量导致的受访者内部依赖性。在个体模型中，所有接种信念量表都与新冠疫苗接种率的提高显著相关。在一个综合模型中，除了新冠疫苗接种的益处外，所有信念量表都是疫苗接种的显著预测因素。总体而言，表明新冠疫苗重要性的信念量表和关于新冠疫苗接种的规范信念是新冠疫苗接种的最强预测因素。研究结果表明，接种信念的变化会影响随后的新冠疫苗接种情况，这对未来增加新冠疫苗接种的干预措施的制定具有启示意义。
