BACKGROUND

Vaccines reduce the severity of symptoms, and risk of hospitalisation and death from infectious diseases. Yet, vaccination hesitancy persists. Research identifying psychological risk factors for vaccination hesitancy is limited and reports conflicting results. This study sought to address these inconsistencies and explore the role of personality and cognitive ability in COVID-19 vaccination hesitancy and uptake in a prospective cohort study.

METHODS

Data came from young adults (Generation-1; G1) and their mothers (Generation-0; G0) in the Avon Longitudinal Study of Parents and Children (ALSPAC). Multinomial logistic regressions, adjusting for several sociodemographic confounders, were used to explore whether personality and cognitive ability were associated with COVID-19 vaccination hesitancy and uptake. 4,960 G1 and 4,853 G0 mothers were included in the study population.

FINDINGS

Among G1, 38.4% exhibited vaccination hesitancy, yet 91.9% of the cohort received the vaccine. In adjusted models, higher levels of openness, agreeableness, conscientiousness, and cognitive ability were associated with an increased probability of wanting the vaccine. Similarly, higher levels of agreeableness, openness and cognitive ability were associated with an increased probability of vaccination uptake. However, the evidence of associations with vaccine uptake were generally weaker than with vaccination hesitancy. 56.7% of the offspring who did not want the vaccine either received the vaccine or intended to, whilst 43.3% still had no intention.Among G0 mothers, 25.6% were vaccination hesitant, yet 99.0% of the cohort received the vaccine. 3.1% said they did not want the vaccine; approximately 80% of these either received the vaccine or intended to. We found inconclusive evidence for an association between cognitive ability and vaccination hesitancy among G0 mothers.

INTERPRETATION

This study identified psychological factors associated with vaccination hesitancy and uptake. If these associations are causal, these findings may help design more effective vaccination hesitancy interventions.