Iscte-Instituto Universitário de Lisboa, Business Research Unit (BRU-Iscte), Lisboa, Portugal.
Vaccine. 2024 Aug 30;42(21):126168. doi: 10.1016/j.vaccine.2024.126168. Epub 2024 Jul 27.
Vaccine reluctance is both a complex and context-specific issue and is the result of many complicating factors that need to be addressed more systematically. In Europe, several country-based ad-hoc studies have been carried out on COVID-19 vaccines/vaccination and vaccine reluctance but a comprehensive overview covering all 27 European Union (EU27) countries is lacking. Such study can help understand vaccine reluctance in the overall EU as well as examine differences between individual countries.
This study relies on data from Flash Eurobarometer 505, covering all 27 European Union member states; the sample size is N=26,641. It takes a fuzzy clustering approach to construct typologies of attitudes towards COVID-19 vaccination, and subsequently develops an "Index of Attitudes" (IA) which accounts for individual positioning of EU citizens. The data analysis is based on grade of membership (GoM) model which is a reliable statistical tool to tackle heterogeneous populations.
The output of GoM model unveiled a hierarchical fuzzy 3-partition corresponding to three clearly identified typologies of feelings towards COVID-19 vaccination: Typology 1 entails favourable feelings while moderate-favourable feelings describe the Typology 2. Finally, Tipology 3 encompasses the scepticism towards COVID-19 vaccines. The IA, which quantifies the sentiment of European citizens towards COVID-19 vaccination in a 0-1 scale, reveals that although EU27 citizens overall are not against COVID-19 vaccination (index mean =0.44) some, mostly in eastern countries, deviate from this prevailing trend.
Distrust in the safety and efficacy of all kinds of vaccines, as well as a generalised distrust in European and national institutions, are associated with the reluctance in relation towards COVID-19 vaccination. However, this reluctance varies across countries. The outcomes of our study not only inform national government and health care agents but also help define communication strategies to reach the most reluctant citizens. The segmentation it provides makes it easier to customise campaigns that raise awareness of the consequences of not being vaccinated, particularly as new SARS-CoV-2 variants emerge.
疫苗犹豫是一个复杂且具体情况各异的问题，是许多需要更系统解决的复杂因素共同作用的结果。在欧洲，已经针对 COVID-19 疫苗/接种和疫苗犹豫开展了几项基于国家的特别研究，但缺乏涵盖 27 个欧盟成员国的全面概述。这样的研究可以帮助了解整个欧盟的疫苗犹豫情况，并检查各国之间的差异。
本研究依赖于涵盖 27 个欧盟成员国的 Flash Eurobarometer 505 数据；样本量为 N=26641。它采用模糊聚类方法构建了对 COVID-19 疫苗接种态度的分类，随后开发了一个“态度指数”（IA），该指数考虑了欧盟公民的个人定位。数据分析基于隶属度等级（GoM）模型，这是一种可靠的统计工具，可用于处理异质人群。
GoM 模型的输出揭示了一个分层模糊三分区，对应于 COVID-19 疫苗接种态度的三个明显确定的类型：类型 1包含有利的感觉，而中等偏有利的感觉描述了类型 2。最后，类型 3包含对 COVID-19 疫苗的怀疑。IA 以 0-1 范围内的量化了欧盟公民对 COVID-19 疫苗接种的情绪，结果表明，尽管欧盟 27 国公民总体上不反对 COVID-19 疫苗接种（指数均值=0.44），但一些国家，主要是东部国家，偏离了这一主流趋势。
对各种疫苗的安全性和有效性的不信任，以及对欧洲和国家机构的普遍不信任，与对 COVID-19 疫苗接种的犹豫有关。然而，这种犹豫在各国之间有所不同。我们研究的结果不仅为各国政府和医疗保健机构提供了信息，还有助于制定沟通策略，以接触到最不愿意接种疫苗的公民。它提供的细分使得更容易定制提高对未接种疫苗后果的认识的宣传活动，特别是当新的 SARS-CoV-2 变体出现时。
