Anto-Ocrah Martina, Chen Michael, Affan Nabeeha Jabir, DeSplinter Lindsey, Hollenbach Stefanie
Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
Int J Womens Health. 2024 Dec 9;16:2123-2136. doi: 10.2147/IJWH.S478548. eCollection 2024.
BACKGROUND & OBJECTIVES: Growing data on the impact of herd immunity and susceptibility of unvaccinated persons to chronic COVID sequelae requires deeper understanding of vaccine stigma and hesitancy to facilitate population needs. Reproductive-aged women (18-45 years) were at a "vaccine paradox" during COVID-19 - hesitant to receive the vaccine, yet at increased risk for COVID infection. In this study, we sought to: identify demographic predictors, reasons, geographic location of vaccine hesitancy, and COVID-specific attributes that predict future vaccination willingness. We hypothesized that high COVID risk perception and high COVID stress would be predictors of willingness.
Study Design: Cross-sectional survey of women across the United States. Main Outcomes and Measures: Vaccine hesitancy was defined as responding "No/Not Sure" to the question "Have you received any of the COVID-19 vaccines?" The COVID-Risk scale evaluate perceived COVID Risk, and the COVID-19 Perceived Stress Scale (PSS-10-c) evaluated COVID stress. Open ended questions inquired about participants' vaccine concerns.
Of the 1,037 women who accessed the survey, 948 (91%) consented and completed. Predictors of vaccine hesitancy included younger aged parents (p=0.005), non-white race (p=0.003), and having high school or lower educational attainment (p<0.0001). Using smoking as a proxy measure of "health behavior", we found long-term smokers or quitters were more hesitant than those who never smoked (p=0.03). Geographic analyses showed the most vaccine hesitant women resided in Southeast and Midwest US. Hesitancy reasons included side effects (21%) and fertility/pregnancy concerns (4%). High COVID risk perception (p=0.0004) and high COVID stress (p=0.01) significantly predicted future willingness to get vaccinated.
This research provides insights for managing the "vaccine paradox" in reproductive age women, and identifying factors that influence COVID-19 vaccine hesitancy and future vaccination willingness. Public health and policy advocates could target messaging around COVID risk and stress in Southeastern and Midwestern regions; as well as address women's concerns around fertility and other side effects.
关于群体免疫的影响以及未接种疫苗者对新冠长期后遗症易感性的数据不断增加，这需要我们更深入地了解疫苗污名化和接种犹豫现象，以满足人群需求。育龄妇女（18 - 45岁）在新冠疫情期间处于“疫苗悖论”状态——对接种疫苗犹豫不决，但感染新冠的风险却有所增加。在本研究中，我们试图：确定人口统计学预测因素、原因、疫苗犹豫的地理位置以及预测未来接种意愿的新冠特定属性。我们假设对新冠高风险的认知和高新冠压力会是接种意愿的预测因素。
研究设计：对美国各地女性进行横断面调查。主要结果与测量指标：疫苗犹豫被定义为对“你是否接种过任何新冠疫苗？”这个问题回答“否/不确定”。新冠风险量表评估感知到的新冠风险，新冠疫情感知压力量表（PSS - 10 - c）评估新冠压力。开放式问题询问了参与者对疫苗的担忧。
在1037名访问该调查的女性中，948名（91%）同意并完成了调查。疫苗犹豫的预测因素包括父母年龄较小（p = 0.005）、非白人种族（p = 0.003）以及高中及以下教育程度（p < 0.0001）。以吸烟作为“健康行为”的替代指标，我们发现长期吸烟者或已戒烟者比从不吸烟者更犹豫（p = 0.03）。地理分析表明，疫苗犹豫程度最高的女性居住在美国东南部和中西部。犹豫的原因包括副作用（21%）和对生育/怀孕的担忧（4%）。对新冠高风险的认知（p = 0.0004）和高新冠压力（p = 0.01）显著预测了未来接种疫苗的意愿。
本研究为解决育龄女性中的“疫苗悖论”以及识别影响新冠疫苗犹豫和未来接种意愿的因素提供了见解。公共卫生和政策倡导者可以针对美国东南部和中西部地区围绕新冠风险和压力进行宣传；同时解决女性对生育和其他副作用的担忧。
