Mitchell Adam, Hassan Mariam, Kahn Fredrik, Litins'ka Yana, Almgren Matilda, Malmqvist Ulf, Östergren Per-Olof, Inghammar Malin, Björk Jonas, Bennet Louise
Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Department of Clinical Sciences Malmö, Family Medicine and Community Medicine, Lund University, Lund, Sweden.
Eur J Public Health. 2025 Jun 1;35(3):477-483. doi: 10.1093/eurpub/ckaf030.
Low vaccination coverage against SARS-CoV-2 (COVID-19) is a public health concern. The aim of this study was to identify barriers and motivators associated with COVID-19 vaccination and develop a vaccine acceptance scoring system. From the overall population residing in Skåne county Sweden in 2022 (n = 1 384 531), 3600 randomly selected individuals (aged ≥18 years) received a survey. Questions were grouped into six domains reflecting trust in vaccines and institutions, benefit-risk balance, injunctive and descriptive norms and accessibility. Responses were scored as either assenting (1 p) or dissenting (0 p) in relation to its domain. A score between 1 and 5 p was constructed for each domain and a total vaccine acceptance score was analysed. Internal consistency overall and within domains was assessed with Cronbach's alpha. Associations with vaccination status and vaccine acceptance scores in relation to domains were modelled with logistic regression. 820 responses were received, 646 vaccinated (response rate 36%), and 174 unvaccinated (response rate 10%), with relatively high internal consistency overall (α = 0.76). Domains markedly associated with vaccination were injunctive norms OR 5.06 (95% CI 3.27, 7.83), descriptive norms OR 2.64 (1.63, 4.30) and trust in vaccines OR 1.66 (1.15, 2.40). Vaccine acceptance was measured with sufficient reliability in a Swedish population. Norms, in this context, general perceptions of acceptable/unacceptable behaviours and notion on actual performed behaviours, were together with trust in vaccines most strongly associated with vaccination. Future pandemic responses should consider these aspects in communication strategies and targeted interventions to increase and equalize vaccination uptake.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2，即新冠病毒）疫苗接种覆盖率低是一个公共卫生问题。本研究的目的是确定与新冠病毒疫苗接种相关的障碍和动机，并开发一种疫苗接受度评分系统。从2022年居住在瑞典斯科讷郡的总人口（n = 1384531）中，随机抽取3600名年龄≥18岁的个体进行调查。问题分为六个领域，反映对疫苗和机构的信任、利弊权衡、指令性和描述性规范以及可及性。根据每个领域的情况，将回答评为同意（1分）或不同意（0分）。为每个领域构建一个1至5分的评分，并分析总体疫苗接受度得分。使用克朗巴哈系数评估总体和各领域内的内部一致性。通过逻辑回归对与疫苗接种状况以及各领域疫苗接受度得分之间的关联进行建模。共收到820份回复，其中646人接种了疫苗（回复率36%），174人未接种疫苗（回复率10%），总体内部一致性相对较高（α = 0.76）。与疫苗接种显著相关的领域是指令性规范，比值比为5.06（95%置信区间3.27，7.83）；描述性规范，比值比为2.64（1.63，4.30）；以及对疫苗的信任，比值比为1.66（1.15，2.40）。在瑞典人群中，疫苗接受度的测量具有足够的可靠性。在这种情况下，规范是对可接受/不可接受行为的一般认知以及对实际行为的观念，与对疫苗的信任一起，与疫苗接种的关联最为紧密。未来应对大流行的措施应在沟通策略和有针对性的干预措施中考虑这些方面，以提高疫苗接种率并使其均衡。
