vaccine confidence and hesitancy at the start of covid 19 vaccine deployment in the CORD-Papers-2022-06-02 (Version 1)

Title: Vaccine Confidence and Hesitancy at the Start of COVID-19 Vaccine Deployment in the UK: An Embedded Mixed-Methods Study
Abstract: Background: Approval for the use of COVID-19 vaccines has been granted in a number of countries but there are concerns that vaccine uptake may be low amongst certain groups. Methods: This study used a mixed methods approach based on online survey and an embedded quantitative/qualitative design to explore perceptions and attitudes that were associated with intention to either accept or refuse offers of vaccination in different demographic groups during the early stages of the UK's mass COVID-19 vaccination programme (December 2020). Analysis used multivariate logistic regression structural text modeling and anthropological assessments. Results: Of 4535 respondents 85% (n = 3859) were willing to have a COVID-19 vaccine. The rapidity of vaccine development and uncertainties about safety were common reasons for COVID-19 vaccine hesitancy. There was no evidence for the widespread influence of mis-information although broader vaccine hesitancy was associated with intentions to refuse COVID-19 vaccines (OR 20.60 95% CI 14.2030.30 p < 0.001). Low levels of trust in the decision-making (OR 1.63 95% CI 1.08 2.48 p = 0.021) and truthfulness (OR 8.76 95% CI 4.1519.90 p < 0.001) of the UK government were independently associated with higher odds of refusing COVID-19 vaccines. Compared to political centrists conservatives and liberals were respectively more (OR 2.05 95%CI 1.512.80 p < 0.001) and less (OR 0.30 95% CI 0.220.41 p < 0.001) likely to refuse offered vaccines. Those who were willing to be vaccinated cited both personal and public protection as reasons with some alluding to having a sense of collective responsibility. Conclusion: Dominant narratives of COVID-19 vaccine hesitancy are misconceived as primarily being driven by misinformation. Key indicators of UK vaccine acceptance include prior behaviors transparency of the scientific process of vaccine development mistrust in science and leadership and individual political views. Vaccine programmes should leverage the sense of altruism citizenship and collective responsibility that motivated many participants to get vaccinated.
Published: 2021-11-11
Journal: Front Public Health
DOI: 10.3389/fpubh.2021.745630
DOI_URL: http://doi.org/10.3389/fpubh.2021.745630
Author Name: Roberts Chrissy h
Author link: https://covid19-data.nist.gov/pid/rest/local/author/roberts_chrissy_h
Author Name: Brindle Hannah
Author link: https://covid19-data.nist.gov/pid/rest/local/author/brindle_hannah
Author Name: Rogers Nina T
Author link: https://covid19-data.nist.gov/pid/rest/local/author/rogers_nina_t
Author Name: Eggo Rosalind M
Author link: https://covid19-data.nist.gov/pid/rest/local/author/eggo_rosalind_m
Author Name: Enria Luisa
Author link: https://covid19-data.nist.gov/pid/rest/local/author/enria_luisa
Author Name: Lees Shelley
Author link: https://covid19-data.nist.gov/pid/rest/local/author/lees_shelley
sha: 62ce7302aeb8339f3a2f027d2861fb205079eca0
license: cc-by
license_url: https://creativecommons.org/licenses/by/4.0/
source_x: Medline; PMC; WHO
source_x_url: https://www.medline.com/https://www.ncbi.nlm.nih.gov/pubmed/https://www.who.int/
pubmed_id: 34858927
pubmed_id_url: https://www.ncbi.nlm.nih.gov/pubmed/34858927
pmcid: PMC8632016
pmcid_url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8632016
url: https://www.ncbi.nlm.nih.gov/pubmed/34858927/ https://doi.org/10.3389/fpubh.2021.745630
has_full_text: TRUE
Keywords Extracted from Text Content: UK's UK alluding centrists participants COVID-19 vaccines Vaccine 14.20-30.30 COVID-19 Floating/Center ACC15 REF16 vaccines I'd NO I ACC04iii raft Covid ACC10 REF02 [I Facebook REF07 covid children mice ACC01-ACC16 MHRA Liberal/Left blood friends smallpox-none [I have] Multiple autoimmune diseases, vaccine ACC07 NHS COVID-19 COVID-19 vaccines Thalidomide ACC06 REF05 ACC01 Opren LE ACC04 lung Facebook's fetuses ACC05iii polio heart foetal cells 120,826 people ACC16 SL ACC03 covid vaccine respondents London School of Hygiene & Tropical Medicine Pfizer/BioNTech BNT162b2 sampling-method matrix ACC04v [I am] £ Ebola virus ACC13 NHS-led 8,384 Howeve UK COVID-19 ACC02ii adrenaline REF15 Complacency STM Vaccines lazy-consensus penicillin REF11 corpus [I am] Slightly YES COVID-19 vaccine household | I UK vaccine refusers brain participants CERC.0039B ACC11 Sierra Leone measles REF12 coronavirus-if COVID-19 REF14 US Vaccine Hesitancy web-form herd coronavirus Coronovirus REF03 REF10 vitamin D mother (mis)trust women Lupus REF13 ACC08 5-10 Jackson vaccine dis-or BNT162b2 (moderna)/efficacy UK government's ACC14 Figure 1 accept/refuse muscle cancer NHS Scheinerman NR Mnra SARS-CoV-2 vaccine people COVID-19:-I'm REF09 REF08 thalidomide Syndrome/APS/Antiphospholipid individuals ACC09 ACC05v Hep C jabs McCoy (author? SARS-Cov-2 SARS-CoV-2 vaccines STEVENS JOHNSON Disease, I [Free text] ACC05i SARS-CoV-2 REF01 UK's COVID-19 Vaccine ACC12 ACC05ii ∼4,500 would/wouldn't participants Eggo
Extracted Text Content in Record: First 5000 Characters:Background: Approval for the use of COVID-19 vaccines has been granted in a number of countries but there are concerns that vaccine uptake may be low amongst certain groups. Methods: This study used a mixed methods approach based on online survey and an embedded quantitative/qualitative design to explore perceptions and attitudes that were associated with intention to either accept or refuse offers of vaccination in different demographic groups during the early stages of the UK's mass COVID-19 vaccination programme (December 2020). Analysis used multivariate logistic regression, structural text modeling and anthropological assessments. Results: Of 4,535 respondents, 85% (n = 3,859) were willing to have a COVID-19 vaccine. The rapidity of vaccine development and uncertainties about safety were common reasons for COVID-19 vaccine hesitancy. There was no evidence for the widespread influence of mis-information, although broader vaccine hesitancy was associated with intentions to refuse COVID-19 vaccines (OR 20.60, 95% CI 14.20-30.30, p < 0.001). Low levels of trust in the decision-making (OR 1.63, 95% CI 1.08, 2.48, p = 0.021) and truthfulness (OR 8.76, 95% CI 4.15-19.90, p < 0.001) of the UK government were independently associated with higher odds of refusing COVID-19 vaccines. Compared to political centrists, conservatives and liberals were, respectively, more (OR 2.05, 95%CI 1.51-2.80, p < 0.001) and less (OR 0.30, 95% CI 0.22-0.41, p < 0.001) likely to refuse offered vaccines. Those who were willing to be vaccinated cited both personal and public protection as reasons, with some alluding to having a sense of collective responsibility. Conclusion: Dominant narratives of COVID-19 vaccine hesitancy are misconceived as primarily being driven by misinformation. Key indicators of UK vaccine acceptance Vaccine Confidence include prior behaviors, transparency of the scientific process of vaccine development, mistrust in science and leadership and individual political views. Vaccine programmes should leverage the sense of altruism, citizenship and collective responsibility that motivated many participants to get vaccinated. In December 2020, the United Kingdom became the first country to approve the use of a vaccine directed against SARS-Cov-2 after successful trials of the Pfizer/BioNTech BNT162b2 mRNA vaccine (1) . Regulatory approval of the Oxford University/AstraZeneca ChAdOx1 (2) and Moderna mRNA-1273 (3) products brought two additional vaccines to the UK market by early January 2021. Immediately after the licensing of BNT162b2, the UK government commenced an ambitious national vaccination campaign that aimed to maximize the shortterm impacts by (1) leveraging the probability that there would be high levels of efficacy from a single dose of (any available) COVID-19 vaccine and (2) by delivering available vaccine to older and clinically vulnerable individuals first (4) . The UK's gamble on the effectiveness of a single dose was vindicated by subsequent evidence that a single dose of BNT162b2 was highly protective against emergency hospitalization and mortality, whilst a single dose of ChAdOx1 similarly protected from severe disease (5) . Early findings from passive surveillance of household transmission in England (6) also showed that vaccination was associated with a reduced secondary attack rate, suggesting that vaccinated people who contracted SARS-CoV-2 infections were less able to transmit infection than unvaccinated people (7) . The UK's vaccination strategy and programme has been hailed a success, with three-quarters of all UK adults having received at least one dose of a SARS-CoV-2 vaccine and 50% having received two doses by 2021-03-17 (8) . This figure is somewhat higher than the estimates of a June 2020 survey of around 13,000 people in 19 countries, which reported that on average 71% of respondents were either likely or very likely to accept a SARS-CoV-2 vaccine. The very high uptake of SARS-CoV-2 vaccines in the UK appears to indicate a substantial increase in SARS-CoV-2 vaccine confidence and also seems to fly in the face of both (1) that these vaccines remain mostly uncharacterised for long-term safety and (2) that there has been a recent national and global trend of vaccine hesitancy for a range of vaccines (9) which has emerged as one of the most significant and complex public health challenges of the twenty-first century. The WHO SAGE Working Group on Vaccine Hesitancy previously developed the "3 Cs" model of vaccine hesitancy (10) which describes three key factors [Confidence, Complacency, Convenience] that contribute to vaccine hesitancy. The success of the UK's SARS-CoV-2 vaccination strategy can potentially be explained as having made the process of vaccination highly convenient by making a sufficient number of vaccine doses available through the National Health Service (NHS), at local health centers and at zero cost to the public. The level of complacency is also likely to be very low be
Keywords Extracted from PMC Text: REF01 UK government's 35–37 Pfizer/BioNTech BNT162b2 ACC14 REF12 COVID-19" SARS-Cov-2 BNT162b2 Scheinerman REF13 participants 50–69 cancer STM Bad | Fair | Good | UK COVID-19 sampling-method UK REF14 REF07 ACC09 ACC12 friends ACC08 Liberal/Left NR Home-maker | Retired | Student | Unemployed] Complacency " REF03 ACC03 Facebook's London School of Hygiene & Tropical Medicine raft household | I herd REF09 ACC06 heart corpus ACC15 NHS-led REF04 vaccine refusers lazy-consensus LE NHS UK Government 2011 " [I respondents Vaccine" 3.6- REF02 ACC04 COVID-19 SARS-CoV-2 vaccines CERC.0039B REF08 matrix McCoy (author? mice" people ACC10 REF10 SL measles Vaccine Hesitancy Thalidomide ACC05 Floating/Center" SARS-CoV-2 vaccine ACC11 (mis)trust lung Jackson ACC01 ACC16 US German Federal Ministry of Health (BMG) 3,658 COVID-19 vaccine ACC13 NHS COVID-19 £ UK's COVID-19 would/wouldn't REF15 REF11 Sierra Leone REF05 ACC07 SARS-CoV-2 web-form COVID-19 vaccines coronavirus
Extracted PMC Text Content in Record: First 5000 Characters:In December 2020, the United Kingdom became the first country to approve the use of a vaccine directed against SARS-Cov-2 after successful trials of the Pfizer/BioNTech BNT162b2 mRNA vaccine (1). Regulatory approval of the Oxford University/AstraZeneca ChAdOx1 (2) and Moderna mRNA-1273 (3) products brought two additional vaccines to the UK market by early January 2021. Immediately after the licensing of BNT162b2, the UK government commenced an ambitious national vaccination campaign that aimed to maximize the short-term impacts by (1) leveraging the probability that there would be high levels of efficacy from a single dose of (any available) COVID-19 vaccine and (2) by delivering available vaccine to older and clinically vulnerable individuals first (4). The UK's gamble on the effectiveness of a single dose was vindicated by subsequent evidence that a single dose of BNT162b2 was highly protective against emergency hospitalization and mortality, whilst a single dose of ChAdOx1 similarly protected from severe disease (5). Early findings from passive surveillance of household transmission in England (6) also showed that vaccination was associated with a reduced secondary attack rate, suggesting that vaccinated people who contracted SARS-CoV-2 infections were less able to transmit infection than unvaccinated people (7). The UK's vaccination strategy and programme has been hailed a success, with three-quarters of all UK adults having received at least one dose of a SARS-CoV-2 vaccine and 50% having received two doses by 2021-03-17 (8). This figure is somewhat higher than the estimates of a June 2020 survey of around 13,000 people in 19 countries, which reported that on average 71% of respondents were either likely or very likely to accept a SARS-CoV-2 vaccine. The very high uptake of SARS-CoV-2 vaccines in the UK appears to indicate a substantial increase in SARS-CoV-2 vaccine confidence and also seems to fly in the face of both (1) that these vaccines remain mostly uncharacterised for long-term safety and (2) that there has been a recent national and global trend of vaccine hesitancy for a range of vaccines (9) which has emerged as one of the most significant and complex public health challenges of the twenty-first century. The WHO SAGE Working Group on Vaccine Hesitancy previously developed the "3 Cs" model of vaccine hesitancy (10) which describes three key factors [Confidence, Complacency, Convenience] that contribute to vaccine hesitancy. The success of the UK's SARS-CoV-2 vaccination strategy can potentially be explained as having made the process of vaccination highly convenient by making a sufficient number of vaccine doses available through the National Health Service (NHS), at local health centers and at zero cost to the public. The level of complacency is also likely to be very low because of the highly visible personal, social, cultural, economic and global impacts of the pandemic. The drivers and extent of UK confidence in SARS-CoV-2 vaccines are however more debatable (11) and in this work we aim to understand how individuals living in the UK made decisions about their intentions to either accept or refuse vaccination at the very beginning of the UK national vaccination programme that commenced in December 2020. In order to achieve this goal we carried out an online survey of ~4,500 adults living in the UK and applied an embedded mixed-methods approach to analysis and interpretation. This study was approved by the research ethics committees of the London School of Hygiene & Tropical Medicine (ref: 17860) and World Health Organization (ref: CERC.0039B). The data were fully anonymous and the study team were unable to identify any respondents. The respondents provided informed consent at the start of the survey by means of ticking a box on the web-form. All questions in the survey were optional, meaning that participants could skip questions if they did not want to divulge specific data. We designed and deployed an embedded mixed-methods online survey as previously described (12). Briefly, the survey included both quantitative and qualitative (open-ended text) questions that were relevant to the UK COVID-19 outbreak, COVID-19 vaccines and their relationship to participants' health, health behaviors and attitudes. All data were collected anonymously and securely using ODK (13). The survey was advertised using Facebook's premium "Boost Post" feature (14) and ran from 2020-12-08 to 2020-12-16. All questions in the survey were voluntary, meaning that participants could skip questions that they did not wish to answer. Adverts were targeted to the eligible population of people aged 18 and over and living in the UK. All participants were asked to provide informed consent and to confirm their eligibility. The survey included questions on the topics of (1) Demographics, (2) Compliance with testing and isolation following COVID-19 symptoms, (3) Use of the NHS COVID-19 contact tracing app, (4) Trust in the gover
PDF JSON Files: document_parses/pdf_json/62ce7302aeb8339f3a2f027d2861fb205079eca0.json
PMC JSON Files: document_parses/pmc_json/PMC8632016.xml.json
G_ID: vaccine_confidence_and_hesitancy_at_the_start_of_covid_19_vaccine_deployment_in_the