From COVID-19 Vaccine Hesitancy to Vaccine Acceptance: Results of a Longitudinal Survey

• Published in: Public health reports (1974) 2023-07, Vol.138 (4), p.681-690
• Main Authors: Fisher, Kimberly A., Nguyen, Ngoc, Fouayzi, Hassan, Crawford, Sybil, Singh, Sonal, Dong, May, Wittenberg, Ruth, Mazor, Kathleen M.
• Format: Article
• Language: English
• Subjects: Adult; Adults; Attitudes; Chi-square test; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 Vaccines; Educational attainment; Humans; Immunization; Influenza; Influenza Vaccines; Longitudinal Studies; Male; Political identity; Public health; Respondents; Rules; Social interactions; Social support; Statistical analysis; Statistical tests; Statistics; Surveys; Vaccination; Vaccines
• ISSN: 0033-3549; 1468-2877
• DOI: 10.1177/00333549231176006

Objectives: COVID-19 vaccines are widely available, but uptake is suboptimal. To develop strategies to increase vaccination rates, we sought to (1) characterize adults initially hesitant to be vaccinated for COVID-19 who later received the vaccine and (2) identify factors associated with their vaccination decision. Methods: In January 2021, we conducted an online survey of US adults via Prolific that assessed vaccination intent, COVID-19–related knowledge and attitudes, and demographic characteristics. In May 2021, we recontacted respondents to assess vaccination status and factors influencing their vaccination decision. We used χ2 statistics and t tests to examine associations between respondents’ vaccination status and their characteristics, knowledge, and attitudes. We analyzed reasons for vaccination using thematic analysis. Results: Of 756 initially vaccine-hesitant respondents, 529 (70.0%) completed the follow-up survey. Nearly half of those initially not sure about vaccination (47.3%, 112 of 237) were vaccinated at follow-up, while 21.2% (62 of 292) of those initially planning not to be vaccinated were vaccinated at follow-up. Of those initially not sure, higher educational attainment, greater knowledge of COVID-19, and a doctor’s recommendation were associated with vaccination. Of those initially intending not to be vaccinated, male sex, Democratic political affiliation, receipt of an influenza shot within 5 years, being more worried about COVID-19, and having greater COVID-19 knowledge were associated with increased likelihood of being vaccinated. Of 167 respondents who gave reasons for vaccination, protecting oneself and others (59.9%), practical issues (29.9%), social influences (17.4%), and vaccine safety (13.8%) were the main reasons. Conclusion: Providing information on the protective value of vaccination, implementing rules that make remaining unvaccinated burdensome, making vaccination easy, and providing social support may influence vaccine-hesitant adults to accept vaccination.