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Factors Associated With the Intention to Receive the COVID-19 Vaccine: Cross-sectional National Study.
JMIR Public Health Surveill. 2022 11 14; 8(11):e37203.JP

Abstract

BACKGROUND

The COVID-19 pandemic is an unprecedented public health crisis, and vaccines are the most effective means of preventing severe consequences of this disease. Hesitancy regarding vaccines persists among adults in the United States, despite overwhelming scientific evidence of safety and efficacy.

OBJECTIVE

The purpose of this study was to use the Health Belief Model (HBM) and reasoned action approach (RAA) to examine COVID-19 vaccine hesitancy by comparing those who had already received 1 vaccine to those who had received none.

METHODS

This study examined demographic and theory-based factors associated with vaccine uptake and intention among 1643 adults in the United States who completed an online survey during February and March 2021. Survey items included demographic variables (eg, age, sex, political ideology), attitudes, and health belief variables (eg, perceived self-efficacy, perceived susceptibility). Hierarchical logistic regression analyses were used for vaccine uptake/intent. The first model included demographic variables. The second model added theory-based factors to examine the association of health beliefs and vaccine uptake above and beyond the associations explained by demographic characteristics alone.

RESULTS

The majority of participants were male (n=974, 59.3%), White (n=1347, 82.0%), and non-Hispanic (n=1518, 92.4%) and reported they had already received a COVID-19 vaccine or definitely would when it was available to them (n=1306, 79.5%). Demographic variables significantly associated with vaccine uptake/intent included age (adjusted odds ratio [AOR] 1.05, 95% CI 1.04-1.06), other race (AOR 0.47, 95% CI 0.27-0.83 vs White), and political ideology (AOR 15.77, 95% CI 7.03-35.35 very liberal vs very conservative). The theory-based factors most strongly associated with uptake/intention were attitudes (AOR 3.72, 95% CI 2.42-5.73), self-efficacy (AOR 1.75, 95% CI 1.34-2.29), and concerns about side effects (AOR 0.59, 95% CI 0.46-0.76). Although race and political ideology were significant in the model of demographic characteristics, they were not significant when controlling for attitudes and beliefs.

CONCLUSIONS

Vaccination represents one of the best tools to combat the COVID-19 pandemic, as well as other possible pandemics in the future. This study showed that older age, attitudes, injunctive norms, descriptive norms, and self-efficacy are positively associated with vaccine uptake and intent, whereas perceived side effects and lack of trust in the vaccine are associated with lower uptake and intent. Race and political ideology were not significant predictors when attitudes and beliefs were considered. Before vaccine hesitancy can be addressed, researchers and clinicians must understand the basis of vaccine hesitancy and which populations may show higher hesitancy to the vaccination so that interventions can be adequately targeted.

Authors+Show Affiliations

Department of Public Health, Purdue University, West Lafayette, IN, United States. Cancer Prevention and Control Program, Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN, United States.Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States.Department of Family Medicine, School of Medicine, Indiana University, Indianapolis, IN, United States. Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, United States.Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, United States.AI for Good Research Lab, Microsoft Corporation, Redmond, WA, United States.Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, United States. Richard M Fairbanks School of Public Health, Indiana University, Indianapolis, IN, United States. Center for Health Information and Communication, Health Services Research & Development Service, Richard L Roudebush VA Medical Center, Veterans Health Administration, Indianapolis, IN, United States.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

36219842

Citation

Kasting, Monica L., et al. "Factors Associated With the Intention to Receive the COVID-19 Vaccine: Cross-sectional National Study." JMIR Public Health and Surveillance, vol. 8, no. 11, 2022, pp. e37203.
Kasting ML, Macy JT, Grannis SJ, et al. Factors Associated With the Intention to Receive the COVID-19 Vaccine: Cross-sectional National Study. JMIR Public Health Surveill. 2022;8(11):e37203.
Kasting, M. L., Macy, J. T., Grannis, S. J., Wiensch, A. J., Lavista Ferres, J. M., & Dixon, B. E. (2022). Factors Associated With the Intention to Receive the COVID-19 Vaccine: Cross-sectional National Study. JMIR Public Health and Surveillance, 8(11), e37203. https://doi.org/10.2196/37203
Kasting ML, et al. Factors Associated With the Intention to Receive the COVID-19 Vaccine: Cross-sectional National Study. JMIR Public Health Surveill. 2022 11 14;8(11):e37203. PubMed PMID: 36219842.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors Associated With the Intention to Receive the COVID-19 Vaccine: Cross-sectional National Study. AU - Kasting,Monica L, AU - Macy,Jonathan T, AU - Grannis,Shaun J, AU - Wiensch,Ashley J, AU - Lavista Ferres,Juan M, AU - Dixon,Brian E, Y1 - 2022/11/14/ PY - 2022/02/11/received PY - 2022/10/09/accepted PY - 2022/05/20/revised PY - 2022/10/12/pubmed PY - 2022/11/18/medline PY - 2022/10/11/entrez KW - COVID-19 KW - COVID-19 vaccines KW - Health Belief Model KW - SARS-CoV-2 KW - demographic KW - health intervention KW - logistic regression KW - online survey KW - public health KW - reasoned action approach KW - vaccination KW - vaccination intention KW - vaccine hesitancy SP - e37203 EP - e37203 JF - JMIR public health and surveillance JO - JMIR Public Health Surveill VL - 8 IS - 11 N2 - BACKGROUND: The COVID-19 pandemic is an unprecedented public health crisis, and vaccines are the most effective means of preventing severe consequences of this disease. Hesitancy regarding vaccines persists among adults in the United States, despite overwhelming scientific evidence of safety and efficacy. OBJECTIVE: The purpose of this study was to use the Health Belief Model (HBM) and reasoned action approach (RAA) to examine COVID-19 vaccine hesitancy by comparing those who had already received 1 vaccine to those who had received none. METHODS: This study examined demographic and theory-based factors associated with vaccine uptake and intention among 1643 adults in the United States who completed an online survey during February and March 2021. Survey items included demographic variables (eg, age, sex, political ideology), attitudes, and health belief variables (eg, perceived self-efficacy, perceived susceptibility). Hierarchical logistic regression analyses were used for vaccine uptake/intent. The first model included demographic variables. The second model added theory-based factors to examine the association of health beliefs and vaccine uptake above and beyond the associations explained by demographic characteristics alone. RESULTS: The majority of participants were male (n=974, 59.3%), White (n=1347, 82.0%), and non-Hispanic (n=1518, 92.4%) and reported they had already received a COVID-19 vaccine or definitely would when it was available to them (n=1306, 79.5%). Demographic variables significantly associated with vaccine uptake/intent included age (adjusted odds ratio [AOR] 1.05, 95% CI 1.04-1.06), other race (AOR 0.47, 95% CI 0.27-0.83 vs White), and political ideology (AOR 15.77, 95% CI 7.03-35.35 very liberal vs very conservative). The theory-based factors most strongly associated with uptake/intention were attitudes (AOR 3.72, 95% CI 2.42-5.73), self-efficacy (AOR 1.75, 95% CI 1.34-2.29), and concerns about side effects (AOR 0.59, 95% CI 0.46-0.76). Although race and political ideology were significant in the model of demographic characteristics, they were not significant when controlling for attitudes and beliefs. CONCLUSIONS: Vaccination represents one of the best tools to combat the COVID-19 pandemic, as well as other possible pandemics in the future. This study showed that older age, attitudes, injunctive norms, descriptive norms, and self-efficacy are positively associated with vaccine uptake and intent, whereas perceived side effects and lack of trust in the vaccine are associated with lower uptake and intent. Race and political ideology were not significant predictors when attitudes and beliefs were considered. Before vaccine hesitancy can be addressed, researchers and clinicians must understand the basis of vaccine hesitancy and which populations may show higher hesitancy to the vaccination so that interventions can be adequately targeted. SN - 2369-2960 UR - https://www.unboundmedicine.com/medline/citation/36219842/Factors_Associated_With_the_Intention_to_Receive_the_COVID_19_Vaccine:_Cross_sectional_National_Study_ DB - PRIME DP - Unbound Medicine ER -