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Infectious Medicine 2023, 2(2): 89-95 https://doi.org/10.1016/j.imj.2023.03.001
Original Article | Open Access | Issue | Published: 25 March 2023

Hesitant adopters: COVID-19 vaccine hesitancy among diverse vaccinated adults in the United States

Show Author's Information Sharon Reecea,  Sheena CarlLeea,  Aaron J. Scottb,  Don E. Willisc,  Brett Rowlandb,  Kristin Larsena,  Ijanae Holman-Allgooda,  Pearl A. McElfishc( )
College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR 72703, USA
Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72703, USA
College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72703, USA
Keywords:
COVID-19 vaccine, Vaccine hesitancy, Hesitant adopters, US adults
Cite this article:
Reece S, CarlLee S, Scott AJ, et al. Hesitant adopters: COVID-19 vaccine hesitancy among diverse vaccinated adults in the United States. Infectious Medicine, 2023, 2(2): 89-95. https://doi.org/10.1016/j.imj.2023.03.001
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Abstract Full text About this article
Background

Despite the United States (US) having an abundant supply of COVID-19 vaccines, vaccination rates lag behind other high-income countries, suggesting that vaccine hesitancy and attitudes play a greater role in public health measures than pure supply and access. With the acknowledgment that vaccination attitudes and status may or may not be correlated, this study examined COVID-19 vaccine hesitancy among vaccinated US adults by asking: 1) What is the prevalence of COVID-19 vaccine hesitancy among the vaccinated? 2) Does COVID-19 vaccine hesitancy vary across sociodemographic characteristics? 3) Does COVID-19 vaccine hesitancy vary by healthcare access and influenza vaccination over the past 5 years?

Methods

Data were collected through an online survey of 2022 US adults with a final analytic sample of 1383 vaccinated respondents.

Results

Overall, 48.8% of vaccinated adults reported some level of hesitancy, while a slight majority reported they were “not at all hesitant”. Younger respondents, women, and Black and American Indian or Alaska Native participants had greater adjusted odds of being more hesitant towards receiving the COVID-19 vaccine. Respondents who had a primary care physician had greater adjusted odds than those who did not have a primary care physician of being more hesitant towards receiving the COVID-19 vaccine.

Conclusions

This is the first population-based national sample study examining COVID-19 vaccine hesitancy among vaccinated individuals from subgroups of distinctive backgrounds in order to inform targeted strategies for reducing vaccine hesitancy. Findings can assist in efforts to increase vaccination rates and also decrease vaccine hesitancy at the national level.


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Abstract
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About this article

Hesitant adopters: COVID-19 vaccine hesitancy among diverse vaccinated adults in the United States

Show Author's information Sharon Reecea, Sheena CarlLeea, Aaron J. Scottb, Don E. Willisc, Brett Rowlandb, Kristin Larsena, Ijanae Holman-Allgooda, Pearl A. McElfishc( )
College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR 72703, USA
Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72703, USA
College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR 72703, USA

Abstract

Background

Despite the United States (US) having an abundant supply of COVID-19 vaccines, vaccination rates lag behind other high-income countries, suggesting that vaccine hesitancy and attitudes play a greater role in public health measures than pure supply and access. With the acknowledgment that vaccination attitudes and status may or may not be correlated, this study examined COVID-19 vaccine hesitancy among vaccinated US adults by asking: 1) What is the prevalence of COVID-19 vaccine hesitancy among the vaccinated? 2) Does COVID-19 vaccine hesitancy vary across sociodemographic characteristics? 3) Does COVID-19 vaccine hesitancy vary by healthcare access and influenza vaccination over the past 5 years?

Methods

Data were collected through an online survey of 2022 US adults with a final analytic sample of 1383 vaccinated respondents.

Results

Overall, 48.8% of vaccinated adults reported some level of hesitancy, while a slight majority reported they were “not at all hesitant”. Younger respondents, women, and Black and American Indian or Alaska Native participants had greater adjusted odds of being more hesitant towards receiving the COVID-19 vaccine. Respondents who had a primary care physician had greater adjusted odds than those who did not have a primary care physician of being more hesitant towards receiving the COVID-19 vaccine.

Conclusions

This is the first population-based national sample study examining COVID-19 vaccine hesitancy among vaccinated individuals from subgroups of distinctive backgrounds in order to inform targeted strategies for reducing vaccine hesitancy. Findings can assist in efforts to increase vaccination rates and also decrease vaccine hesitancy at the national level.

Keywords: COVID-19 vaccine, Vaccine hesitancy, Hesitant adopters, US adults

References(38)

[1]

T. Callaghan, M. Motta, S. Sylvester, et al., Parent psychology and the decision to delay childhood vaccination, Soc. Sci. Med. 238 (2019) 112407, doi:10.1016/j.socscimed.2019.112407.
DOI Google Scholar
[2]
Our World in Data. COVID-19 vaccine doses donated to COVAX. 2022; Available on: https://ourworldindata.org/grapher/covax-donations (accessed on 10 November 2022).
[3]

P. Hyland, F. Vallières, M. Shevlin, et al., Resistance to COVID-19 vaccination has increased in Ireland and the United Kingdom during the pandemic, Public Health 195 (2021) 54–56, doi:10.1016/j.puhe.2021.04.009.
DOI Google Scholar
[4]
Centers for Disease Control and Prevention. Vaccinate with confidence COVID-19 vaccines strategy for adults. 2022; Available on: https://www.cdc.gov/vaccines/covid-19/vaccinate-with-confidence/strategy.html (accessed on 10 November 2022).
[5]

D.E. Willis, J.A. Andersen, K. Bryant-Moore, et al., COVID-19 vaccine hesitancy: Race/ethnicity, trust, and fear, Clin. Transl. Sci. 14 (6) (2021) 2200–2207, doi:10.1111/cts.13077.
DOI Google Scholar
[6]

A.A. Malik, S.M. McFadden, J. Elharake, et al., Determinants of COVID-19 vaccine acceptance in the US, EClinicalMedicine 26 (2020) 100495, doi:10.1016/j.eclinm.2020.100495.
DOI Google Scholar
[7]

P.G. Szilagyi, K. Thomas, M.D. Shah, et al., National trends in the US public’s likelihood of getting a COVID-19 vaccine—April 1 to December 8, 2020, JAMA 325 (4) (2021) 396–398, doi:10.1001/jama.2020.26419.
DOI Google Scholar
[8]

P.A. McElfish, J.P. Selig, A.J. Scott, et al., Associations between 5-year influenza vaccination and sociodemographic factors and healthcare access among Arkansans, Vaccine 40 (27) (2022) 3727–3731, doi:10.1016/j.vaccine.2022.05.031.
DOI Google Scholar
[9]

A. Battarbee, M.S. Stockwell, M. Varner, et al., Attitudes toward COVID-19 illness and COVID-19 vaccination among pregnant women: a cross-sectional multicenter study during August-December 2020, Am. J. Perinatol. 39 (1) (2022) 75–83.
DOI Google Scholar
[10]

C. Coughenour, M. Gakh, M. Sharma, et al., Assessing determinants of COVID-19 vaccine hesitancy in Nevada, Health Secur 19 (6) (2021) 592–604, doi:10.1055/s-0041-1735878.
DOI Google Scholar
[11]

E. Dubé, C. Laberge, M. Guay, et al., Vaccine hesitancy: an overview, Hum. Vaccin. Immunother. 9 (8) (2013) 1763–1773, doi:10.4161/hv.24657.
DOI Google Scholar
[12]

S.C. Quinn, A.M. Jamison, J. An, et al., Measuring vaccine hesitancy, confidence, trust and flu vaccine uptake: results of a national survey of White and African American adults, Vaccine 37 (9) (2019) 1168–1173, doi:10.4161/hv.24657.
DOI Google Scholar
[13]

M. Daly, A. Jones, E. Robinson, Public trust and willingness to vaccinate against COVID-19 in the US from October 14, 2020 to March 29, 2021, J. Am. Med. Assoc. 325 (23) (2021) 2397, doi:10.1001/jama.2021.8246.
DOI Google Scholar
[14]

D.E. Willis, J.P. Selig, J.A. Andersen, et al., Hesitant but vaccinated: assessing COVID-19 vaccine hesitancy among the recently vaccinated, J. Behav. Med. (2022) 1–10, doi:10.1007/s10865-021-00270-6.
DOI Google Scholar
[15]

R. Moore, R.S. Purvis, E. Hallgren, et al., Motivations to vaccinate among hesitant adopters of the COVID-19 vaccine, J. Community Health 47 (2) (2021) 237–245, doi:10.1007/s10900-021-01037-5.
DOI Google Scholar
[16]

E. Hallgren, R. Moore, R.S. Purvis, et al., Facilitators to vaccination among hesitant adopters, Hum. Vaccin. Immunother. 17 (12) (2021) 5168–5175, doi:10.1080/21645515.2021.2010427.
DOI Google Scholar
[17]
A. Kirzinger, G. Sparks, and M. Brodie. KFF COVID-19 vaccine monitor: in their own words, six months later. 2021; Available on: https://www.kff.org/coronaviruscovid-19/poll-finding/kff-covid-19-vaccine-monitor-in-their-own-words-six-monthslater/ (accessed on 10 November 2022).
DOI
[18]

R.S. Purvis, E. Hallgren, R.A. Moore, et al., Trusted sources of COVID-19 vaccine information among hesitant adopters in the United States, Vaccines (Basel) 9 (12) (2021) 1418, doi:10.3390/vaccines9121418.
DOI Google Scholar
[19]

P.A. McElfish, B. Rowland, A.J. Scott, et al., Hesitant adopters: an examination of hesitancy among adults in Arkansas who have taken the COVID-19 vaccine, Clin. Transl. Sci. 15 (10) (2022) 2316–2322, doi:10.1111/cts.13367.
DOI Google Scholar
[20]

R. Moore, R.S. Purvis, D.E. Willis, et al., The vaccine hesitancy continuum among hesitant adopters of the COVID-19 vaccine, Clin. Transl. Sci. 15 (2) (2022) 2844–2857, doi:10.1111/cts.13385.
DOI Google Scholar
[21]

R.S. Purvis, R. Moore, D.E. Willis, et al., Factors influencing COVID-19 vaccine decision-making among hesitant adopters in the United States, Hum. Vaccin. Immunother. 18 (6) (2022) 2114701, doi:10.1080/21645515.2022.2114701.
DOI Google Scholar
[22]

N. Brewer, G.B. Chapman, A.J. Rothman, et al., Increasing vaccination: putting psychological science into action, Psychol. Sci. Public Interest 18 (3) (2017) 149–207, doi:10.1177/1529100618760521.
DOI Google Scholar
[23]

R. Liu, G. Li, Hesitancy in the time of coronavirus: Temporal, spatial, and sociodemographic variations in COVID-19 vaccine hesitancy, SSM Popul. Health 15 (2021) 100896, doi:10.1016/j.ssmph.2021.100896.
DOI Google Scholar
[24]

S.L. Enkel, K. Attwell, T.L. Snelling, et al., Hesitant compliers’: qualitative analysis of concerned fully-vaccinating parents, Vaccine 36 (44) (2018) 6459–6463, doi:10.1016/j.vaccine.2017.09.088.
DOI Google Scholar
[25]

J.J. Quint, M.E. Van Dyke, H. Maeda, et al., Disaggregating data to measure racial disparities in COVID-19 outcomes and guide community response—Hawaii, March 1, 2020-February 28, 2021, MMWR Morb. Mortal. Wkly. Rep. 70 (37) (2021) 1267–1273, doi:10.15585/mmwr.mm7037a1.
DOI Google Scholar
[26]

R. Chang, C. Penaia, K. Thomas, Count Native Hawaiian And Pacific Islanders in COVID-19 data: it’s an OMB mandate, Health Affairs Blog, 2020.
DOI Google Scholar
[27]

A. Mercer, A. Lau, C. Kennedy, How Different Weighting Method Work, Pew Research Center Methods, 2018.
Google Scholar
[28]

C. Latkin, L. Dayton, G. Yi, et al., Mask usage, social distancing, racial, and gender correlates of COVID-19 vaccine intentions among adults in the US, PLoS One 16 (2) (2022) e0246970, doi:10.1371/journal.pone.0246970.
DOI Google Scholar
[29]

J. Calarco, E. Andersen, “I’m Not Gonna Put That On My Kids”: gendered opposition to new public health initiatives, SocArXiv (2021).
DOI Google Scholar
[30]

A. Bagasra, S. Doan, C. Allen, Racial differences in institutional trust and COVID-19 vaccine hesitancy and refusal, BMC Public Health 21 (1) (2021) 2104, doi:10.1186/s12889-021-12195-5.
DOI Google Scholar
[31]

H.A. Washington, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans From Colonial Times to the Present, Harlem Moon, United States, 2006.
[32]

A. Rosenthal, M. Motta, C. Farhart, Beyond Tuskegee, to Middlesboro: how perspectives of policing shape vaccine attitudes for Black Americans, SocARXiv (2021).
DOI Google Scholar
[33]

D.E. Willis, J.A. Andersen, B.E.E. Montgomery, et al., COVID-19 vaccine hesitancy and experiences of discrimination among Black adults, J. Racial Ethn. Health Disparities (2022) 1–10, doi:10.1007/s40615-022-01290-x.
DOI Google Scholar
[34]

M. Siegel, I. Critchfield-Jain, M. Boykin, et al., Racial/ethnic disparities in state-level COVID-19 vaccination rates and their association with structural racism, J. Racial Ethn. Health Disparities 9 (6) (2021) 2361–2374, doi:10.1007/s40615-021-01173-7.
DOI Google Scholar
[35]

E. Savoia, R. Piltch-Loeb, B. Goldberg, et al., Predictors of COVID-19 vaccine hesitancy: socio-demographics, co-morbidity and past experience of racial discrimination, Public Global Health 9 (7) (2021) 767, doi:10.3390/vaccines9070767.
DOI Google Scholar
[36]

S.C. Quinn, A. Jamison, V.S. Friemuth, et al., Exploring racial influences on flu vaccine attitudes and behavior: results of a national survey of White and African American adults, Vaccine 35 (8) (2017) 1167–1174, doi:10.1016/j.vaccine.2016.12.046.
DOI Google Scholar
[37]
G. Sanchez, and R. Foxworth, Native Americans and COVID-19 vaccine hesitancy: pathways toward increasing vaccination rates for native communities. 2021, Health Affairs Blog.
[38]

C. Lo, L. Chiu, A. Qian, et al., Association of primary care physicians per capita with COVID-19 vaccination rates among US counties, JAMA Netw. Open 5 (2) (2022) e2147920, doi:10.1001/jamanetworkopen.2021.47920.
DOI Google Scholar
Publication history
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Publication history

Received: 15 December 2022
Revised: 03 March 2023
Accepted: 19 March 2023
Published: 25 March 2023
Issue date: June 2023

Copyright

© 2023 The Author(s). Tsinghua University Press.

Acknowledgements

None.

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This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

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