Minneapolis, MN—Have COVID-19 vaccines caused more skepticism overall about vaccines and actually increased hesitancy about being immunized?

A new study from the University of Minnesota Medical School in Minneapolis suggested that might be the case. "Extensive media coverage and potential controversy about COVID-19 vaccination during the pandemic may have affected people's general attitudes towards vaccination," the authors wrote in the Journal of Behavioral Medicine.

The study team sought to describe key psychological issues related to vaccination and assess how the pandemic and availability of COVID-19 vaccine affected them.

As part of an ongoing online study, the authors recruited a national U.S. sample of 1,227 young gay, bisexual, and other men who have sex with men between October 2019 and June 2021.

The authors assessed the "4Cs" (antecedents of vaccination). In a range of 1 to 5, they reported, "Overall, men had high levels of confidence (trust in vaccines; M = 4.13), calculation (deliberation; M = 3.97) and collective responsibility (protecting others; M = 4.05) and low levels of complacency (not perceiving disease risk; M = 1.72).

In multivariable analyses, the study found that "confidence and collective responsibility varied relative to the pandemic phase/vaccine availability, reflecting greater hesitancy during later stages of the pandemic. Antecedents also varied by demographic characteristics. Findings suggested negative effects of the COVID-19 pandemic on key antecedents of general vaccination and identify potential targets for interventions."

Background information in the article recounts how the World Health Organization identified vaccination hesitancy as one of the 10 leading threats to global health in 2019. The researchers added, "It is important to monitor hesitancy as new threats—such as coronavirus disease 2019 (COVID-19)—emerge, and new vaccines become available."

The authors described how, beginning during vaccine development, COVID-19 vaccination has received extensive media coverage and has engendered many controversies, often fueled by widespread misinformation. The study pointed out that several issues have been at play:

• Vaccine safety and side effects
• Vaccine efficacy
• Vaccine shedding
• Inclusion of controversial substances in the vaccines
• Government infringement.

All of those have affected hesitancy about COVID-19 vaccines, according to the researchers, who cautioned, "Importantly, the pandemic and these controversies could also affect vaccination hesitancy more generally. However, little is known about temporal changes in general vaccination hesitancy during the course of the COVID-19 pandemic. Identifying such temporal changes in vaccination hesitancy is of great public health importance given the large decreases in vaccination rates that have been observed during the pandemic."

That is especially the case with young adults, according to the authors, because they have been among the age groups with the highest levels of hesitancy to receive a vaccine against COVID-19 and often are decisions about their own healthcare for the first time.

"These challenges may be further heightened among certain groups, such as young adult gay, bisexual, and other men who have sex with men (YGBMSM) who report additional barriers to health care such as concerns about disclosing of sexual orientation to a healthcare provider. We, therefore, sought to examine how the COVID-19 pandemic affected key psychological antecedents of vaccination among a national sample of YGBMSM in the U.S," they wrote.

The study added, "Although the young adult men in our study held generally positive attitudes and perceptions about vaccination, overall, we found significant decreases in vaccination confidence and collective responsibility among those enrolled during the later phases of the pandemic, which is particularly concerning as other research has found that, of the 4Cs assessed in this study, these two are the most strongly associated with vaccination intent and behavior among college students. Although we are not able to identify the exact mechanism for these decreases, many young adults report receiving COVID-19 information on social media which has been a source for anti-vaccine content during the pandemic. Thus, strategies to mitigate such content are needed, particularly among YGBMSM and other young adults who may have less experience navigating health care and vaccination decisions independent of their parents or guardians."

In addition to the group studied, researchers point out that greater hesitancy also is found among individuals who are non-Hispanic black, have lower educational attainment, and who do not receive regular preventive care.

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