What drove rampant vaccination hesitancy earlier in the COVID-19 pandemic?
A new study sought to answer that question, with the research published in the International Journal of Environmental Research and Public Health.
The study was led by Jack Kues, PhD, professor emeritus in the Department of Family and Community Medicine at the University of Cincinnati College of Medicine in Ohio. He said the investigative team examined people's behaviors and emotions around COVID-19 before vaccines were available.
"We did a massive survey with several thousand responses from all over the country," Dr. Kues recounted. "We asked one question about whether they would get a vaccine if it became available. We were surprised to find that large numbers of people, even though they believed that the vaccine was going to be developed within months, weren't going to get it."
Dr. Kues noted that the research team was especially surprised to find out that some of the naysayers were highly educated, including those in healthcare. "We didn't know how to respond to that because we were thinking the people who were not going to get the vaccine were not as well-educated, didn't understand science and were more likely to subscribe to many of the conspiracy theories about the vaccine," he stated.
When vaccines were available, researchers then focused on vaccine hesitancy.
"January through May of 2021 was a critical and volatile time period for COVID-19 cases, deaths, and expanding vaccination programs coinciding with important political and social events which will have a lasting impact on how the public views science, places trust in our government and views individual rights," the authors wrote. "Having collected almost 1,400 surveys, our goal was to assess vaccine behavior, explore attitudes toward receiving the vaccine and identify trusted information sources."
Most (83%) of survey respondents said they were at least partially vaccinated. Of the 246 who were unvaccinated, 31.3% were somewhat or extremely likely to get vaccinated when available. For those hesitant about vaccination, the study found that the two most common concerns were vaccine effectiveness (41.1%) and safety (40.2%).
The surveys were completed in the spring of 2021. "Significant differences were observed between respondents who were likely to be vaccinated in the future and those who were hesitant on three of five demographic variables," the study pointed out. "Our data provide unique insight into the history of behavior and motivations related to COVID-19 vaccines—what will be seen as a "wicked problem" for years to come."
Dr. Kues described how, when his team set up informational tables at health fairs, many people completely avoided coming to the table and picking up any of the printed materials.
"We think one reason for avoiding our conversations is that people are just tired of COVID, period," Dr. Kues suggested. "Another is the way the COVID and vaccination issue has gotten caught up in other political issues. It's similar to talking to somebody about stopping smoking. They believe that you're going to attack or belittle them. They believe that you're going to tell them that they're careless or thoughtless. In that regard, they're not entirely wrong. We often believe that we are right, and they just need to be educated."
As a result, the researchers have changed their approach to COVID-19 education.
"Health fairs are all about health," Dr. Kues said. "If you're advertising that you're now going to talk about something they don't want to talk about, they won't come to you. But if we put it into a larger health context that is about diabetes, nutrition, high blood pressure, dealing with other health issues, they are more likely to engage in a conversation. In that context, COVID can be discussed as a health risk."
Issues that fed vaccine hesitancy were mixed messages from the media and public health officials and inconsistent data from studies, Dr. Kues stated, adding, "It's important to continue doing these discrete studies if you want to understand the phenomenon that is COVID-19. You've got to step back and look at it as a complex puzzle. You've got to examine all the things that were moving over time in order to understand the variables that cause these short-term and long-term changes."
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