COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II

Daniel Freeman^{1

2}, Bao S Loe³, Andrew Chadwick⁴, Cristian Vaccari⁴, Felicity Waite^{1

2}, Laina Rosebrock^{1

2}, Lucy Jenner^{1

2}, Ariane Petit^{1

2}, Stephan Lewandowsky⁵, Samantha Vanderslott⁶, Stefania Innocenti⁷, Michael Larkin⁸, Alberto Giubilini⁹, Ly-Mee Yu¹⁰, Helen McShane¹¹, Andrew J Pollard⁶, Sinéad Lambe^{1

2}

Affiliations

¹ Department of Psychiatry, University of Oxford, Oxford, UK.
² Oxford Health NHS Foundation Trust, Oxford, UK.
³ The Psychometrics Centre, University of Cambridge, Cambridge, UK.
⁴ Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK.
⁵ School of Psychological Science, University of Bristol, Bristol, UK.
⁶ Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
⁷ Smith School of Enterprise and the Environment, University of Oxford, Oxford, UK.
⁸ Department of Psychology, Life and Health Sciences, Aston University, Birmingham, UK.
⁹ Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK.
¹⁰ Nuffield Department of Primary Care, University of Oxford, Oxford, UK.
¹¹ Nuffield Department of Medicine, The Jenner Institute, University of Oxford, Oxford, UK.

PMID: 33305716
PMCID: PMC7804077
DOI: 10.1017/S0033291720005188

COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II

Daniel Freeman et al. Psychol Med. 2022 Oct.

. 2022 Oct;52(14):3127-3141.

doi: 10.1017/S0033291720005188. Epub 2020 Dec 11.

Authors

Affiliations

¹ Department of Psychiatry, University of Oxford, Oxford, UK.
² Oxford Health NHS Foundation Trust, Oxford, UK.
³ The Psychometrics Centre, University of Cambridge, Cambridge, UK.
⁴ Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK.
⁵ School of Psychological Science, University of Bristol, Bristol, UK.
⁶ Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
⁷ Smith School of Enterprise and the Environment, University of Oxford, Oxford, UK.
⁸ Department of Psychology, Life and Health Sciences, Aston University, Birmingham, UK.
⁹ Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK.
¹⁰ Nuffield Department of Primary Care, University of Oxford, Oxford, UK.
¹¹ Nuffield Department of Medicine, The Jenner Institute, University of Oxford, Oxford, UK.

PMID: 33305716
PMCID: PMC7804077
DOI: 10.1017/S0033291720005188

Abstract

Background: Our aim was to estimate provisional willingness to receive a coronavirus 2019 (COVID-19) vaccine, identify predictive socio-demographic factors, and, principally, determine potential causes in order to guide information provision.

Methods: A non-probability online survey was conducted (24th September-17th October 2020) with 5,114 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. The Oxford COVID-19 vaccine hesitancy scale assessed intent to take an approved vaccine. Structural equation modelling estimated explanatory factor relationships.

Results: 71.7% (n=3,667) were willing to be vaccinated, 16.6% (n=849) were very unsure, and 11.7% (n=598) were strongly hesitant. An excellent model fit (RMSEA=0.05/CFI=0.97/TLI=0.97), explaining 86% of variance in hesitancy, was provided by beliefs about the collective importance, efficacy, side-effects, and speed of development of a COVID-19 vaccine. A second model, with reasonable fit (RMSEA=0.03/CFI=0.93/TLI=0.92), explaining 32% of variance, highlighted two higher-order explanatory factors: 'excessive mistrust' (r=0.51), including conspiracy beliefs, negative views of doctors, and need for chaos, and 'positive healthcare experiences' (r=-0.48), including supportive doctor interactions and good NHS care. Hesitancy was associated with younger age, female gender, lower income, and ethnicity, but socio-demographic information explained little variance (9.8%). Hesitancy was associated with lower adherence to social distancing guidelines.

Conclusions: COVID-19 vaccine hesitancy is relatively evenly spread across the population. Willingness to take a vaccine is closely bound to recognition of the collective importance. Vaccine public information that highlights prosocial benefits may be especially effective. Factors such as conspiracy beliefs that foster mistrust and erode social cohesion will lower vaccine up-take.

Keywords: Covid-19 vaccine hesitancy; conspiracy beliefs; mistrust; vaccine confidence.

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Figures

**Fig. 1.**
Structural equation model 1: Beliefs about a COVID-19 vaccine and vaccine hesitancy. *Note*: *p < 0.01, **p < 0.01, ***p < 0.001. IMP = collective importance; SPD = speed of development; WRK = vaccine will be effective; S.EF = side effects; VAC.HES = vaccine hesitancy.

**Fig. 2.**
Structural equation model 2 (final): Mistrust. *Note:* *p < 0.01, **p < 0.01, ***p < 0.001. CVK = Knowledge about childhood vaccinations; GEN.K = general knowledge about vaccines; DIS.DOC = interpersonal disrespect from doctors; NEG.VD = negative views of vaccine developers; NHS.NEG= negative experiences of NHS care; CHAOS = need for chaos; C19.CON = coronavirus general conspiracy beliefs; VAC.CON = vaccination conspiracy beliefs; RES.DOC = respect from doctors; POS.DOC = positive attitudes to doctors; NHS.POS = positive NHS experiences; POS.MED = positive attitudes to medication; GP.POS = positive GP experiences; MISTRUST = higher order excessive mistrust factor; +VE HC = higher-order positive healthcare experiences factor; SLF.COM = subjective sense of social status in community; SLF.UK = subjective sense of social status in UK; VAC.HES = vaccine hesitancy.

**Fig. 3.**
Oxford Covid-19 vaccine hesitancy scale.

See this image and copyright information in PMC

References

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COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II

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COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II

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