Factors Associated with COVID-19 Vaccine Hesitancy

Abstract

It is critical to develop tailored strategies to increase acceptability of the COVID-19 vaccine and decrease hesitancy. Hence, this study aims to assess and identify factors associated with COVID-19 vaccine hesitancy in Portugal. We used data from a community-based survey, "COVID-19 Barometer: Social Opinion", which includes data regarding intention to take COVID-19 vaccines, health status, and risk perception in Portugal from September 2020 to January 2021. We used multinomial regression to identify factors associated with intention to delay or refuse to take COVID-19 vaccines. COVID-19 vaccine hesitancy in Portugal was high: 56% would wait and 9% refuse. Several factors were associated with both refusal and delay: being younger, loss of income during the pandemic, no intention of taking the flu vaccine, low confidence in the COVID-19 vaccine and the health service response during the pandemic, worse perception of government measures, perception of the information provided as inconsistent and contradictory, and answering the questionnaire before the release of information regarding the safety and efficacy of COVID-19 vaccines. It is crucial to build confidence in the COVID-19 vaccine as its perceived safety and efficacy were strongly associated with intention to take the vaccine. Governments and health authorities should improve communication and increase trust.

Keywords: COVID-19; vaccination; vaccine hesitancy.

Figure 1

Forest plot of vaccine hesitancy for contextual influences. Adjusted odds-ratio (adjusted for gender, age, education, and period of questionnaire) and the respective 95% confidence intervals are denoted by black dots and black lines, respectively. (A) Individuals who would wait to take the vaccine compared to individuals who would take the vaccine; (B) individuals who would not take the vaccine compared to individuals who would take the vaccine; (C) individuals who would not take the vaccine compared to individuals who would wait to take the vaccine.

Figure 2

Forest plot of vaccine hesitancy for individual and group influences. Adjusted odds-ratio (adjusted for gender, age, education, and period of questionnaire) and the respective 95% confidence intervals are denoted by black dots and black lines, respectively. Forest plot confidence intervals and estimates were cut off at 10. (A) Individuals who would wait to take the vaccine compared to individuals who would take the vaccine; (B) individuals who would not take the vaccine compared to individuals who would take the vaccine; (C) individuals who would not take the vaccine compared to individuals who would wait to take the vaccine.

Figure 3

Forest plot of vaccine hesitancy for COVID-19-specific factors. Adjusted odds-ratio (adjusted for gender, age, education, and period of questionnaire) and the respective 95% confidence intervals are denoted by black dots and black lines, respectively. Forest plot confidence intervals and estimates were cut off at 10. (A) Individuals who would wait to take the vaccine compared to individuals who would take the vaccine; (B) individuals who would not take the vaccine compared to individuals who would take the vaccine; (C) individuals who would not take the vaccine compared to individuals who would wait to take the vaccine.