Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 29:10:873098.
doi: 10.3389/fpubh.2022.873098. eCollection 2022.

COVID-19 Vaccine Hesitancy in Italy: Predictors of Acceptance, Fence Sitting and Refusal of the COVID-19 Vaccination

Cristina Zarbo  1 , Valentina Candini  1 , Clarissa Ferrari  2 , Miriam d'Addazio  1 , Gemma Calamandrei  3 , Fabrizio Starace  4 , Marta Caserotti  5 , Teresa Gavaruzzi  5 , Lorella Lotto  5 , Alessandra Tasso  6 , Manuel Zamparini  1 , Giovanni de Girolamo  1
Affiliations

COVID-19 Vaccine Hesitancy in Italy: Predictors of Acceptance, Fence Sitting and Refusal of the COVID-19 Vaccination

Cristina Zarbo et al. Front Public Health. .

Abstract

Background: The hesitancy in taking the COVID-19 vaccine is a global challenge. The need to identify predictors of COVID-19 vaccine reluctance is critical. Our objectives were to evaluate sociodemographic, psychological, and behavioral factors, as well as attitudes and beliefs that influence COVID-19 vaccination hesitancy in the general population of Italy.

Methods: A total of 2,015 people were assessed in two waves (March, April and May, 2021). Participants were divided into three groups: (1) individuals who accepted the vaccination ("accepters"); (2) individuals who refused the vaccination ("rejecters"); and (3) individuals who were uncertain about their attitudes toward the vaccination ("fence sitters"). Group comparisons were performed using ANOVA, the Kruskal-Wallis test and chi-square tests. The strength of the association between the groups and the participants' characteristics was analyzed using a series of multinomial logistic regression models with bootstrap internal validation (one for each factor).

Results: The "fence sitters" group, when compared to the others, included individuals of younger age, lower educational level, and worsening economic situation in the previous 3 months. After controlling for sociodemographic factors, the following features emerged as the main risk factors for being "fence sitters" (compared with vaccine "accepters"): reporting lower levels of protective behaviors, trust in institutions and informational sources, frequency of use of informational sources, agreement with restrictions and higher conspirative mentality. Higher levels of COVID-19 perceived risk, trust in institutions and informational sources, frequency of use of informational sources, agreement with restrictions and protective behaviors were associated with a higher likelihood of becoming "fence sitters" rather than vaccine "rejecters."

Conclusions: The "fence sitters" profile revealed by this study is intriguing and should be the focus of public programmes aimed at improving adherence to the COVID-19 vaccination campaign.

Keywords: conspiracy; perceived risk; protective behaviors; restrictions; trust; vaccination.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow-Chart of groups' stratification.
Figure 2
Figure 2
Average scores of factors in the three groups (Accepters, Fence Sitters, and Rejecters)*. *To facilitate visualization and interpretation, Wellbeing and Conspiracy scores were standardized. Error bars represent 95% confidence intervals.
Figure 3
Figure 3
Graphical representation of ORs (and 95%CI) of the multiple logistic regression models.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Worldometers . Coronavirus Update Last updated: September 30, 2021. Available online at: https://www.worldometers.info/coronavirus/ (accessed February 9, 2022).
    1. Xiong J, Lipsitz O, Nasri F, Lui LMW, Gill H, Phan L, et al. . Impact of COVID-19 pandemic on mental health in the general population: a systematic review. J Affect Disord. (2020) 277:55–64. 10.1016/j.jad.2020.08.001 - DOI - PMC - PubMed
    1. El Keshky MES, Basyouni SS, Al Sabban AM. Getting Through COVID-19: The Pandemic's Impact on the Psychology of Sustainability, Quality of Life, and the Global Economy - a systematic review. Front Psychol. (2020) 11:585897. 10.3389/fpsyg.2020.585897 - DOI - PMC - PubMed
    1. Robinson E, Jones A, Lesser I, Daly M. International estimates of intended uptake and refusal of COVID-19 vaccines: a rapid systematic review and meta-analysis of large nationally representative samples. Vaccine. (2021) 39:2024–34. 10.1016/j.vaccine.2021.02.005 - DOI - PMC - PubMed
    1. World Health Organization . Vaccination and Trust: How Concerns Arise and the Role of Communication in Mitigating Crises (2017).

Publication types

Substances