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COVID-19 Vaccine Hesitancy in the United States: A Systematic Review.

ABSTRACT: Vaccine hesitancy in the US throughout the pandemic has revealed inconsistent results. This systematic review has compared COVID-19 vaccine uptake across US and investigated predictors of vaccine hesitancy and acceptance across different groups. A search of PUBMED database was conducted till 17th July, 2021. Articles that met the inclusion criteria were screened and 65 studies were selected for a quantitative analysis. The overall vaccine acceptance rate ranged from 12 to 91.4%, the willingness of studies using the 10-point scale ranged from 3.58 to 5.12. Increased unwillingness toward COVID-19 vaccine and Black/African Americans were found to be correlated. Sex, race, age, education level, and income status were identified as determining factors of having a low or high COVID-19 vaccine uptake. A change in vaccine acceptance in the US population was observed in two studies, an increase of 10.8 and 7.4%, respectively, between 2020 and 2021. Our results confirm that hesitancy exists in the US population, highest in Black/African Americans, pregnant or breastfeeding women, and low in the male sex. It is imperative for regulatory bodies to acknowledge these statistics and consequently, exert efforts to mitigate the burden of unvaccinated individuals and revise vaccine delivery plans, according to different vulnerable subgroups, across the country.

SUBMITTER: Yasmin F

PROVIDER: S-EPMC8650625 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectivesTo investigate the differences in vaccine hesitancy and preference of the currently available COVID-19 vaccines between two countries, namely, China and the United States (U.S.).MethodA cross-national survey was conducted in both China and the United States, and discrete choice experiments, as well as Likert scales, were utilized to assess vaccine preference and the underlying factors contributing to vaccination acceptance. Propensity score matching (PSM) was performed to enable a direct comparison between the two countries.ResultsA total of 9077 (5375 and 3702 from China and the United States, respectively) respondents completed the survey. After propensity score matching, over 82.0% of respondents from China positively accepted the COVID-19 vaccination, while 72.2% of respondents from the United States positively accepted it. Specifically, only 31.9% of Chinese respondents were recommended by a doctor to have COVID-19 vaccination, while more than half of the U.S. respondents were recommended by a doctor (50.2%), local health board (59.4%), or friends and families (64.8%). The discrete choice experiments revealed that respondents from the United States attached the greatest importance to the efficacy of COVID-19 vaccines (44.41%), followed by the cost of vaccination (29.57%), whereas those from China held a different viewpoint, that the cost of vaccination covered the largest proportion in their trade-off (30.66%), and efficacy ranked as the second most important attribute (26.34%). Additionally, respondents from China tended to be much more concerned about the adverse effect of vaccination (19.68% vs. 6.12%) and have a lower perceived severity of being infected with COVID-19.ConclusionAlthough the overall acceptance and hesitancy of COVID-19 vaccination in both countries are high, underpinned distinctions between these countries were observed. Owing to the differences in COVID-19 incidence rates, cultural backgrounds, and the availability of specific COVID-19 vaccines in the two countries, vaccine rollout strategies should be nation-dependent.

Project description:The aim of this study is to correlate lifestyle characteristics to COVID-19 vaccination rates at the U.S. County level and provide where and when COVID-19 vaccination impacted different households. We grouped counties by their dominant LifeMode, and the mean vaccination rates per LifeMode are calculated. A 95% confidence interval for both the mean and median vaccination rate for each LifeMode is generated. The limits of this interval were compared to the nationwide statistics to determine whether each LifeMode's vaccine uptake differs significantly from the nationwide average. We used Environmental Systems Research Institute Inc. (ESRI) Tapestry LifeModes data that are collected at the U.S. household level through geodemographic segmentation typically used for marketing purposes. High risk Lifestyle segments and their locations are clearly the areas in the U.S. where the public might benefit from a COVID-19 vaccine. We then used logistic regression analysis to predict vaccination rates using ESRI's tapestry segmentation and other demographic variables. Our findings demonstrate that vaccine uptake appears to be highest in the urban corridors of the Northeast and the West Coast and in the retirement communities of Arizona and Florida and lowest in the rural areas of the Great Plains and Southeast. Looking closely at other parts of the West such as the Dakotas and Montana, counties that contain Native American reservations have higher vaccination rates. Racial/ethnic minorities also adopt the vaccine at higher rates. The most effective predictor of vaccination hesitancy was Republican voting habits, with Republican counties less likely to take the vaccine. The other predictors in order of importance were college education, minority race/ethnicity, median income, and median age. Our approach correlating lifestyle characteristics to COVID-19 vaccination rate at the U.S. County level provided unique insights into where and when COVID-19 vaccination impacted different households. The results suggest that prevention and control policies can be implemented to those specific households.

Project description:AimAlthough multiple COVID-19 vaccines are approved for global use, vaccine hesitancy poses a substantial risk for global health. Therefore, the aim of this umbrella review is to identify those factors that influence COVID-19 vaccination hesitancy in the general population. This is necessary to improve the effectiveness of future vaccination programmes.MethodsPubMed, Embase, Scopus, PsycInfo, the Cochrane Database of Systematic Reviews, Epistemonikos, and PROSPERO (International Prospective Register of Systematic Reviews) were searched on December 21, 2021. This review included reviews which investigated factors of intention, willingness, or hesitancy with regard to the COVID-19 vaccination in adult populations, with no restrictions on setting. Content-based structure was used to synthesise the extracted data. The findings were presented based on the Strategic Advisory Group of Experts (SAGE) Working Group Model for vaccine hesitancy.ResultsA total of 3,392 studies were identified, of which 31 met the inclusion criteria. The most frequently documented factors associated with COVID-19 vaccine hesitancy included contextual factors, such as sex, age, and social inequalities; individual and group factors, such as trust in the healthcare system, public health authorities, and governments, and history of vaccination; vaccine-specific factors, such as concern for vaccine safety, perceived vaccine barriers, perceived effectiveness of vaccines, and concern about the rapid development of the vaccine; and disease-specific factors, such as fear of being infected with COVID-19, perceived severity of COVID-19, and knowledge of COVID-19.ConclusionThere are multiple factors associated with COVID-19 vaccine hesitancy. Our findings lay the foundation to further understand COVID-19 vaccination uptake and provide possible targets for intervention programmes. However, there are gaps in research concerning certain populations, including vaccination in people with mental disorders.Supplementary informationThe online version contains supplementary material available at 10.1007/s10389-022-01753-9.

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COVID-19 Vaccine Hesitancy in the United States: A Systematic Review.

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