April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: “Getting a vaccine that came in a hurry”: A Mixed Methods Examination of COVID-19 Vaccine Beliefs and Hesitancy
Introduction Although COVID-19 vaccines are safe and effective – and widely available in the U.S. – hesitation persists (KFF, October 2021). Studies of COVID-19 vaccine hesitancy have found intriguing effects (e.g., of online misinformation, Loomba et al., 2021; optimal vaccine characteristics, Matta, 2020; ideal message framing, Palm et al., 2021) and identified potential targets for persuasion campaigns (e.g., Hornik et al., 2020). But what specific beliefs separate those who want to get a vaccine from those who do not, and how might we close this gap? Methods We respond to these questions using an exploratory sequential mixed methods approach. We recruited 30 U.S. adults in March 2021 to complete an online, open-ended elicitation survey on COVID-19 vaccination perceptions via Amazon MTurk (see Fishbein & Ajzen, 2010). We used an inductive, grounded theory approach to analyze qualitative responses; themes were used to develop a close-ended survey instrument distributed in April and June 2021 to a nationally representative sample of U.S. adults (n=750; SSRS Opinion Panel). We used t-tests (comparing beliefs among those who were vaccine confident vs. hesitant) and hierarchical logistic regression models to analyze quantitative responses; all analyses were weighted to match the U.S. population on key demographic characteristics. Results In the qualitative sample, nearly every respondent referenced three advantages of vaccination: protecting oneself from illness or infection, protecting others, and resuming normal life. Side effects were the main disadvantage, either short-term (fever, sore arm) or long-term. Those who were vaccine confident (73%) vs. hesitant (27%) generated similar perceptions; however, a few patterns emerged. Severe side effects were frequently cited for those who were vaccine hesitant; these individuals also expressed fears about corruption, suppressed or insufficient information, and the speed of development (“a vaccine that came in a hurry”), reflecting mistrust. We developed 18 close-ended survey items from these themes; of these, only two beliefs were not significantly different when comparing those who were vaccine confident (64%) vs. hesitant (36%) in the quantitative sample. We also conducted hierarchical logistic regression models predicting vaccine confidence, sequentially adding categories of beliefs and noting changes in pseudo R2. Serious side effects (10%) and mistrust in the vaccine location / distributor (11%) accounted for the most variance in vaccine confidence; protecting oneself; protecting others; and evidence of safety & efficacy also explained variance, although not as much (4%, 6%, and 2%, respectively). Discussion This approach – which blended rich, qualitative responses with nationally representative quantitative survey data – aimed to identify and better understand the antecedents of COVID-19 vaccine hesitancy. Several themes emerged from the qualitative analysis, including the importance of altruism (“helping others feel safe”); self-protection (“immunity against COVID-19”); and side effects (“could die from allergic reactions to the vaccine”). Many of these themes were reflected in the pattern of quantitative survey responses; in particular, severe side effects and mistrust are major deterrents to COVID-19 vaccination confidence. These results suggest that future communication campaigns should focus on building trust and assuaging fears about severe or long-term side effects, especially as vaccine confidence stalls.