Determinants and Trends of COVID-19 Vaccine Hesitancy and Vaccine Uptake in a National Cohort of US Adults: A Longitudinal Study

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Abstract

We estimated the trends and correlates of vaccine hesitancy and its association with subsequent vaccine uptake among 5,458 adults in the United States. Participants belonged to the Communities, Households, and SARS-CoV-2 Epidemiology COVID (CHASING COVID) Cohort, a national longitudinal study. Trends and correlates of vaccine hesitancy were examined longitudinally in 8 interview rounds from October 2020 to July 2021. We also estimated the association between willingness to vaccinate and subsequent vaccine uptake through July 2021. Vaccine delay and refusal decreased from 51% and 8% in October 2020 to 8% and 6% in July 2021, respectively. Compared with non-Hispanic (NH) White participants, NH Black and Hispanic participants had higher adjusted odds ratios (aOR) for both vaccine delay (for NH Black, aOR = 2.0 (95% confidence interval (CI): 1.5, 2.7), and for Hispanic, 1.3 (95% CI: 1.0, 1.7)) and vaccine refusal (for NH Black, aOR = 2.5 (95% CI: 1.8, 3.6), and for Hispanic, 1.4 (95% CI: 1.0, 2.0)) in June 2021. COVID-19 vaccine hesitancy, compared with vaccine-willingness, was associated with lower odds of subsequent vaccine uptake (for vaccine delayers, aOR = 0.15, 95% CI: 0.13, 0.18; for vaccine refusers, aOR = 0.02; 95% CI: 0.01, 0.03 ), adjusted for sociodemographic factors and COVID-19 history. Vaccination awareness and distribution efforts should focus on vaccine delayers.

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  1. SciScore for 10.1101/2021.05.12.21257116: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The study was approved by the Institutional Review Board at the City University of New York (CUNY)
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    15 Ascertainment of other exposures at V0-V5: To assess the effect of prior exposure to COVID-19 on willingness to vaccinate, we defined COVID-19 history as a dichotomous variable using three inputs: self-reported COVID-19 PCR diagnosis or seropositivity (Y/N between V0 and V5), self-identifying as a COVID-19 long hauler (Y/N between V4 and V5), or being seropositive for COVID-19 antibodies in tests performed for as part of our study between May and October.
    V5
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study also has limitations. Participants self-reported vaccination status as well as exposures, so the study is subject to misclassification and reporting bias. Because enrollment was done online, those without smartphones, computers, or a stable internet connection were less likely to be included. Sample sizes for the vaccine eligible subgroups were small. While we adjusted all models for demographic factors, there is a possibility of unmeasured/uncontrolled confounding. About 10% of our participants were LTFU between V3 and V5. While LTFU was not associated with the outcome, it was associated with age, sex, college education, serostatus, and COVID history, which could potentially bias our results. In summary, even though coronavirus vaccine confidence has increased over time in our cohort overall, more than a third reported an intention to delay receiving the vaccine when it becomes available to them. Racial/ethnic gaps in vaccine hesitancy widened, despite overall decrease in hesitancy. To address these disparities, health education and awareness efforts should be better focused on vaccine hesitant low income and minority individuals to address vaccine-related concerns, and vaccine availability should be prioritized in communities where they reside to help ensure more equitable vaccine uptake. To mitigate the long-lasting impact of COVID-19 as a public health threat, it is important that no groups are left behind by vaccination initiatives.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

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