Acceptance of and preference for COVID-19 vaccination in healthcare workers: a comparative analysis and discrete choice experiment

  1. Chuanxi Fu
  2. Zheng wei
  3. Fengchang Zhu
  4. Sen Pei
  5. Shunping Li
  6. Liuren Zhang
  7. Xiaohui Sun
  8. Yue Wu
  9. Ping Liu
  10. Mark Jit

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Abstract

Background

A major obstacle to successful coronavirus disease (COVID-19) vaccine rollout is vaccine hesitancy. Acceptance of and preferences for COVID-19 vaccination among healthcare workers (HCWs) is critical, because they are a key target group for vaccination programs, and they are also highly influential to vaccine uptake in the wider population. This study sought to comparatively determine the acceptance of and preference for COVID-19 vaccination among HCWs and the general population.

Methods

An Internet-based, region-stratified discrete-choice experiment was conducted among 352 HCWs and 189 general population respondents recruited in March 2020 from 26 Chinese provinces. We accessed knowledge of disease, attitude towards and acceptance of COVID-19 vaccination. Several attributes (related to COVID-19 disease, COVID-19 vaccination and one social acceptance) were identified as key determinants of vaccine acceptance.

Results

HCWs had a more in-depth understanding of COVID-19 and showed a higher willingness to accept COVID-19 vaccines with lower effectiveness and/or more severe adverse effects compared to the general population. 76.4% of HCWs (vs 72.5% of the general population) expressed willingness to receive vaccination (χ 2 =2.904, p =0.234). High levels of willingness to accept influenza (65.3%) and pneumococcal (55.7%) vaccination were also seen in HCWs. Future COVID-19 disease incidence (OR: 4.367, 95% CI 3.721–5.126), decisions about vaccination among social contacts of respondents (OR 0.398, 95% CI 0.339–0.467), and infection risk >30% (OR 2.706, 95% CI 1.776–2.425) significantly increased the probability of vaccination acceptance in HCWs.

Conclusion

Multi-component interventions to address the key determinants of hesitancy in both HCWs and in the general population should be considered for COVID-19 vaccination programs.

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  1. Version published to 10.1101/2020.04.09.20060103v2 on medRxiv
  2. ScreenIT

    SciScore for 10.1101/2020.04.09.20060103: (What is this?)

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

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    A fractional factorial design based on orthogonal arrays (ORTHOPLAN procedure, IBM SPSS Statistics) was used to select 16 hypothetical profiles derived from 648 (3×2×3×2×2×3×3) candidate attribute profiles.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    Descriptive analysis was performed using SPSS Version 25.0 (IBM Corporation, New York, United States) and statistics DCE process was carried out in STATA 16.
    STATA
    suggested: (Stata, RRID:SCR_012763)

    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:
    There are several limitations in the present study. First, subjects were recruited and surveyed online instead of face-to-face interview, which may lead to potential bias for the DCE study. Second, we do not distinguish doctors and nurses in hospitals, health providers in the community or those in the center for disease control and preventions, who may have different levels of knowledge and choice decision. Factors contributed to a vaccination decision include personal risk perception, vaccination attitude or motivation, information sources, access and demographic variables, as well as social influences and practical factors(33). For the future COVID-19 vaccination, an efficient and flexible vaccination system nationwide to ensure fair and affordable services is necessary. In this system, vaccine demand and hesitancy in various populations should be addressed. Multi-component interventions should be taken into consideration. Education in HCWs should be taken as a priority so that further benefit of their recommendation to the public could be anticipated.

    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.

    About SciScore

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  3. Version published to 10.1101/2020.04.09.20060103v1 on medRxiv