Do people reduce compliance with COVID-19 guidelines following vaccination? A longitudinal analysis of matched UK adults

  1. Liam Wright
  2. Andrew Steptoe
  3. Hei Wan Mak
  4. Daisy Fancourt

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Abstract

COVID-19 vaccines do not confer immediate immunity and vaccinated individuals may still be at risk of transmitting the virus. Governments have not exempted vaccinated individuals from behavioural measures to reduce the spread of COVID-19, such as practising social distancing. However, vaccinated individuals may have reduced compliance with these measures, given lower perceived risks.

Methods

We used monthly panel data from October 2020 to March 2021 in the UK COVID-19 Social Study to assess changes in compliance following vaccination. Compliance was measured with two items on compliance with guidelines in general and compliance with social distancing. We used matching to create comparable groups of individuals by month of vaccination (January, February or not vaccinated by February) and fixed effects regression to estimate changes in compliance over the study period.

Results

Compliance increased between October 2020 and March 2021, regardless of vaccination status or month of vaccination. There was no clear evidence that vaccinated individuals decreased compliance relative to those who were not yet vaccinated.

Conclusion

There was little evidence that sample members vaccinated in January or February reduced compliance after receiving vaccination for COVID-19. Continued monitoring is required as younger individuals receive the vaccine, lockdown restrictions are lifted and individuals receive second doses of the vaccine.

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  1. Version published to 10.1136/jech-2021-217179
  2. Version published to 10.1101/2021.04.13.21255328v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.04.13.21255328: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the UCL Research Ethics Committee [12467/005] and all participants gave informed consent.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your code and data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study had a number of other limitations. First, we used two self-report measures of compliance which may be subject to biases such as recall bias or social desirability bias. Being vaccinated could be considered a form of compliance so our general compliance measure may not have been specific enough to pick up on differences in specific compliance behaviour. Second, our sample was not representative and, moreover, comprised of individuals who comply more than on average (Wright & Fancourt, 2020). This may have biased associations toward the null. Third, the existence of the vaccine program may have induced behaviour changes in the non-vaccinated group, if these individuals were less concerned about transmitting the virus (Trogen & Caplan, 2021). Fourth, compliance was changing over time, even in the absence of vaccination. Previous research has shown that the strength of several factors in predicting compliance differs over pandemics (van der Weerd et al., 2011; Wright & Fancourt, 2020). Our matched samples may therefore not provide an appropriate counterfactual and results may be biased by unobserved confounding. Nevertheless, by exploiting the longitudinal nature of our sample, we were able to use compliance in months prior to vaccination as a placebo test. No statistically significant differences were found in these months, which may add confidence to our results. Our results suggest that there is no immediate cause for concern of widespread non-compliance among vacci...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    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

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.04.13.21255328v1 on medRxiv