COVID-19 vaccine hesitancy in the UK: a longitudinal household cross-sectional study

  1. Kausik Chaudhuri
  2. Anindita Chakrabarti
  3. Joht Singh Chandan
  4. Siddhartha Bandyopadhyay

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Abstract

Background

The approved COVID-19 vaccines have shown great promise in reducing disease transmission and severity of outcomes. However, the success of the COVID-19 vaccine rollout is dependent on public acceptance and willingness to be vaccinated. In this study, we aim to examine how the attitude towards public sector officials and the government impact vaccine willingness. The secondary aim is to understand the impact of ethnicity on vaccine-willingness after we explicitly account for trust in public institutions.

Methods

This cross-sectional study used data from a UK population based longitudinal household survey (Understanding Society COVID-19 study, Understanding Society: the UK Household Longitudinal Study) between April 2020-January 2021. Data from 22,421 participants in Waves 6 and 7 of the study were included after excluding missing data. Demographic details in addition to previous survey responses relating to public sector/governmental trust were included as covariates in the main analysis. A logit model was produced to describe the association between public sector/governmental mistrust and the willingness for vaccination with interaction terms included to account for ethnicity/socio-economic status.

Results

In support of existing literature, we identified those from BAME groups were more likely to be unwilling to take the COVID-19 vaccine. We found that positive opinions towards public sector officials (OR 2.680: 95% CI 1.888 – 3.805) and the UK government (OR 3.400; 95% CI 2.454—4.712) led to substantive increase in vaccine willingness. Most notably we identified this effect to vary across ethnicity and socio-economic status with those from South Asian background (OR 4.513; 95% CI 1.012—20.123) and possessing a negative attitude towards public officials and the government being the most unwilling to be vaccinated.

Conclusions

These findings suggests that trust in public sector officials play a key factor in the low vaccination rates particularly seen in at-risk groups. Given the additional morbidity/mortality risk posed by COVID-19 to those from lower socio-economic or ethnic minority backgrounds, there needs to be urgent public health action to review how to tailor health promotion advice given to these groups and examine methods to improve trust in public sector officials and the government.

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  1. Version published to 10.1186/s12889-021-12472-3
  2. ScreenIT

    SciScore for 10.1101/2021.07.09.21260206: (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

    No key resources detected.

    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:
    One of the limitations of our study is the use of survey data conducted until January 2021 as people’s vaccination willingness might have changed with arrival of information regarding side-effects of vaccine especially in case AstraZeneca vaccine. Our data reveals that three responses: “I am worried about side effects; I am worried about unknown future effects and I don’t trust vaccines” were the main reasons behind vaccine unwillingness (around 60%). Individuals when being asked for vaccination willingness, the survey did not ask about country of the vaccine manufacturer, type of vaccine individuals are likely to be administered, duration of vaccine immunity and place of vaccine administration. During the two rounds of survey, the UK was going through the second wave of Covid-19 and willingness to take vaccine might have changed in response to increasing numbers of infections/deaths. Also, the respondents may not have been aware of vaccine efficacy outside clinical trials especially in context of hospital admissions/severe illness and this could impact COVID-19 vaccine willingness. In order to begin the recovery phase of the COVID-19 pandemic, there is an urgency to implement strong and successful global vaccine programmes. However, vaccine hesitancy may derail any intention to do so. Our findings have confirmed previous findings suggesting those from lower socio-economic and minority ethnic communities have the highest rates of vaccine hesitancy. Upon further examination it...

    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.

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  3. Version published to 10.1101/2021.07.09.21260206v1 on medRxiv