Factors indicating intention to vaccinate with a COVID-19 vaccine among older U.S. adults
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Abstract
The success of vaccination efforts to curb the COVID-19 pandemic will require broad public uptake of immunization and highlights the importance of understanding factors associated with willingness to receive a vaccine.
Methods
U.S. adults aged 65 and older enrolled in the Heartline TM clinical study were invited to complete a COVID-19 vaccine assessment through the Heartline TM mobile application between November 6–20, 2020. Factors associated with willingness to receive a COVID-19 vaccine were evaluated using an ordered logistic regression as well as a Random Forest classification algorithm.
Results
Among 9,106 study participants, 81.3% (n = 7402) responded and had available demographic data. The majority (91.3%) reported a willingness to be vaccinated. Factors most strongly associated with vaccine willingness were beliefs about the safety and efficacy of COVID-19 vaccines and vaccines in general. Women and Black or African American respondents reported lower willingness to vaccinate. Among those less willing to get vaccinated, 66.2% said that they would talk with their health provider before making a decision. During the study, positive results from the first COVID-19 vaccine outcome study were released; vaccine willingness increased after this report.
Conclusions
Even among older adults at high-risk for COVID-19 complications who are participating in a longitudinal clinical study, 1 in 11 reported lack of willingness to receive COVID-19 vaccine in November 2020. Variability in vaccine willingness by gender, race, education, and income suggests the potential for uneven vaccine uptake. Education by health providers directed toward assuaging concerns about vaccine safety and efficacy can help improve vaccine acceptance among those less willing.
Trial registration
Clinicaltrials.gov NCT04276441 .
Article activity feed
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SciScore for 10.1101/2021.01.10.20248831: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: The study protocol was approved by an IRB and all participants provide informed consent to analyze de-identified data, including surveys delivered through the Heartline™ app. Randomization The algorithm was trained using a dataset that was randomly split by stratum (either not willing or willing to be vaccinated), into a 2/3 training set (n=4935 with 91.3% willing to vaccinate) and a 1/3 different hold-out set to verify model performance (n=2467 with 91.3% willing to vaccinate). Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing …
SciScore for 10.1101/2021.01.10.20248831: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: The study protocol was approved by an IRB and all participants provide informed consent to analyze de-identified data, including surveys delivered through the Heartline™ app. Randomization The algorithm was trained using a dataset that was randomly split by stratum (either not willing or willing to be vaccinated), into a 2/3 training set (n=4935 with 91.3% willing to vaccinate) and a 1/3 different hold-out set to verify model performance (n=2467 with 91.3% willing to vaccinate). Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:These findings should be interpreted in the context of several potential limitations. There is an inherent bias that comes with studying populations who have chosen to enroll into a clinical study. Heartline™ participants have less representation of Black or African American and Asians compared to the general U.S. 65+ population and skew higher in education and income, which may have led to an overestimate of vaccine acceptance compared with the general population. Nevertheless, finding that 1 in 11 patients in this selected group are unwilling to be vaccinated may portend even lower rates in a broader population. Next, our analysis of the impact of vaccine-related news occurred during a time period when infections continued to rise; whether changes in attitudes were due to vaccine news or due to other factors is unclear. Finally, we asked about vaccine willingness, which may not directly translate into behavior, particularly if attitudes shift over time. We also highlight several strengths, including a high response rate (>80%), a short period of data collection (2 weeks), and the ability to deploy the survey rapidly in response to the pandemic. In a 65 and older U.S. population, most are willing to be vaccinated, with Black or African American participants and females significantly less willing. The majority would be willing to discuss their concerns with their providers, who could leverage the beliefs identified here in tailoring a message to encourage vaccination. Develop...
Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title NCT04276441 Recruiting A Study to Investigate if Early Atrial Fibrillation (AF) Dia… 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.
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