Time trends, factors associated with, and reasons for COVID-19 vaccine hesitancy: A massive online survey of US adults from January-May 2021
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
Abstract
COVID-19 vaccine hesitancy has become a leading barrier to increasing the US vaccination rate.
Objective
To evaluate time trends in COVID-19 vaccine intent during the US vaccine rollout, and identify key factors related to and self-reported reasons for COVID-19 vaccine hesitancy in May 2021.
Design, participants and setting
A COVID-19 survey was offered to US adult Facebook users in several languages yielding 5,088,772 qualifying responses from January 6 to May 31, 2021. Data was aggregated by month. Survey weights matched the sample to the age, gender, and state profile of the US population.
Exposure
Demographics, geographic factors, political/COVID-19 environment, health status, beliefs, and behaviors.
Main outcome measures
“If a vaccine to prevent COVID-19 were offered to you today, would you choose to get vaccinated.” Hesitant was defined as responding probably or definitely would not choose to get vaccinated (versus probably or definitely would, or already vaccinated).
Results
COVID-19 vaccine hesitancy decreased by one-third from 25.4% (95%CI, 25.3, 25.5) in January to 16.6% (95% CI, 16.4, 16.7) in May, with relatively large decreases among participants with Black, Pacific Islander or Hispanic race/ethnicity and ≤high school education. Independent risk factors for vaccine hesitancy in May (N = 525,644) included younger age, non-Asian race, < 4 year college degree, living in a more rural county, living in a county with higher Trump vote share in the 2020 election, lack of worry about COVID-19, working outside the home, never intentionally avoiding contact with others, and no past-year flu vaccine. Differences in hesitancy by race/ethnicity varied by age (e.g., Black adults more hesitant than White adults <35 years old, but less hesitant among adults ≥45 years old). Differences in hesitancy by age varied by race/ethnicity. Almost half of vaccine hesitant respondents reported fear of side effects (49.2% [95%CI, 48.7, 49.7]) and not trusting the COVID-19 vaccine (48.4% [95%CI, 48.0, 48.9]); over one-third reported not trusting the government, not needing the vaccine, and waiting to see if safe. Reasons differed by degree of vaccine intent and by race/ethnicity.
Conclusion
COVID-19 vaccine hesitancy varied by demographics, geography, beliefs, and behaviors, indicating a need for a range of messaging and policy options to target high-hesitancy groups.
Article activity feed
-
-
-
-
SciScore for 10.1101/2021.07.20.21260795: (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: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations and Strengths: The study employs a novel sampling method with a soft ask and low response rate, the effect of which has not yet been fully studied. Survey weights adjust for non-response and coverage bias (i.e., matching the sample to gender, age, and geographic profile of the US). However, a comparison with the American Community Survey20 shows our sample is more educated with higher vaccine uptake than general population, …
SciScore for 10.1101/2021.07.20.21260795: (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: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations and Strengths: The study employs a novel sampling method with a soft ask and low response rate, the effect of which has not yet been fully studied. Survey weights adjust for non-response and coverage bias (i.e., matching the sample to gender, age, and geographic profile of the US). However, a comparison with the American Community Survey20 shows our sample is more educated with higher vaccine uptake than general population, indicating that vaccine hesitancy is underestimated in this sample. Importantly, these characteristics have been consistent over time. CTIS results follow similar patterns observed by others,8 and have been helpful for tracking trends, understanding associations and informing policies21,22. Demographic questions were asked at the end of the survey and had high unit non-response (e.g., 12% for age), which was treated as a category in analysis. Additionally, we assume the survey was completed in good faith. However, a review of fill-in responses for self-described gender suggest a small percentage of participants used that category to make political statements (e.g., trans-phobic comments). A sensitivity analysis eliminating respondents with self-described gender produced very similar results, though the increase in hesitancy for those age ≥75 years was attenuated (data not shown). A strength of our novel sampling method is that it yielded a large sample with diverse characteristics that enabled detailed subgroup analyses that identified new find...
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.
-