Survey suggests COVID-19 vaccine hesitancy stems from a distrust in the vaccine development and approval process

Survey results of COVID-19 vaccine hesitancy in Pennsylvania suggest that fewer people are likely to get the COVID-19 vaccine than the number of people who got the flu shot last year.

Several countries have now granted approvals for vaccines to curb COVID-19, the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

However, the vaccine will be truly effective only if the public has confidence in being vaccinated. There are concerns about people refusing to get vaccinated, indicating the need for measures to raise public confidence in vaccines.

In the United States, there is little data on how confident people are about COVID-19 vaccines. A survey in May 2020 found 67% would take a vaccine. Another survey in September 2020 revealed only 51% of U. S. adults would take the vaccine; the same survey in May 2020 suggested 72% would take the vaccine.

The main reasons for the hesitancy to get vaccinated, according to the September survey, were concerns regarding the development and approval process. Prior to COVID-19, the main reasons for not getting vaccinated was a lack of confidence in the vaccine and lack of trust in healthcare workers. Such a shift in vaccine confidence could indicate a shift in the predictors of vaccine confidence.

COVID-19 vaccine

COVID-19 Vaccine. Image Credit:

Hesitating to get the COVID-19 vaccine

Researchers from Pennsylvania State College of Medicine and Pennsylvania State University studied COVID-19 vaccine confidence and reported their results in a paper published in the medRxiv* preprint server.

The researchers surveyed 950 adults in Centre County, Pennsylvania. The main objective was to assess how likely they would be to get vaccinated. Other questions asked about people’s attitude to vaccinations, past behavior, and if they were worried about unknown side effects of the vaccine, as well as their trust in the current system for evaluating the safety of the vaccine.

The survey respondents were typically middle-aged, highly educated, employed, Caucasian, and about 68% were women. The results showed about 55% were “very likely” to get the vaccine and 20% “somewhat likely,” although about 70% had taken the flu vaccine this season. Thus, fewer people than those taking the flu vaccine intend to take the coronavirus vaccine.

The authors used regression analysis to determine predictors of vaccination intention. They found that the strongest predictor of positive vaccination intention was trust in the vaccine and perceived county COVID-19 vaccination norms. Getting the flu shot last year and generally having positive attitudes to vaccines were not strong positive predictors. Worry about unknown side effects was the strongest predictor of negative vaccination intention. Socio-demographic status, political views, and religiosity did not predict vaccination intentions.

COVID-19 vaccine hesitancy different from hesitancy to all vaccines

The survey suggests there is a difference in confidence between vaccines overall and confidence in a COVID-19 vaccine. This arises from a distrust in the system that evaluates the COVID-19 vaccine.

People who do not want to take the vaccine are worried that the speed at which the vaccine was developed may have compromised its integrity and the involvement of politics in the agencies responsible for oversight reduced their trustworthiness.

This is different from the distrust in vaccines in general before COVID-19. Previously, people did not believe in vaccines mainly because of misconceptions about their effects. So before, the strategy was to overcome these misconceptions, whereas the survey suggests that with COVID-19 vaccines the main emphasis must be on reassuring the public that the integrity of the system was maintained in the development and approval of the vaccine.

This is in line with other polls that showed people did not trust the coronavirus vaccine development and approval process and other recommendations of complete transparency in the vaccine development and approval process.

However, the study results are only for a single time point in the cohort study, so the results may not be generalizable over time. Furthermore, the results are only for a narrow population demographic of well-educated Caucasian women. But, the timing of the study, closer to the release of a COVID-19 vaccine, might reflect the true thoughts of people compared to older studies.

Although more studies are needed to confirm if the results of the study can be applied more generally.

it is highly likely that fewer US adults intend to take a coronavirus vaccine than currently take the flu vaccine”

In addition, strategies to overcome hesitancy in taking the COVID-19 vaccine will likely need different techniques, like emphasizing the safety of the vaccine and development integrity, than those that have been used in the past for vaccines in general.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:
Lakshmi Supriya

Written by

Lakshmi Supriya

Lakshmi Supriya got her BSc in Industrial Chemistry from IIT Kharagpur (India) and a Ph.D. in Polymer Science and Engineering from Virginia Tech (USA).


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