Background
Methods
Study population
Survey development
Recruitment
Data and measures
Quantitative analysis
Qualitative analysis
Results
Telephone vaccine survey
Characteristic | Will get a vaccine once available | P-value | |
---|---|---|---|
Agree [N = 111] | Disagree [N = 73] | ||
% (N) | % (N) | ||
Male Sex | 91.0 (101) | 71.2 (52) | 0.0005 |
African American/Black [N = 182] | 70.6 (77) | 63.0 (46) | 0.28 |
Hispanic/Latinx [N = 183] | 9.0 (10) | 8.3 (6) | 0.87 |
Married | 35.1 (39) | 31.5 (23) | 0.61 |
College degree | 28.8 (32) | 26.0 (19) | 0.68 |
Single family residence | 47.8 (53) | 60.3 (44) | 0.10 |
Live alone [N = 183] | 35.5 (39) | 20.6 (15) | 0.03 |
Primarily use public transportation | 24.3 (27) | 9.6 (7) | 0.01 |
Mean (SD) | Mean (SD) | ||
Age (Mean years, SD) | 58.7 (12.4) | 51.6 (13.1) | 0.0003 |
PHQ-2* Score† (Mean Score) | 1.8 (1.9) | 2.5 (2.0) | 0.02 |
GAD-2* Score† (Mean Score) [N = 180] | 2.0 (2.0) | 2.5 (2.3) | 0.09 |
VR-12* Physical Component Score‡ (Mean, SD) | 35.5 (11.5) | 35.4 (13.7) | 0.96 |
VR-12* Mental Component Score‡ (Mean, SD) | 45.1 (13.0) | 38.5 (15.0) | 0.002 |
Comorbidity Index (Charlson) | 3.0 (3.02) | 1.9 (2.5) | 0.02 |
Comorbidity Index (Elixhauser) | 12.7 (14.8) | 8.3 (5.5) | 0.04 |
Knowledge or Belief | Will get a vaccine once available | P-value | |
---|---|---|---|
Agree N = 111 | Disagree N = 73 | ||
% (N) | % (N) | ||
Perceived knowledge about COVID-19 pandemic (Moderate/A lot) [N = 183] | 78.2 (86) | 80.8 (59) | 0.67 |
Agree that: | |||
Persons ≥ 65 are more likely to get more severe illness from COVID-19 [N = 181] | 95.4 (103) | 91.8 (67) | 0.32 |
COVID-19 can be spread from person-to-person | 99.1 (108) | 95.9 (70) | 0.15 |
People with COVID-19 always show symptoms | 19.6 (21) | 9.70 (7) | 0.07 |
Most people who get COVID-19 only show mild symptoms [N = 174] | 42.3 (44) | 34.3 (24) | 0.29 |
After a person has recovered from COVID-19 he/she cannot get it again [N = 179] | 7.3 (8) | 5.7 (4) | 0.67 |
Low perceived risk of personally getting COVID-19 [N = 181] | 36.4 (40) | 52.1 (37) | 0.04 |
High perceived severity if infected with COVID-19 [N = 171] | 75.5 (77) | 69.6 (48) | 0.39 |
I believe that: | |||
Vaccines are safe for the general population [N = 177] | 86.2 (94) | 52.9 (36) | < 0.0001 |
There is enough information about vaccine safety [N = 181] | 68.7(76) | 30.6 (22) | < 0.0001 |
Vaccines decrease the chance of infections [N = 178] | 83.3 (90) | 60.0 (42) | 0.0005 |
Vaccines decrease the severity of disease if infected [N = 174] | 87.6 (92) | 63.8 (44) | 0.0002 |
Vaccines make me less worried about becoming infected with diseases N = 177] | 79.4 (85) | 34.3 (24) | < 0.0001 |
Never receive the annual flu shot | 15.3 (17) | 45.2 (33) | < 0.0001 |
Soreness (in the arm) would make me less likely to get the vaccine [N = 183] | 14.4 (16) | 26.4 (19) | 0.04 |
Agree with: I will get the COVID-19 vaccine if | |||
A doctor recommends it for me [N = 183] | 91.0 (101) | 12.5 (9) | < 0.0001 |
A religious leader recommends it for me [N = 174] | 61.4 (62) | 4.1 (3) | < 0.0001 |
A family member recommends it for me [N = 178] | 78.9 (86) | 4.4 (3) | < 0.0001 |
Would recommend friends/family get the COVID-19 vaccine [N = 181] | 83.6 (92) | 14.1 (10) | < 0.0001 |
Will get a vaccine once available | P-value | ||
---|---|---|---|
Agree Mean (SD) | Disagree Mean (SD) | ||
General Trust in Physician | 78.6 (20.8) | 66.6 (22.4) | 0.0003 |
General Trust in VA Healthcare (N = 183) | 79.0 (19.9) | 64.4 (23.4) | 0.0001 |
Trust government management of pandemic | 42.0 (20.2) | 20.9 (24.2) | 0.0001 |
In-depth interviews of 10 participants disagreeing to get COVID-19 vaccination
Theme I: Barriers to COVID-19 vaccination | |
Speed of development | “But the only reason why I’m skeptical is because of how quickly they came out with the vaccine.” [#6] |
Risk of side effects | “…but if I’m not feeling it then why put myself through the getting the [COVID-19] shot, and having a day where you don’t feel so great… why put my body through the stress?” [#3] |
“If 6 months down the line they [other people] are experiencing headaches, or there’s anything degenerative in their overall health that wasn’t there prior to taking the COVID vaccine. Are they experiencing things that they think may be attributed to receipt of the vaccine?” [#5] | |
Theme II: Decision making for receiving or not receiving the COVID-19 vaccine | |
Deliberation | “They might come out with a better vaccine, but you can’t have both of them… The better one then, I would have to wait some more I guess to see if it works.” [#1] |
“Again, here I am skeptical and hesitant. And I don’t know which one to take, number one. I don’t know which one would be better for me. The Pfizer might be good for you. The Johnson might be good for [name]… There’s a variety; all three of them gives you a choice of which one to take. But how do I know which one is best for me? … I just don’t know what to do…which way to go. I’m undecided, and I don’t know what particular criteria to use to make a choice.” [#4] | |
Active postponement | “…the vaccine is tricky, that’s why I haven’t taken a shot yet…I want to wait and see what it’s going to do to other people in 3 months—6 months…” [#1] |
“They want me to take it…I told them I will when I feel comfortable with it, but—not too soon and I don’t need to be in the first wave of people taking it.” [#3] | |
“…until they make it mandatory, and I have the choice, I am going to wait. Nothing personal to the people who have created these vaccines. Or to the doctors that recommend it, or to you, your staff, anyone. I am just not sure.” [#4] | |
“Well, it could be forever—I may decide that I don’t want it at all. But at this point I am open because at the early stages of the pandemic announcement my daughter was sick, and she was sick for 28–29 days and it really did her bad. So, I know that it is real, but I don’t know if I’m ready to subject myself to the vaccine.” [#5] | |
Theme III: Use of COVID-19 vaccination as a tool of racism | |
“… I’m speaking from a black perspective—most of my friends… and a lot of black people are afraid that there might be two different vaccines out there. One that is geared toward White Americans and one that is geared toward Black Americans. A lot of people are afraid that thing administered to African Americans might not be the same thing that they are administering to White Americans and it could have an adverse effect on African Americans.” [#5] | |
Theme VI: Cues to Action | |
Repercussions of not getting vaccinated | “You can do more if you got a shot than somebody can do if they don’t get the shot. It’s almost like let’s vilify the person that’s not gonna get it. And the people that do get it, they’re good.” [#10] |
“… the state or the government would have to regulate it to say that they had to have that [the COVID-19 vaccine]. They’re not going to say, “Hey, you, you have to go get your shot”. They’re just going to say, “You need this shot if you’re going to continue work.” [#2] | |
“I’m open to it. I’m open to see. But it has to be something that’s going to be convincing to me. That it’s necessary. And that if I don’t take it, it’s going to cause repercussions in some kind of way, that’s going to require me to have to take it. Otherwise, I don’t be able to do z-y–z, or I won’t be able to see my grandchildren; I won’t be able to go back to church; or I won’t be able to go to the store anymore.” [#4] | |
Peer or social network influence | “Cause if I voice my personal opinion to a so-called friend to how I feel about it [the COVID-19 vaccine] then our friendship is ruined.” [#9] |
Well, every now and then I’ll go online… but… I’m more concerned about people that I actually know; how their faring after taking it…those are the people I’m going to really rely on—folks that I see and talk to on a regular basis.” [#5] |
In-depth interviews: Selected themes and example quotations
“That’s one of the things that’s really has affected me—the deaths that I’ve seen… That’s a strain on my mind.” [#4]
“…I’m so paranoid about it. It’s like every two weeks I go get tested, just for reassurance.” [#7]
“…you don’t get to choose what vaccines you get in the military… you wouldn’t think that the military—the people that are paying you to go and do something to put your life on the line to protect and serve the country—are gonna screw you up medically so you can’t do that. It’s like you have faith in them, because they got faith in you to do a job… you’re givin’ up those rights an organization that’s gonna have your best interests because they need, they need you.” [#10]
“I haven’t taken any shots since I left the military.” [#7]“…if it weren’t for the doctor’s recommendation, I wouldn’t be considering it [the flu shot] at all… that’s the only reason I got one this year.” [#8]
“I’m not going to be anybody’s test dummy… everybody is a test dummy—they don’t know what effects are going to happen and I need to see some results after a year of everybody getting it [the COVID-19 vaccine]; if those people are still even alive” [#9]
“And then I think the biggest thing, the biggest thing that makes me not trust the vaccine… for them to be them to be just up-and-down, left and right, with the guidances that they put out, it makes no sense. It almost feel-feels like they’re lying.” [#10]