News Center for Dissemination & Implementation COVID-19

Why vaccine hesitancy? Newly published study assesses predictors

Written by Kim Furlow, Institute for Public Health

Photo by Jessica Podraza, Unsplash

A study published this month in the journal, Clinical Infectious Diseases, and co-authored by Director of the Center for Dissemination & Implementation at the Institute for Public Health, Elvin Geng, MD, says that the “vaccine hesitant” are composed of some who reject the vaccine and while others are reluctant yet deliberating. Those firmly against vaccination invoke categorical mistrust (e.g., don’t trust the government, don’t believe COVID-19 is serious) while the reluctant cite uncertainties and countervailing considerations (e.g., side effects, benefits of waiting and seeing).

The paper entitled, Deliberation, Dissent, and Distrust: Understanding distinct drivers of COVID-19 vaccine hesitancy in the United States outlines the study, which analyzed data from the U.S. Census Bureau and assessed predictors of vaccine hesitancy and rejection between January to March of this year.

Some key findings:

  • Hesitancy early in attitudes before widespread availability of the vaccine is strongly associated with actual lower vaccine uptake once vaccines became available at the state level
  • Those who are hesitant (who express doubts about vaccination) are composed of those who are reluctant but deliberating and those who are firm about rejecting the vaccine.
  • Reasons for either reluctance or rejection vary.  Those who say they will probably not receive the vaccine tended to invoke reasons such as doubts about efficacy or concern about side effects.  Those who will definitely not receive the vaccine express mistrust of the government or skepticism about the severity of COVID-19.
  • The study shows that “income, education, and state political leanings predicted vaccine hesitancy.”
  • The sociodemographic predictors of reluctance are distinct from rejection – those in the Black population and women for example, were more likely to be hesitant overall, but among the hesitant, were more likely to be reluctant and deliberative and less likely to reject the vaccine altogether.

Dr. Geng notes, “For public health to meet people where they are, we need to understand where they stand and why.  This study helps to illuminate that.”

Deliberation, Dissent, and Distrust: Understanding distinct drivers of COVID-19 vaccine hesitancy in the United States

Authors: Khai Hoan Tram, MD, Infectious Diseases fellow at the University of Washington; Sahar Saeed, PhD; Cory Bradley, PhD, MSW, MPH; Branson Fox, BA; Ingrid Eshun-Wilson, MD; Aaloke Mody, MD; Elvin Geng, MD, MPH