In the primary yr of its availability, 84.2% of US adults received not less than one dose of COVID-19 vaccine. Progress in COVID-19 vaccination slowed after April 2021, and hundreds of thousands of Americans remain unvaccinated. Latest research within the American Journal of Preventive Medicine, published by Elsevier, finds wide geographic variance in vaccine uptake and identifies the underlying behavioral and social drivers that factor into the choice to stay unvaccinated. The findings suggest that improving COVID-19 vaccine confidence will not be solved by a “one-size-fits-all solution.”
Many studies have explored vaccine coverage and vaccine confidence at a national level, but these are prone to vary widely by geography and sociodemographic. We decided to explore state and regional trends in COVID-19 vaccine confidence and the underlying reasons for non-vaccination.”
Nina B. Masters, PhD, lead investigator, Epidemic Intelligence Service, and Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
The study used data from the National Immunization Survey-Adult COVID Module. It is a nationally representative household cellphone survey of US adults aged 18 or older. Of the 531,798 participants surveyed (April 22 to December 31, 2021), respondents who had not received a COVID-19 vaccine were then asked how likely they were (definitely, probably, probably not, definitely won’t, unsure) to get vaccinated. Additional questions were asked in regards to the individual’s concerns about COVID-19 and confidence in vaccine safety and importance.
To know social norms, the participants were asked what number of friends and relations had received a COVID-19 vaccination, and if a healthcare provider had advisable that they receive the vaccine. For practical aspects, the survey asked whether one’s work or school required COVID-19 vaccination and whether or not they experienced any actual or perceived difficulty in accessing a vaccination. Demographic data were also collected. The evaluation examined these variables nationally and for every state for every month within the survey period, to support trends over time.
Generally, rural residents were less prone to be vaccinated than urban residents, but within the Southeast and Midwest, differences in vaccination coverage by urbanicity were smaller. In most states, Black and Hispanic adults were less prone to be vaccinated than White and non-Hispanic adults. Nevertheless, within the South and the Southeast, where vaccination rates were low in comparison with the remaining of the US, vaccination coverage was similar across race and ethnicity. The Southeast and Midwest had the biggest proportion of unvaccinated individuals who indicated that they might probably get a COVID-19 vaccine or were unsure. These regions saw similar trends in concern about COVID-19 and confidence within the importance of getting vaccinated.
Overall, individuals with low confidence within the importance of the vaccine were five times more prone to remain unvaccinated. This implies that focused messaging in regards to the advantages of vaccination, in comparison with the chance of the disease, stays a priority. Adults in rural areas – in addition to those with lower than a school degree, without insurance, making lower than $75,000/yr and under 65 – had higher prevalence of non-vaccination across all regions, while associations between vaccination and race/ethnicity varied by region.
“Our evaluation supports the concept that reasons for non-vaccination are personal and individual, and there are nuances and differences on this reasoning, for instance, between an unvaccinated, young individual living in a rural community within the Southeast and an unvaccinated, older individual living within the Northeast who has mostly vaccinated family and friends. It is important to fulfill people where they’re to construct confidence in vaccines,” said Dr. Masters. “The CDC has made national, regional, and state data available on the Behavioral and Social Drivers of COVID-19 vaccination through national surveys of adults and fogeys. State and native health departments may find a way to strengthen their ongoing efforts locally by accessing these data on the CDC COVID Data Tracker: Vaccine Confidence.”
Source:
Journal reference:
Masters, N.B., et al. (2022) Geographic Heterogeneity in Behavioral and Social Drivers of COVID-19 Vaccination. American Journal of Preventive Medicine. doi.org/10.1016/j.amepre.2022.06.016.