JMIR Publications

ABSTRACT

Background:

Vaccine hesitancy is a growing issue that the WHO ranks as one of the top 10 threats to global health. Public confidence in vaccines and rates of routine childhood vaccination have been declining around the world since the pandemic, when many countries saw the instatement of COVID-19 vaccine mandates.

Objective:

We leveraged the COVID-19 add-on study, conducted by the CHILD Cohort Study (Canada’s most phenotypically diverse, large prospective longitudinal birth cohort), to determine characteristics associated with adult participants’ vaccine hesitancy. Our goal was to identify potential strategies for addressing vaccine uptake concerns. This study complements others by examining more behavioural, socioeconomic, attitudinal and additional characteristics, in some cases with greater granularity, and by further exploring the effects of COVID-19 vaccine mandates on vaccine uptake and beliefs.

Methods:

We generated penalized logistic regression models and used statistical tests to analyze a dataset of nearly 700 questionnaire responses where vaccine hesitancy was measured by participants’ agreement or disagreement with the following statements: “Getting myself vaccinated is important for the health of others in my community” and “Getting vaccinated is a good way to protect myself from disease''. We also examined whether vaccination status or opinions changed after the imposition of vaccine mandates.

Results:

While vaccine mandates were successful in increasing COVID-19 specific vaccine uptake in hesitant individuals vs confident individuals, they were ineffective in modifying hesitant individuals’ beliefs about vaccines. Vaccine-confident individuals were more likely to engage in pandemic safety measures such as physical distancing, while vaccine-hesitant individuals were more likely to have or had chronic medical conditions in the past, experience economic precarity, have lower socioeconomic status and/or formal education level, have had difficulty accessing medical care, and rely on friends and internet sites that were not governmental for COVID-19 related information.

Conclusions:

To ensure that relevant information regarding vaccines reaches all segments of the population, outreach strategies should be tailored to individuals with a variety of cultural or educational backgrounds. Improving access to medical care could also improve access to reliable information. Vaccine mandates do not impact an individual’s beliefs in vaccines, and so countering vaccine hesitancy itself is likely to be more effective in terms of ensuring continuous vaccine uptake in a population.