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Temporal Changes in Factors Associated With COVID-19 Vaccine Hesitancy and Uptake Among Adults in Hong Kong
28 Pages Posted: 14 Dec 2021
More...Abstract
Background: COVID-19 vaccine hesitancy can lead to reduced vaccine uptake and hinder the safe relaxation of other public health measures. This study aims to determine the factors associated with vaccine hesitancy and uptake among adults before and after the implementation of the COVID-19 vaccination programme in Hong Kong.
Methods: We conducted cross-sectional telephone surveys every 4 weeks over a 9-month period. In each survey, we collected socio-demographic data and responses on COVID-19 vaccination receipt and vaccine hesitancy, chronic medical conditions, perceived risk of COVID-19, perceived personal efficacy in self-protection, confidence in the government’s ability to control the pandemic, compliance with social distancing measures, and confidence in COVID-19 vaccines. Multivariable logistic regression models were used to examine the factors associated with COVID-19 vaccine hesitancy at different time points.
Findings: From November 2020 through July 2021, we conducted 10 cross-sectional surveys including 7,411 respondents. The levels of vaccine hesitancy fluctuated over time. From December 2020 to May 2021, the age group with the highest vaccine hesitancy was young adults 18-34y, while the vaccine hesitancy was highest among adults ≥65y in June-July 2021. Our regression analyses showed that before and at the beginning of the rollout of the mass vaccination programme, there was no statistically significant association between chronic medical conditions and vaccine hesitancy. However, 2-5 months after the programme implementation respondents with chronic medical conditions were more likely to be hesitant. From January to June 2021, higher confidence in the government was associated with lower vaccine hesitancy. Confidence in COVID-19 vaccines was consistently associated with lower vaccine hesitancy at different stages of the programme.
Interpretation: The factors associated with COVID-19 vaccine hesitancy changed over time. This study highlighted the importance to monitor temporal changes in COVID-19 vaccine hesitancy and associated factors, and adjust promotion strategies correspondingly to boost vaccination uptake.
Funding Information: Health and Medical Research Fund, Hong Kong.
Declaration of Interests: BJC consults for AstraZeneca, GSK, Moderna, Pfizer, Roche and Sanofi Pasteur. The authors report no other potential conflicts of interest.
Ethics Approval Statement: This study was approved by the Institutional Review Board of The University of Hong Kong (Reference No.: UW 20-095). All respondents provided verbal informed consent before data collection.
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