Factors Associated with Vaccination Intention against the COVID-19 Pandemic: A Global Population-Based Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Setting
2.2. Participant Recruitment
2.3. Survey Instruments
2.4. Statistical Analysis
3. Results
3.1. Participant Characteristics
3.2. Demographic and Socio-Economic Factors Associated with COVID-19 Vaccination Intention
3.3. Associations between Physical Chronic Conditions and COVID-19 Vaccination Intention
3.4. Associations between Mental Illnesses and COVID-19 Vaccination Intention
3.5. Associations between Perceptions and COVID-19 Vaccination Intention
4. Discussion
4.1. Summary of Major Findings
4.2. Explanations and Comparisons with Previous Literature
4.3. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | All Participants (n = 2459) | Participants Who Are Willing to Receive COVID-19 Vaccination (n = 2075) | Participants Who Are Unwilling to Receive COVID-19 Vaccination (n = 384) | p |
---|---|---|---|---|
Age years (mean ± sd) | 29.31 ± 11.07 | 29.72 ± 11.41 | 27.11 ± 8.69 | <0.001 |
Sex n (%) | ||||
Male | 886 | 725 (81.8%) | 161 (18.2%) | 0.007 |
Female | 1526 | 1312 (86.0%) | 214 (14.0%) | |
Race | ||||
Asian | 1616 | 1357 (84.0%) | 259 (16.0%) | 0.001 |
White | 252 | 196 (77.8%) | 56 (22.2%) | |
Black | 167 | 142 (85.0%) | 25 (15.0%) | |
American Indian or Alaska Native | 85 | 74 (87.1%) | 11 (12.9%) | |
Others | 325 | 294 (90.5%) | 31 (9.5%) | |
Years of education | ||||
0–9 years | 100 | 70 (70.0%) | 30 (30.0%) | <0.001 |
10–12 years | 353 | 280 (79.3%) | 73 (20.7%) | |
>12 years | 1995 | 1716 (86.0%) | 279 (14.0%) | |
Residence | ||||
Urban area | 1559 | 1313 (84.2%) | 246 (15.8%) | 0.122 |
Rural area | 618 | 511 (82.7%) | 107 (17.3%) | |
Rural–urban fringe | 226 | 200 (88.5%) | 26 (11.5%) | |
Living status | ||||
Live alone | 261 | 218 (83.5%) | 43 (16.5%) | 0.471 |
Live with family | 1979 | 1681 (84.9%) | 298 (15.1%) | |
Live with other people | 193 | 158 (81.9%) | 35 (18.1%) | |
Work/study status | ||||
Full-time employed | 1076 | 925 (86.0%) | 151 (14.0%) | <0.001 |
Part-time/self employed | 238 | 183 (76.9%) | 55 (23.1%) | |
Students | 984 | 845 (85.9%) | 139 (14.1%) | |
Others | 151 | 114 (75.5%) | 37 (24.5%) | |
Health insurance coverage | ||||
None | 518 | 411 (79.3%) | 107 (20.7%) | <0.001 |
Partial coverage | 536 | 423 (78.9%) | 113 (21.1%) | |
Full coverage (public) | 918 | 808 (88.0%) | 110 (12.0%) | |
Full coverage (private) | 418 | 370 (88.5%) | 48 (11.5%) | |
Welfare benefits | ||||
Yes | 768 | 608 (79.2%) | 160 (20.8%) | <0.001 |
No | 1681 | 1458 (86.7%) | 223 (13.3%) | |
Previous history of influenza vaccination | ||||
Yes | 1594 | 1400 (87.8%) | 194 (12.2%) | <0.001 |
No | 855 | 666 (77.9%) | 189 (22.1%) |
Univariable Analysis cOR (95% CI) | p | Multivariable Analysis aOR (95% CI) | p | |
---|---|---|---|---|
Age years | 1.02 (1.01–1.04) | <0.001 | 1.04 (1.02–1.05) | <0.001 |
Sex | ||||
Male (ref) | 1 (ref) | 1 (ref) | ||
Female | 1.36 (1.09–1.70) | 0.007 | 1.31 (1.01–1.70) | 0.044 |
Race | ||||
Asian (ref) | 1 (ref) | 0.001 | 1 (ref) | 0.228 |
White | 0.67 (0.48–0.92) | 0.015 | 0.99 (0.66–1.49) | 0.960 |
Black | 1.08 (0.69–1.69) | 0.722 | 1.17 (0.69–1.97) | 0.557 |
American Indian or Alaska Native | 1.28 (0.67–2.45) | 0.449 | 1.78 (0.85–3.76) | 0.129 |
Others | 1.81 (1.22–2.68) | 0.003 | 1.54 (0.97–2.44) | 0.067 |
Years of education | ||||
0–9 years (ref) | 1 (ref) | <0.001 | 1 (ref) | 0.024 |
10–12 years | 1.64 (1.00–2.71) | 0.051 | 1.72 (0.97–3.05) | 0.066 |
>12 years | 2.64 (1.69–4.12) | <0.001 | 2.05 (1.21–3.48) | 0.008 |
Residence | ||||
Urban area (ref) | 1 (ref) | 0.125 | 1 (ref) | 0.082 |
Rural area | 0.89 (0.70–1.15) | 0.381 | 1.20 (0.89–1.62) | 0.221 |
Rural–urban fringe | 1.44 (0.94–2.22) | 0.096 | 1.67 (1.03–2.71) | 0.038 |
Living status | ||||
Live alone (ref) | 1 (ref) | 0.472 | 1 (ref) | 0.540 |
Live with family | 1.11 (0.78–1.58) | 0.549 | 1.05 (0.71–1.55) | 0.821 |
Live with other people | 0.89 (0.54–1.45) | 0.643 | 0.82 (0.47–1.43) | 0.484 |
Work/study status | ||||
Full-time (ref) | 1 (ref) | <0.001 | 1 (ref) | <0.001 |
Part-time/self employed | 0.54 (0.38–0.77) | 0.001 | 0.61 (0.41–0.91) | 0.015 |
Students | 0.99 (0.77–1.27) | 0.952 | 1.69 (1.19–2.39) | 0.003 |
Others | 0.50 (0.33–0.76) | 0.001 | 0.45 (0.28–0.73) | 0.001 |
Health insurance coverage | ||||
None (ref) | 1 (ref) | <0.001 | 1 (ref) | <0.001 |
Partial coverage | 0.97 (0.72–1.31) | 0.865 | 0.98 (0.69–1.38) | 0.887 |
Full coverage (public) | 1.91 (1.43–2.56) | <0.001 | 1.78 (1.25–2.54) | 0.001 |
Full coverage (private) | 2.01 (1.39–2.90) | <0.001 | 1.88 (1.23–2.89) | 0.004 |
Welfare benefits | ||||
Yes | 0.58 (0.46–0.73) | <0.001 | 0.55 (0.42–0.72) | <0.001 |
No (ref) | 1 (ref) | 1 (ref) | ||
Previous history of influenza vaccination | ||||
Yes | 2.05 (1.64–2.55) | <0.001 | 2.26 (1.74–2.93) | <0.001 |
No (ref) | 1 (ref) | 1 (ref) |
Participants Who Are Unwilling to Receive Vaccination (n = 384) | Univariable and Multivariable Regression Analysis | p | |
---|---|---|---|
Any physical conditions | |||
Yes | 110 (20.1%) | cOR (95%CI) = 0.66 (0.52–0.85) | 0.001 |
No (ref) | 274 (14.3%) | * aOR (95%CI) = 0.68 (0.51–0.90) | 0.008 |
Cardiovascular disease | |||
Yes | 21 (30.4%) | cOR (95%CI) = 0.41 (0.24–0.69) | 0.001 |
No | 353 (15.2%) | * aOR (95%CI) = 0.47 (0.26–0.88) | 0.018 |
Hypertension | |||
Yes | 56 (23.6%) | cOR (95%CI) = 0.55 (0.40–0.76) | <0.001 |
No | 315 (14.5%) | * aOR (95%CI) = 0.42 (0.28–0.63) | <0.001 |
Type 2 diabetes | |||
Yes | 27 (31.8%) | cOR (95%CI) = 0.38 (0.24–0.60) | <0.001 |
No | 346 (14.9%) | * aOR (95%CI) = 0.38 (0.22–0.64) | <0.001 |
Immunodeficiency | |||
Yes | 41 (39.0%) | cOR (95%CI) = 0.27 (0.18–0.40) | <0.001 |
No | 335 (14.6%) | * aOR (95%CI) = 0.40 (0.24–0.65) | <0.001 |
Chronic disease of the respiratory system | |||
Yes | 64 (27.2%) | cOR (95%CI) = 0.45 (0.33–0.61) | <0.001 |
No | 311 (14.4%) | * aOR (95%CI) = 0.49 (0.34–0.71) | <0.001 |
Chronic liver disease | |||
Yes | 33 (55.0%) | cOR (95%CI) = 0.14 (0.08–0.24) | <0.001 |
No | 342 (14.7%) | * aOR (95%CI) = 0.24 (0.13–0.46) | <0.001 |
Chronic kidney disease | |||
Yes | 33 (57.9%) | cOR (95%CI) = 0.12 (0.07–0.21) | <0.001 |
No | 340 (14.6%) | * aOR (95%CI) = 0.17 (0.09–0.31) | <0.001 |
Cancer during past 5 years | |||
Yes | 48 (60.8%) | cOR (95%CI) = 0.11 (0.07–0.17) | <0.001 |
No | 327 (14.1%) | * aOR (95%CI) = 0.11 (0.06–0.19) | <0.001 |
Sickle cell disease | |||
Yes | 33 (67.3%) | cOR (95%CI) = 0.08 (0.05–0.15) | <0.001 |
No | 342 (14.6%) | * aOR (95%CI) = 0.08 (0.04–0.17) | <0.001 |
Participants Who Are Unwilling to Receive Vaccination (n = 384) | Univariable and Multivariable Regression Analysis | p | |
---|---|---|---|
Any mental disorders (Any Yes in A35-A47) | |||
Yes | 129 (28.0%) | cOR (95%CI) = 0.38 (0.30–0.48) | <0.001 |
No (ref) | 255 (12.8%) | * aOR (95%CI) = 0.30 (0.22–0.41) | <0.001 |
Depression | |||
Yes | 86 (28.5%) | cOR (95%CI) = 0.40 (0.31–0.53) | <0.001 |
No | 296 (13.9%) | * aOR (95%CI) = 0.34 (0.24–0.48) | <0.001 |
Mania/bipolar disorder | |||
Yes | 40 (50.6%) | cOR (95%CI) = 0.16 (0.10–0.25) | <0.001 |
No | 332 (14.2%) | * aOR (95%CI) = 0.16 (0.09–0.27) | <0.001 |
Psychotic disorders (including schizophrenia) | |||
Yes | 39 (62.9%) | cOR (95%CI) = 0.10 (0.06–0.17) | <0.001 |
No | 339 (14.4%) | * aOR (95%CI) = 0.09 (0.05–0.18) | <0.001 |
Anxiety disorder | |||
Yes | 53 (23.7%) | cOR (95%CI) = 0.56 (0.40–0.78) | 0.001 |
No | 325 (14.8%) | * aOR (95%CI) = 0.50 (0.34–0.74) | <0.001 |
Posttraumatic stress disorder | |||
Yes | 35 (38.5%) | cOR (95%CI) = 0.28 (0.18–0.43) | <0.001 |
No | 345 (14.8%) | * aOR (95%CI) = 0.31 (0.18–0.51) | <0.001 |
Eating disorder | |||
Yes | 35 (37.6%) | cOR (95%CI) = 0.29 (0.19–0.44) | <0.001 |
No | 345 (14.8%) | * aOR (95%CI) = 0.31 (0.18–0.52) | <0.001 |
Compulsive disorders (OCD) | |||
Yes | 55 (50.9%) | cOR (95%CI) = 0.16 (0.11–0.23) | <0.001 |
No | 326 (14.1%) | * aOR (95%CI) = 0.16 (0.09–0.26) | <0.001 |
Substance abuse or addiction disorder | |||
Yes | 31 (60.8%) | cOR (95%CI) = 0.11 (0.06–0.20) | <0.001 |
No | 349 (14.7%) | * aOR (95%CI) = 0.12 (0.06–0.24) | <0.001 |
Attention disorder (ADD or ADHD) | |||
Yes | 42 (53.8%) | cOR (95%CI) = 0.14 (0.09–0.23) | <0.001 |
No | 337 (14.3%) | * aOR (95%CI) = 0.15 (0.08–0.26) | <0.001 |
Somatoform disorder | |||
Yes | 25 (43.1%) | cOR (95%CI) = 0.23 (0.14–0.40) | <0.001 |
No | 356 (15.0%) | * aOR (95%CI) = 0.34 (0.18–0.63) | 0.001 |
Personality disorder | |||
Yes | 42 (66.7%) | cOR (95%CI) = 0.08 (0.05–0.14) | <0.001 |
No | 337 (14.3%) | * aOR (95%CI) = 0.09 (0.04–0.17) | <0.001 |
Autism Spectrum Disorder | |||
Yes | 33 (62.3%) | cOR (95%CI) = 0.10 (0.06–0.18) | <0.001 |
No | 343 (14.5%) | * aOR (95%CI) = 0.10 (0.05–0.21) | <0.001 |
Cognitive disorder/dementia | |||
Yes | 32 (74.4%) | cOR (95%CI) = 0.06 (0.03–0.12) | <0.001 |
No | 349 (14.7%) | * aOR (95%CI) = 0.08 (0.04–0.19) | <0.001 |
Participants Who Are Unwilling to Receive Vaccination (n = 384) | Univariable and Multivariable Regression Analysis | p | |
---|---|---|---|
● Country in which the vaccine is produced. | |||
Yes | 156 (13.9%) | cOR (95% CI) = 1.26 (1.01–1.57) | 0.043 |
No | 224 (16.9%) | * aOR (95% CI) = 1.48 (1.15–1.89) | 0.002 |
● Recommendation from my family doctor. | |||
Yes | 126 (8.9%) | cOR (95% CI) = 3.29 (2.61–4.14) | <0.001 |
No | 251 (24.4%) | * aOR (95% CI) = 3.47 (2.67–4.50) | <0.001 |
● Recommendation of the Ministry of Health. | |||
Yes | 152 (9.5%) | cOR (95% CI) = 3.47 (2.77–4.35) | <0.001 |
No | 229 (26.8%) | * aOR (95% CI) = 3.98 (3.07–5.16) | <0.001 |
● Whether the vaccine has been in use for 2 years or more. | |||
Yes | 188 (16.7%) | cOR (95% CI) = 0.82 (0.66–1.02) | 0.081 |
No | 184 (14.1%) | * aOR (95% CI) = 0.88 (0.69–1.13) | 0.308 |
● Whether the vaccine has no serious side-effects. | |||
Yes | 226 (13.9%) | cOR (95% CI) = 1.45 (1.16–1.81) | 0.001 |
No | 155 (18.9%) | * aOR (95% CI) = 1.44 (1.12–1.86) | 0.004 |
● Whether the vaccine is used in other countries. | |||
Yes | 180 (12.1%) | cOR (95% CI) = 1.91 (1.53–2.38) | <0.001 |
No | 199 (20.8%) | * aOR (95% CI) = 1.79 (1.40–2.29) | <0.001 |
● My risk of getting infected with COVID-19. | |||
Yes | 176 (12.0%) | cOR (95% CI) = 1.93 (1.55–2.41) | <0.001 |
No | 200 (20.8%) | * aOR (95% CI) = 1.95 (1.52–2.51) | <0.001 |
● How easy it is to get the vaccine (e.g., available out-of-hours or in pharmacies). | |||
Yes | 136 (10.0%) | cOR (95% CI) = 2.65 (2.11–3.33) | <0.001 |
No | 244 (22.7%) | * aOR (95% CI) = 2.78 (2.15–3.59) | <0.001 |
● Whether the vaccine is free of charge. | |||
Yes | 147 (9.8%) | cOR (95% CI) = 3.04 (2.42–3.81) | <0.001 |
No | 233 (24.8%) | * aOR (95% CI) = 3.04 (2.37–3.91) | <0.001 |
● Whether restrictions on movement and gathering in groups would be lifted if most people got the vaccine. | |||
Yes | 145 (10.7%) | cOR (95% CI) = 2.32 (1.85–2.90) | <0.001 |
No | 235 (21.7%) | * aOR (95% CI) = 2.32 (1.81–2.98) | <0.001 |
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Huang, J.; Chan, S.C.; Ko, S.; Wang, H.H.X.; Yuan, J.; Xu, W.; Zheng, Z.-J.; Xue, H.; Zhang, L.; Jiang, J.Y.; et al. Factors Associated with Vaccination Intention against the COVID-19 Pandemic: A Global Population-Based Study. Vaccines 2022, 10, 1539. https://doi.org/10.3390/vaccines10091539
Huang J, Chan SC, Ko S, Wang HHX, Yuan J, Xu W, Zheng Z-J, Xue H, Zhang L, Jiang JY, et al. Factors Associated with Vaccination Intention against the COVID-19 Pandemic: A Global Population-Based Study. Vaccines. 2022; 10(9):1539. https://doi.org/10.3390/vaccines10091539
Chicago/Turabian StyleHuang, Junjie, Sze Chai Chan, Samantha Ko, Harry H. X. Wang, Jacky Yuan, Wanghong Xu, Zhi-Jie Zheng, Hao Xue, Lin Zhang, Johnny Y. Jiang, and et al. 2022. "Factors Associated with Vaccination Intention against the COVID-19 Pandemic: A Global Population-Based Study" Vaccines 10, no. 9: 1539. https://doi.org/10.3390/vaccines10091539