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Global Trends and Correlates of COVID-19 Vaccination Hesitancy: Findings from the iCARE Study

Department of Health, Kinesiology & Applied Physiology, Concordia University, Montréal, QC H4B 1R6, Canada
Montreal Behavioural Medicine Centre, Research Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l’Ile de Montréal (CIUSSS-NIM), Montréal, QC H4J 1C5, Canada
Department of Psychology, University of Québec at Montreal (UQAM), Montréal, QC C3H 3P8, Canada
Unity Health Toronto, Department of Medicine, Division of Respirology, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, ON M52 3M2, Canada
Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
Physical Therapy Department, Faculty of Allied Medical Sciences, Isra University, Queen Alia International Airport South of the Capital Amman, Amman 11622, Jordan
Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
Department of Psychology, University of Cyprus, Nicosia 2109, Cyprus
Department of Applied Health Research, University College London, London WC1E 7HB, UK
Author to whom correspondence should be addressed.
On behalf of the iCARE Study Team.
Academic Editors: Chiara de Waure, Aldo Rosano and Chiara Cadeddu
Vaccines 2021, 9(6), 661;
Received: 5 May 2021 / Revised: 28 May 2021 / Accepted: 11 June 2021 / Published: 17 June 2021
(This article belongs to the Special Issue COVID-19 Vaccines: A Public Health Perspective)
The success of large-scale COVID-19 vaccination campaigns is contingent upon people being willing to receive the vaccine. Our study explored COVID-19 vaccine hesitancy and its correlates in eight different countries around the globe. We analyzed convenience sample data collected between March 2020 and January 2021 as part of the iCARE cross-sectional study. Univariate and multivariate statistical analyses were conducted to explore the correlates of vaccine hesitancy. We included 32,028 participants from eight countries, and observed that 27% of the participants exhibited vaccine hesitancy, with increases over time. France reported the highest level of hesitancy (47.3%) and Brazil reported the lowest (9.6%). Women, younger individuals (≤29 years), people living in rural areas, and those with a lower perceived income were more likely to be hesitant. People who previously received an influenza vaccine were 70% less likely to report COVID-19 vaccine hesitancy. We observed that people reporting greater COVID-19 health concerns were less likely to be hesitant, whereas people with higher personal financial concerns were more likely to be hesitant. Our findings indicate that there is substantial vaccine hesitancy in several countries, with cross-national differences in the magnitude and direction of the trend. Vaccination communication initiatives should target hesitant individuals (women, younger adults, people with lower incomes and those living in rural areas), and should highlight the immediate health, social and economic benefits of vaccination across these settings. Country-level analyses are warranted to understand the complex psychological, socio-environmental, and cultural factors associated with vaccine hesitancy. View Full-Text
Keywords: COVID-19; vaccine hesitancy; international analysis; cross-sectional survey COVID-19; vaccine hesitancy; international analysis; cross-sectional survey
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MDPI and ACS Style

Stojanovic, J.; Boucher, V.G.; Gagne, M.; Gupta, S.; Joyal-Desmarais, K.; Paduano, S.; Aburub, A.S.; Sheinfeld Gorin, S.N.; Kassianos, A.P.; Ribeiro, P.A.B.; Bacon, S.L.; Lavoie, K.L. Global Trends and Correlates of COVID-19 Vaccination Hesitancy: Findings from the iCARE Study. Vaccines 2021, 9, 661.

AMA Style

Stojanovic J, Boucher VG, Gagne M, Gupta S, Joyal-Desmarais K, Paduano S, Aburub AS, Sheinfeld Gorin SN, Kassianos AP, Ribeiro PAB, Bacon SL, Lavoie KL. Global Trends and Correlates of COVID-19 Vaccination Hesitancy: Findings from the iCARE Study. Vaccines. 2021; 9(6):661.

Chicago/Turabian Style

Stojanovic, Jovana, Vincent G. Boucher, Myriam Gagne, Samir Gupta, Keven Joyal-Desmarais, Stefania Paduano, Ala’ S. Aburub, Sherri N. Sheinfeld Gorin, Angelos P. Kassianos, Paula A.B. Ribeiro, Simon L. Bacon, and Kim L. Lavoie 2021. "Global Trends and Correlates of COVID-19 Vaccination Hesitancy: Findings from the iCARE Study" Vaccines 9, no. 6: 661.

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