Effects of different types of written vaccination information on COVID-19 vaccine hesitancy in the UK (OCEANS-III): a single-blind, parallel-group, randomised controlled trial.
Daniel Freeman,Daniel Freeman,Bao Sheng Loe,Ly-Mee Yu,Jason Freeman,Andrew Chadwick,Cristian Vaccari,Milensu Shanyinde,Victoria Harris,Felicity Waite,Felicity Waite,Laina Rosebrock,Laina Rosebrock,Ariane Petit,Ariane Petit,Samantha Vanderslott,Stephan Lewandowsky,Michael Larkin,Stefania Innocenti,Andrew J. Pollard,Helen McShane,Sinéad Lambe,Sinéad Lambe +22 more
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TLDR
In this paper, a single-blind, parallel-group, randomised controlled trial was conducted to test which types of written information about COVID-19 vaccination, in addition to a statement of efficacy and safety, might increase vaccine acceptance.Abstract:
Summary Background The effectiveness of the COVID-19 vaccination programme depends on mass participation: the greater the number of people vaccinated, the less risk to the population. Concise, persuasive messaging is crucial, particularly given substantial levels of vaccine hesitancy in the UK. Our aim was to test which types of written information about COVID-19 vaccination, in addition to a statement of efficacy and safety, might increase vaccine acceptance. Methods For this single-blind, parallel-group, randomised controlled trial, we aimed to recruit 15 000 adults in the UK, who were quota sampled to be representative. Participants were randomly assigned equally across ten information conditions stratified by level of vaccine acceptance (willing, doubtful, or strongly hesitant). The control information condition comprised the safety and effectiveness statement taken from the UK National Health Service website; the remaining conditions addressed collective benefit, personal benefit, seriousness of the pandemic, and safety concerns. After online provision of vaccination information, participants completed the Oxford COVID-19 Vaccine Hesitancy Scale (outcome measure; score range 7–35) and the Oxford Vaccine Confidence and Complacency Scale (mediation measure). The primary outcome was willingness to be vaccinated. Participants were analysed in the groups they were allocated. p values were adjusted for multiple comparisons. The study was registered with ISRCTN, ISRCTN37254291. Findings From Jan 19 to Feb 5, 2021, 15 014 adults were recruited. Vaccine hesitancy had reduced from 26·9% the previous year to 16·9%, so recruitment was extended to Feb 18 to recruit 3841 additional vaccine-hesitant adults. 12 463 (66·1%) participants were classified as willing, 2932 (15·6%) as doubtful, and 3460 (18·4%) as strongly hesitant (ie, report that they will avoid being vaccinated for as long as possible or will never get vaccinated). Information conditions did not alter COVID-19 vaccine hesitancy in those willing or doubtful (adjusted p values >0·70). In those strongly hesitant, COVID-19 vaccine hesitancy was reduced, in comparison to the control condition, by personal benefit information (mean difference –1·49, 95% CI –2·16 to –0·82; adjusted p=0·0015), directly addressing safety concerns about speed of development (−0·91, –1·58 to –0·23; adjusted p=0·0261), and a combination of all information (−0·86, –1·53 to –0·18; adjusted p=0·0313). In those strongly hesitant, provision of personal benefit information reduced hesitancy to a greater extent than provision of information on the collective benefit of not personally getting ill (−0·97, 95% CI –1·64 to –0·30; adjusted p=0·0165) or the collective benefit of not transmitting the virus (−1·01, –1·68 to –0·35; adjusted p=0·0150). Ethnicity and gender were found to moderate information condition outcomes. Interpretation In the approximately 10% of the population who are strongly hesitant about COVID-19 vaccines, provision of information on personal benefit reduces hesitancy to a greater extent than information on collective benefits. Where perception of risk from vaccines is most salient, decision making becomes centred on the personal. As such, messaging that stresses the counterbalancing personal benefits is likely to prove most effective. The messaging from this study could be used in public health communications. Going forwards, the study highlights the need for future health campaigns to engage with the public on the terrain that is most salient to them. Funding National Institute for Health Research (NIHR) Oxford Biomedical Research Centre and NIHR Oxford Health Biomedical Research Centre.read more
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Injection fears and COVID-19 vaccine hesitancy.
Daniel Freeman,Sinéad Lambe,Sinéad Lambe,Ly-Mee Yu,Jason Freeman,Andrew Chadwick,Cristian Vaccari,Felicity Waite,Laina Rosebrock,Ariane Petit,Samantha Vanderslott,Stephan Lewandowsky,Michael Larkin,Stefania Innocenti,Helen McShane,Andrew J. Pollard,Bao Sheng Loe +16 more
TL;DR: In this article, the authors estimate that the proportion of COVID-19 vaccine hesitancy explained by blood-injection-injury fears is approximately 10% of cases of vaccine-related concerns.
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COVID-19 Vaccine Hesitancy Among Chinese Population: A Large-Scale National Study
Jian Wu,Quanman Li,Clifford Silver Tarimo,Meiyun Wang,Jianqin Gu,Wei Wei,Mingze Ma,Lipei Zhao,Zihan Mu,Yudong Miao +9 more
TL;DR: Wang et al. as discussed by the authors found an overall prevalence of COVID-19 vaccine hesitancy was 8.40% (95%CI 8.09-8.72) in primary vaccination and 8.39% in booster vaccination in China, even with a slight cascade of changing vaccination rates between the primary and booster vaccination.
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Nudging toward vaccination: a systematic review.
Mark Donald C Reñosa,Jeniffer Landicho,Jonas Wachinger,Sarah L Dalglish,Kate Bärnighausen,Till Bärnighausen,Shannon A. McMahon +6 more
TL;DR: In this paper, the authors present a comprehensive synthesis of evidence regarding the value and impact of nudges to address vaccine hesitancy (VH) and the global decline of vaccine coverage are a major global health threat and novel approaches for increasing vaccine confidence and uptake are urgently needed.
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Correlates of COVID-19 vaccination intentions: Attitudes, institutional trust, fear, conspiracy beliefs, and vaccine skepticism
TL;DR: In this article , the authors applied a reasoned action approach to explore the factors that determine people's vaccination intentions and found that positive attitudes toward getting vaccinated were supported by trust in science and fear of COVID-19 whereas negative attitudes were associated with acceptance of conspiracy theories and skepticism regarding vaccines in general.
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COVID-19 vaccine hesitancy in eight European countries: Prevalence, determinants, and heterogeneity
Janina I. Steinert,Henrike Sternberg,Hannah Prince,Barbara Fasolo,Matteo M. Galizzi,Tim Büthe,Giuseppe Veltri +6 more
TL;DR: The heterogeneity in vaccine hesitancy and responses to different messages suggests that health authorities should avoid one-size-fits-all vaccination campaigns.
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Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA.
Sahil Loomba,Alexandre de Figueiredo,Simon J. Piatek,Kristen de Graaf,Heidi J. Larson,Heidi J. Larson,Heidi J. Larson +6 more
TL;DR: This paper conducted a randomized controlled trial in the UK and USA to quantify how exposure to online misinformation around COVID-19 vaccines affects intent to vaccinate to protect oneself or others, and found that in both countries-as of September 2020-fewer people would 'definitely' take a vaccine than is likely required for herd immunity.