Predictors of Intention to Vaccinate Against COVID-19: Results of a Nationwide Survey

Highlights

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  Nationwide survey finds that nearly two in five adults reported hesitancy about getting a COVID-19 vaccine when one becomes available.

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  Significant demographic predictors of intent to vaccinate included being male, older, white, non-Hispanic, married, and higher socio-economic status.

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  Democrats were more likely to vaccinate than Republicans, and social media users had weaker vaccination intentions than nonusers.

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  Health predictors of intent to vaccinate included having multiple pre-existing conditions and being currently immunized against influenza.

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  COVID-19 vaccine promotion requires formative research into the concerns of hesitant people.

Abstract

Background

Public polling indicates that vaccine uptake will be suboptimal when COVID-19 vaccines become available. Formative research seeking an understanding of weak vaccination intentions is urgently needed.

Methods

Nationwide online survey of 804 U.S. English-speaking adults. Compensated participants were recruited from the U.S. through an internet survey panel of 2.5 million residents developed by a commercial survey firm. Recruitment was based on quota sampling to produce a U.S. Census-matched sample representative of the nation with regard to region of residence, sex, and age.

Results

COVID-19 vaccination intentions were weak, with 14.8% of respondents being unlikely to get vaccinated and another 23.0% unsure. Intent to vaccinate was highest for men, older people, individuals who identified as white and non-Hispanic, the affluent and college-educated, Democrats, those who were married or partnered, people with pre-existing medical conditions, and those vaccinated against influenza during the 2019-2020 flu season.

In a multiple linear regression, significant predictors of vaccination intent were general vaccine knowledge (β = .311, p < .001), rejection of vaccine conspiracies (β = -.117, p = .003), perceived severity of COVID-19 (β = .273, p < .001), influenza vaccine uptake (β = .178, p < .001), having ≥ 5 pre-existing conditions (β = .098, p = .003), being male (β = .119, p < .001), household income of ≥ $120,000 (β = .110, p = .004), identifying as a Democrat (β = .075, p < .029), and not relying upon social media for virus information (β = -.090, p < 002). Intent to vaccinate was lower for Fox News (57.3%) than CNN/MSNBC viewers (76.4%) (χ2 (1) = 12.68, p < .001). Political party differences in threat appraisals and vaccine conspiracy beliefs are described.

Conclusions

Demographic characteristics, vaccine knowledge, perceived vulnerability to COVID-19, risk factors for COVID-19, and politics likely contribute to vaccination hesitancy.