Trends, patterns and psychological influences on COVID-19 vaccination intention: Findings from a large prospective community cohort study in England and Wales (Virus Watch)

Thomas Byrne, Parth Patel, Madhumita Shrotri, Sarah Beale, Susan Michie, Jabeer Butt, Nicky Hawkins, Pia Hardelid, Alison Rodger, Anna Aryee, Isobel Braithwaite, Wing Lam Erica Fong, Ellen Fragaszy, Cyril Geismar, Jana Kovar, Annalan M.D. Navaratnam, Vincent Nguyen, Andrew Hayward, Robert W. Aldridge*, Linda WijlaarEleni Nastouli, Moira Spyer, Ben Killingley, Ingemar Cox, Vasileios Lampos, Rachel A. McKendry, Tao Cheng, Yunzhe Liu, Anne M. Johnson, Jo Gibbs, Richard Gilson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Vaccination intention is key to the success of any vaccination programme, alongside vaccine availability and access. Public intention to take a COVID-19 vaccine is high in England and Wales compared to other countries, but vaccination rate disparities between ethnic, social and age groups has led to concern. Methods: Online survey of prospective household community cohort study participants across England and Wales (Virus Watch). Vaccination intention was measured by individual participant responses to ‘Would you accept a COVID-19 vaccine if offered?’, collected in December 2020 and February 2021. Responses to a 13-item questionnaire collected in January 2021 were analysed using factor analysis to investigate psychological influences on vaccination intention. Results: Survey response rate was 56% (20,785/36,998) in December 2020 and 53% (20,590/38,727) in February 2021, with 14,880 adults reporting across both time points. In December 2020, 1,469 (10%) participants responded ‘No’ or ‘Unsure’. Of these people, 1,266 (86%) changed their mind and responded ‘Yes’ or ‘Already had a COVID-19 vaccine’ by February 2021. Vaccination intention increased across all ethnic groups and levels of social deprivation. Age was most strongly associated with vaccination intention, with 16–24-year-olds more likely to respond “Unsure” or “No” versus “Yes” than 65–74-year-olds in December 2020 (OR: 4.63, 95 %CI: 3.42, 6.27 & OR 7.17 95 %CI: 4.26, 12.07 respectively) and February 2021 (OR: 27.92 95 %CI: 13.79, 56.51 & OR 17.16 95 %CI: 4.12, 71.55). The association between ethnicity and vaccination intention weakened, but did not disappear, over time. Both vaccine- and illness-related psychological factors were shown to influence vaccination intention. Conclusions: Four in five adults (86%) who were reluctant or intending to refuse a COVID-19 vaccine in December 2020 had changed their mind in February 2021 and planned to accept, or had already accepted, a vaccine.

Original languageEnglish
JournalVaccine
DOIs
Publication statusAccepted/In press - 2021
Externally publishedYes

Bibliographical note

Funding Information:
The research costs for the study have been supported by the MRC Grant Ref: MC_PC 19,070 awarded to UCL on 30 March 2020 and MRC Grant Ref: MR/V028375/1 awarded on 17 August 2020. The study also received $15,000 of Facebook advertising credit to support a pilot social media recruitment campaign on 18th August 2020. This study was supported by the Wellcome Trust through a Wellcome Clinical Research Career Development Fellowship to RA [206602]. The sponsors of the study had no role in conducting this analysis or drafting this manuscript.

Funding Information:
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Robert Aldridge reports financial support was provided by Medical Research Council. Robert Aldridge reports financial support was provided by Facebook Inc. Robert Aldridge reports financial support was provided by Wellcome Trust. The research costs for the study have been supported by the MRC Grant Ref: MC_PC 19070 awarded to UCL on 30 March 2020 and MRC Grant Ref: MR/V028375/1 awarded on 17 August 2020. The study also received $15,000 of Facebook advertising credit to support a pilot social media recruitment campaign on 18th August 2020. This study was supported by the Wellcome Trust through a Wellcome Clinical Research Career Development Fellowship to RA [206602]. The sponsors of the study had no role in conducting this analysis or drafting this manuscript. A.H serves on the UK New and Emerging Respiratory Virus Threats Advisory Group. S.M serves on the Scientific Advisory Group for Emergencies. J.B is Chief Executive of Race Equality Foundation. N.H is and independent consultant advising the Virus Watch study team on framing of results. A.M.J was a Governor of Wellcome Trust from 2011-18 and is Chair of the Committee for Strategic Coordination for Health of the Public Research.

Publisher Copyright:
© 2021 The Author(s)

Keywords

  • COVID-19
  • Intention
  • Public Health
  • Vaccine

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