Reducing COVID-19 Vaccine Hesitancy From a Decisional Conflict Model: A Cross-Sectional Study

Coronavirus disease 2019 (COVID-19) vaccine hesitancy is a major concern in this pandemic context. This study postulates that vaccine hesitancy among individuals might be associated with a high state of decisional conflict which indicates a state of delayed decision-making. This study aimed to identify the factors related to COVID-19 vaccine hesitancy and examine the relationship between COVID-19 vaccine hesitancy and decisional conflict by focusing on 3 sub-factors: value, informed, and support. This cross-sectional study administered an online, self-administered survey to people aged over 20 years old who were living in Japan using an online self-administered survey. To clarify the association between hesitancy and decisional conflict for the first or second vaccination, this study compared the hesitant and non-hesitant groups. Multivariate analysis was conducted to determine which sub-factor contributing to decisional conflict was associated with vaccine hesitancy. A total of 527 responses were included in the analyses. For the first vaccination (n = 527), women and individuals in their 30s were more hesitant. For the second vaccination (n = 485), women, and individuals in their 40s, non-medical individuals, and individuals without any past history were more hesitant. No significant differences were found for employment status, household composition, convulsions history, allergies, or influenza vaccine hesitancy. For vaccine hesitancy and decisional conflict, a moderate positive correlation was found and means were significantly higher for the hesitant group. Unclear values and limited supported were positively associated with vaccine hesitancy. Eliminating decision-making conflicts can effectively reduce vaccine hesitancy. Furthermore, the findings suggest that it is insufficient to merely provide information. Thus, clarifying the value and providing tangible support from the administration is desirable.