Can we convince the unvaccinated to vaccinate: lessons from COVID-19 vaccination

Vaccine hesitancy affects vaccine uptake. Despite initial reluctance to receive the COVID-19 vaccine in 2020, by 2021, many individuals chose to get vaccinated once vaccines became available, while others who had previously been willing to vaccinate changed their minds. In this study, we focused on people who did not follow-up on their intentions to (or not to) vaccinate and why.

This longitudinal study draws on data from a two-wave nationally representative survey of Americans from July 2020 (T1) and July/August 2021 (T2) to examine the factors that contribute to the COVID-19 vaccination-related intention-behavior gap, using multivariable logistic regression.

By T2, 52% of previously COVID-19 vaccine-hesitant individuals were vaccinated and 14% of previously pro-vaccine individuals remained unvaccinated. Among the vaccine-hesitant individuals, factors associated with vaccination included higher risk perception, general vaccine acceptance, being informed about the vaccines, endorsing less COVID-19 misinformation, confidence in scientists, and having health insurance. Among the pro-vaccine individuals, factors associated with being unvaccinated included lower risk perception, lower general vaccine acceptance, being less informed about the vaccines, partisan identification, lower confidence in scientists and not having health insurance.

The study highlights the factors that explain intention-behavior gap in vaccination. We identified what explains individuals' intentions to vaccinate and their actual vaccination behavior one year later, as well as the potential to influence vaccine-hesitant individuals to vaccinate and pro-vaccine individuals from actualizing their vaccination intentions. Understanding these factors is essential in developing evidence-based strategic communications, which can help convince individuals to vaccinate and increase the uptake of COVID-19 as well as other adult vaccines.