COVID-19 vaccine hesitancy and perceived post-vaccination adverse event: Findings from a cross-sectional survey

In Quebec, COVID-19 vaccine uptake among adults was high for the first two doses but decreased for the subsequent booster doses. This study assesses the relationships between attitudes towards vaccination and self-reported experience and severity of adverse events following immunization (AEFIs).

A web survey of Quebec adults who received at least one dose of the COVID-19 vaccine was conducted in September 2023. Participants share their level of vaccine hesitancy before vaccination and their experience with AEFIs after receiving a dose. Participants were asked to note the severity of the symptoms they believed were due to vaccination. Intention to receive other vaccines in the future was questioned. Two coders performed a qualitative content analysis on reported AEFIs (N = 3808). Descriptive and multivariate logistic regression analyses were performed.

Among the 8419 vaccinated respondents, 46.7 % reported having experienced AEFIs. Fatigue or malaise (20.7 %), injection site disorder (17.3 %), musculoskeletal pain (11.2 %), headache (11.0 %), and fever (10.6 %) were the most commonly reported, respectively. Respondents who were very hesitant before the COVID-19 vaccine reported more frequently having a severe AEFI compared to those who were not hesitant (25.0 % vs 3.4 % =, p < 0.001). This affirmation stays true when all severity of adverse events are considered (68.7 % vs 36.9 %) (p < 0.001). Younger age (aOR = 0.98), being a female (aOR = 1.31), a higher education level (University degree aOR = 1.56 vs high school or less), being vaccine-hesitant in general (aOR = 1.69 vs non or less hesitant) were significantly associated (p < 0.001) with self-reported AEFIs in multivariate analysis. Self-reported AEFIs that prevented doing activities (aOR = 4.87) and being vaccine-hesitant in general (aOR = 4.94) were significantly associated with reduced intention to receive other vaccines in the future.

Vaccine hesitancy could influence self-reported AEFIs and their perceived severity. Transparent and tailored communication explaining AEFIs while emphasizing strategies to mitigate these effects could helpful. Our findings also have implications for pharmacovigilance. 301 mots.