COVID-19 vaccine hesitancy among the vaccinated: a cross-sectional survey

Coronavirus disease 2019 (COVID-19) vaccines play a crucial role in preventing serious complications, including intensive care unit (ICU) and hospital admissions, and in reducing the symptoms associated with the infection. However, vaccine hesitancy has been identified as a significant barrier to COVID-19 vaccination. This survey aimed to investigate vaccine hesitancy by exploring and identifying the enablers and barriers to receiving the second dose of the COVID-19 vaccine in a small cohort who had already received a first dose of the COVID-19 vaccine.

A cross-sectional survey was conducted with 959 individuals who received a second dose of the COVID-19 vaccine at Guangdong Provincial People's Hospital, from February 18 to February 23, 2021. The survey investigated the socio-demographic characteristics of the participants, and the enablers and barriers to the COVID-19 vaccination.

In total, 959 individuals completed the survey. The participants had an average age of 43.23±9.86 years, and 80.0% were male, 84.8% were married, and 34.9% had additional private commercial insurance. In terms of vaccine complications, 11.5% reported mild allergic reactions, and 8.7% reported hypertension. Among the participants, 74.7% agreed to receive a second dose of the COVID-19 vaccine. A multivariate logistic regression analysis of the participants who received the first dose of the vaccine revealed a higher level of vaccine acceptance among males [odds ratio (OR) =0.58; P=0.005], older individuals (OR =0.97; P=0.001), those who were married (OR =0.57; P=0.007), those with additional private commercial insurance (OR =0.65; P=0.02), and those who had many colleagues and friends who had received the vaccine (OR =0.58; P=0.007). Conversely, those who misunderstood the safety profile and side effects of the vaccine (OR =4.34; P<0.001) and those who misunderstood the data on the adverse events associated with the COVID-19 vaccine (OR =1.59; P=0.03) were less likely to receive the vaccine.

COVID-19 vaccine hesitancy was lower among males, older individuals, those who were married, those with additional private commercial insurance, and those who had a number of supportive colleagues and friends who had received the vaccine. Misunderstandings of the safety profile of the vaccine and the related adverse events were associated with a higher rate of vaccine hesitancy. Education efforts should seek to reduce vaccine hesitancy by improving understandings of the safety profile and adverse events related to the COVID-19 vaccine, emphasizing the benefit-to-risk ratio both at the individual level and from a socioeconomic perspective. Reducing vaccine hesitancy will increase the uptake of the COVID-19 vaccine, which in turn will reduce morbidity, mortality, and hospitalization, including ICU and critical care admission, thus decreasing the social and economic burden.