What drives willingness to vaccinate and vaccination acceptance? Examining decision-making for seasonal influenza vaccine in Minnesota and a vaccine against an emerging pathogen in Uganda
2020-03
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What drives willingness to vaccinate and vaccination acceptance? Examining decision-making for seasonal influenza vaccine in Minnesota and a vaccine against an emerging pathogen in Uganda
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2020-03
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Introduction: The World Health Organization named vaccine hesitancy as a top-ten global health threat. To address hesitancy, there is a need to understand vaccination decision-making. Purpose: The purpose of these three studies was to assess: (1) what opinions are associated with annual influenza vaccination, (2) factors that motivate willingness to receive seasonal influenza vaccine by age in Minnesota and (3) factors that motivate willingness to receive a new vaccine against an emerging pathogen among university students in Uganda.
Methods: We conducted two discrete choice experiment (DCE) surveys: one with 1,803 Minnesota adults on influenza vaccine and one with 1,600 students in Kampala, Uganda on a new vaccine against an emerging pathogen. We conducted two studies with the Minnesota survey data. We assessed if four different opinions towards vaccines were associated with annual influenza vaccination and if this association differed by age group. We evaluated the association between vaccination messages, the sources of message, incentives, and access on willingness to take an influenza vaccine using a panel of DCE questions. We evaluated the DCE data using a multinomial mixed logistic regression with random effects parameters. Additionally, we used data from this survey to assess associations between opinions and annual influenza vaccination using logistic regression. In the Kampala DCE, we evaluated the association between disease risk, disease severity, trusted individuals, influential voices, vaccine protection, and vaccine side effects on willingness to take a new vaccinate against an emerging pathogen using mixed logistic regression with random intercepts. Results: In our influenza vaccine analysis, we found that those with positive opinions of vaccines had at least 2.3 times higher odds of annual vaccination than those with negative opinions. We found that older age groups were more likely than younger groups to receive the influenza vaccine annually, and the association between positive vaccination opinions and annual vaccination was modified by age group, with a stronger association between positive opinions and annual vaccination in older age groups compared to younger age groups. Participants preferred to receive an influenza vaccine without an appointment and with a $5 gift card, compared to the other options. For a vaccine against an emerging pathogen, we found that increasing risk of disease exposure and increasing fatality disease rate were key drivers of vaccination willingness, compared to the other options. We found that vaccination willingness differed between medical/public health students and those from other disciplines.
Discussion: Results from these studies suggest that for influenza vaccine, vaccination access and incentives are key drivers of willingness to be vaccinated. For a new vaccine against an emerging pathogen, disease risk and severity are key drivers of willingness to be vaccinated.
Conclusion: Vaccination decision-making is context-dependent. To understand and increase vaccination willingness, there is a need to consider the disease, the vaccine, and the population.
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University of Minnesota Ph.D. dissertation. 2020. Major: Epidemiology. Advisors: Nicole Basta, Traci Toomey. 1 computer file (PDF); 138 pages.
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Bonner, Kimberly. (2020). What drives willingness to vaccinate and vaccination acceptance? Examining decision-making for seasonal influenza vaccine in Minnesota and a vaccine against an emerging pathogen in Uganda. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/227923.
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