COVID-19 vaccine hesitancy in a representative working-age population in France: a survey experiment based on vaccine characteristics.
COVID-19 vaccine hesitancy in a representative working-age population in France: a survey experiment based on vaccine characteristics.
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DOI：
10.1016/s2468-2667(21)00012-8
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发表时间：
2021-04
期刊：
影响因子：
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通讯作者：
Luchini S
中科院分区：
文献类型：
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作者：
Schwarzinger M;Watson V;Arwidson P;Alla F;Luchini S
关于疫苗接种意向的民意调查显示，全球对COVID-19疫苗的犹豫正在增加；然而，民意测验在筹备特定新疫苗的大规模接种运动和估计一国人口接受程度方面的作用有限。因此，我们的目的是评估疫苗特性、群体免疫信息和全科医生（GP）建议对法国具有代表性的工作年龄人口的疫苗犹豫的影响。在本次调查实验中，从2020年7月的在线调查研究小组中随机抽取年龄在18-64岁、无SARS-CoV-2感染史的居住在法国的成年人，按性别、年龄、教育程度、家庭规模、居住地区和地区分层，作为法国人口的代表。参与者完成了一份关于他们的背景和疫苗接种行为相关变量（包括过去的疫苗依从性、严重COVID-19的风险因素以及COVID-19的认知和经验）的在线问卷，然后根据全因子设计随机分配到三组中的一组，以获得关于群体免疫的不同信息(bbb50 %的18-64岁成年人必须接种疫苗或感染；50%的成年人必须进行免疫接种[通过接种疫苗或感染]；或没有群体免疫的信息)，以及关于全科医生建议接种疫苗的两个群体之一（全科医生建议接种疫苗或不发表意见）。然后，参与者完成了一系列八个独立的选择任务，旨在根据假设的疫苗特征（有效性[50%、80%、90%或100%]、严重副作用风险[1 / 10000或1 / 100000]、生产地点[欧盟、美国或中国]和给药地点[全科医生诊所、当地药房或大规模疫苗接种中心]）评估疫苗接受或拒绝。用一个两部分模型对应答进行了分析，以区分完全拒绝接种疫苗（不考虑疫苗特性，定义为在所有八项任务中选择不接种疫苗）和疫苗犹豫（根据疫苗特性接受疫苗）。收集了1942名工作年龄成年人的调查回复，其中560人（28.8%）在所有8项任务中选择不接种疫苗（直接拒绝接种疫苗），1382人（71.2%）没有接种疫苗。在我们的模型中，完全拒绝接种疫苗和疫苗犹豫与女性性别、年龄（呈倒u型关系）、受教育程度较低、过去接种推荐疫苗依从性差、未报告特定慢性病（即没有高血压[疫苗犹豫]或没有高血压以外的慢性疾病[完全拒绝接种]）显著相关。直接拒绝接种疫苗也与COVID-19的严重程度较低有关，而当群体免疫益处被告知时，在工作人员与非工作人员以及经历过COVID-19的人（有症状或认识COVID-19患者）中，疫苗犹豫的程度较低。对于涉及大规模疫苗接种中心和群体免疫益处传播的大规模疫苗接种运动，我们的模型预测，法国工作年龄人口中有29.4% （95% CI 28.6 - 30.2）完全拒绝接种疫苗。在中国生产的疫苗中，预测犹豫率最高，效力为50%，严重副作用风险为万分之一（疫苗接受率为27.4%[26.8 - 28.0]），而在欧盟生产的疫苗中，预测犹豫率最低，效力为90%，严重副作用风险为十万分之一（疫苗接受率为61.3%[60.5 - 62.1]）。在法国，COVID-19疫苗的接受程度取决于新疫苗的特点和国家疫苗接种战略，以及其他各种因素。法国公共卫生局。
Opinion polls on vaccination intentions suggest that COVID-19 vaccine hesitancy is increasing worldwide; however, the usefulness of opinion polls to prepare mass vaccination campaigns for specific new vaccines and to estimate acceptance in a country's population is limited. We therefore aimed to assess the effects of vaccine characteristics, information on herd immunity, and general practitioner (GP) recommendation on vaccine hesitancy in a representative working-age population in France. In this survey experiment, adults aged 18–64 years residing in France, with no history of SARS-CoV-2 infection, were randomly selected from an online survey research panel in July, 2020, stratified by gender, age, education, household size, and region and area of residence to be representative of the French population. Participants completed an online questionnaire on their background and vaccination behaviour-related variables (including past vaccine compliance, risk factors for severe COVID-19, and COVID-19 perceptions and experience), and were then randomly assigned according to a full factorial design to one of three groups to receive differing information on herd immunity (>50% of adults aged 18–64 years must be immunised [either by vaccination or infection]; >50% of adults must be immunised [either by vaccination or infection]; or no information on herd immunity) and to one of two groups regarding GP recommendation of vaccination (GP recommends vaccination or expresses no opinion). Participants then completed a series of eight discrete choice tasks designed to assess vaccine acceptance or refusal based on hypothetical vaccine characteristics (efficacy [50%, 80%, 90%, or 100%], risk of serious side-effects [1 in 10 000 or 1 in 100 000], location of manufacture [EU, USA, or China], and place of administration [GP practice, local pharmacy, or mass vaccination centre]). Responses were analysed with a two-part model to disentangle outright vaccine refusal (irrespective of vaccine characteristics, defined as opting for no vaccination in all eight tasks) from vaccine hesitancy (acceptance depending on vaccine characteristics). Survey responses were collected from 1942 working-age adults, of whom 560 (28·8%) opted for no vaccination in all eight tasks (outright vaccine refusal) and 1382 (71·2%) did not. In our model, outright vaccine refusal and vaccine hesitancy were both significantly associated with female gender, age (with an inverted U-shaped relationship), lower educational level, poor compliance with recommended vaccinations in the past, and no report of specified chronic conditions (ie, no hypertension [for vaccine hesitancy] or no chronic conditions other than hypertension [for outright vaccine refusal]). Outright vaccine refusal was also associated with a lower perceived severity of COVID-19, whereas vaccine hesitancy was lower when herd immunity benefits were communicated and in working versus non-working individuals, and those with experience of COVID-19 (had symptoms or knew someone with COVID-19). For a mass vaccination campaign involving mass vaccination centres and communication of herd immunity benefits, our model predicted outright vaccine refusal in 29·4% (95% CI 28·6–30·2) of the French working-age population. Predicted hesitancy was highest for vaccines manufactured in China with 50% efficacy and a 1 in 10 000 risk of serious side-effects (vaccine acceptance 27·4% [26·8–28·0]), and lowest for a vaccine manufactured in the EU with 90% efficacy and a 1 in 100 000 risk of serious side-effects (vaccine acceptance 61·3% [60·5–62·1]). COVID-19 vaccine acceptance depends on the characteristics of new vaccines and the national vaccination strategy, among various other factors, in the working-age population in France. French Public Health Agency (Santé Publique France).