Willingness to Get a COVID-19 Vaccine and Reasons for Hesitancy Among Medicare Beneficiaries: Results From a National Survey
Willingness to Get a COVID-19 Vaccine and Reasons for Hesitancy Among Medicare Beneficiaries: Results From a National Survey
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DOI：
10.1097/phh.0000000000001394
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发表时间：
2022-01-01
影响因子：
3.3
通讯作者：
Cummings, Doyle M.
中科院分区：
文献类型：
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作者：
Luo, Huabin;Qu, Haiyan;Cummings, Doyle M.
目的：评估(1)医疗保险受益者接种新冠肺炎疫苗的意愿，(2)相关因素，(3)疫苗迟疑的原因。方法：数据来自2020年10月至11月进行的联邦医疗保险当前受益人调查(MCBS)2020年秋季新冠肺炎补充调查。接种新冠肺炎疫苗的意愿是通过受访者对是否会在有疫苗时接种新冠肺炎的回答来衡量的。我们将“肯定”和“可能”的反应归类为“愿意接种”，而“可能不”、“肯定不”和“不确定”的反应归类为“疫苗迟疑”。疫苗迟疑的原因是通过一系列是/否的问题来评估的，这些问题侧重于10个潜在原因。分析样本包括6715名65岁及以上的成年人。我们进行了Logistic回归模型，以评估人口统计因素和其他与接种新冠肺炎疫苗意愿相关的因素。所有的分析都是在STATA 14中进行的，并解释了MCBS的复杂调查设计。结果：总体而言，61.0%(95%可信区间[CI]，59.1-63.0)的医疗保险受益人愿意在疫苗可用时接种疫苗。在犹豫不决的人中，超过40%的人表示对政府的不信任和副作用是主要原因。Logistic回归模型结果显示，非西班牙裔黑人(调整后的优势比[AOR]=0.33；95%CI，0.24~0.44)和拉美裔(AOR=0.60；95%CI，0.47~0.77)比非拉美裔白人更不愿意接种疫苗；收入低于25000美元的受益人(AOR=0.71；95%CI，0.62~0.81)比收入25000美元以上的人更不愿意接种疫苗；那些不认为新冠肺炎病毒比流感病毒更具传染性(AOR=0.53；95%CI，0.41-0.69)或更致命(AOR=0.51；95%CI，0.41-0.65)的人，也比那些认为该病毒比流感病毒更具传染性或更致命的人更不愿意接种疫苗。结论：2020年妇幼保健局的调查数据显示，近40%的医疗保险受益者对接种新冠肺炎疫苗犹豫不决，其中种族/少数民族的犹豫不决更大。联邦医疗保险受益人担心疫苗的安全性，一些人似乎得到了错误的信息。需要实施循证的教育和政策层面的干预，进一步推动新冠肺炎疫苗接种。
Objectives: To assess (1) the willingness to get a COVID-19 vaccine among Medicare beneficiaries, (2) the associated factors, and (3) the reasons for vaccine hesitancy. Methods: Data were taken from the Medicare Current Beneficiary Survey (MCBS) 2020 Fall COVID-19 Supplement, conducted October-November 2020. Willingness to get a COVID-19 vaccine was measured by respondents' answer to whether they would get a COVID-19 vaccine when available. We classified responses of "definitely" and "probably" as "willing to get," and responses "probably not," "definitely not," and "not sure" as "vaccine hesitancy." Reasons for vaccine hesitancy were assessed by a series of yes/no questions focusing on 10 potential reasons. The analytical sample included 6715 adults 65 years and older. We conducted a logistic regression model to assess demographic factors and other factors associated with the willingness to get a COVID-19 vaccine. All analyses were conducted in Stata 14 and accounted for the complex survey design of MCBS. Results: Overall, 61.0% (95% confidence interval [CI], 59.1-63.0) of Medicare beneficiaries would be willing to get a vaccine when available. Among those who were hesitant, more than 40% reported that mistrust of the government and side effects as the main reasons. Logistic regression model results showed that non-Hispanic Blacks (adjusted odds ratio [AOR] = 0.33; 95% CI, 0.24-0.44) and Hispanics (AOR = 0.60; 95% CI, 0.47-0.77) were less willing to get a vaccine than non-Hispanic Whites; beneficiaries with an income of less than $25 000 (AOR = 0.71; 95% CI, 0.62-0.81) were less willing to get the vaccine than those with an income of $25 000 or more; those who did not think that the COVID-19 virus was more contagious (AOR = 0.53; 95% CI, 0.41-0.69) or more deadly (AOR = 0.51; 95% CI, 0.41-0.65) were also less willing to get the vaccine than those who thought that the virus was more contagious or more deadly than the influenza virus. Conclusions: The 2020 MCBS survey data showed that close to 40% of Medicare beneficiaries were hesitant about getting a COVID-19 vaccine, and the hesitancy was greater in racial/ethnic minorities. Medicare beneficiaries were concerned about the safety of the vaccine, and some appeared to be misinformed. Evidence-based educational and policy-level interventions need to be implemented to further promote COVID-19 vaccination.