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United States COVID-19 Vaccination Preferences (CVP): 2020 Hindsight

This article was originally published here

Patient. 2021 Mar 30. doi: 10.1007/s40271-021-00508-0. Online ahead of print.


BACKGROUND: Shortly after the 2020 US election, initial evidence on first-generation COVID-19 vaccines showed 70-95% efficacy and minimal risks. Yet, many US adults expressed reluctance.

AIMS: The aim of this study was to compare persons willing and unwilling to be vaccinated against COVID-19 and to estimate the effects of vaccination attributes on uptake: proof of vaccination, vaccination setting, effectiveness, duration of immunity, and risk of severe side effects.

METHOD: Between 9 and 11 November 2020, 1153 US adults completed a discrete choice experiment (DCE) on Phase 2 of the CDC Vaccination Program (August 2021). Each of its eight choice tasks had three vaccination alternatives and “no vaccination for 6 months.” An opt-out inflated logit model was estimated to test for respondent differences and attribute effects.

RESULTS: Respondent demographics were unrelated to one’s willingness to be vaccinated (p value 0.533), but those with less education were more likely to be unwilling (p < 0.001). Among those willing, uptake ranged from 61.70 to 97.75%, depending on the vaccination attributes. Effectiveness and safety had the largest effects. Offering proof of vaccination and a choice of setting increased uptake as much as increasing immunity from 3 to 6 months.

CONCLUSIONS: To maximize uptake, the CDC Program should standardize proof of vaccination and offer a choice of setting, instead of a one-size-fits-all approach. If the first-generation vaccines are efficacious, widely available, and free, overall predicted uptake is 68.81% by the end of Phase 2 (August 2021), which is well below the 75-90% needed for herd immunity. Further health preference research is necessary to uncover and address unwillingness and reluctance to vaccinate against COVID-19.

PMID:33783724 | DOI:10.1007/s40271-021-00508-0

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