How to support COVID-19 vaccine uptake in those that are either undecided or more resistant to receiving a vaccine in England? Content analysis of survey open text responses

ABSTRACT

BackgroundAs of 15 February 2021, over 20 million people in England have received their first dose of a COVID-19 vaccine. Population-level immunological protection requires the large majority to be vaccinated, though given the spread of misinformation and vaccine hesitancy concerns, this may be challenging. Therefore, this study aimed to elicit from those either undecided or more resistant to having a COVID-19 vaccine, what would make them more likely to have a vaccine when made available to them.MethodsIn October/November 2020 we delivered an online population-wide survey of COVID-19 vaccine intention in England. Sampling was stratified by gender, geographical region, and deprivation, with additional purposive sampling of those from an ethnic minority background. An open question ‘What might make it more likely that you, your family, or friends would have a coronavirus vaccine when one is ready?’ was included. We used content analysis to identify and code emergent themes.ResultsWe recruited 1660 participants, who did not want (210), had yet to consider (407), or were not sure (1043) whether to be vaccinated. Of these 946 (57%) were female, 363 (22%) were of an ethnic minority, and 453 (27%) lived in the lowest three Index of Multiple Deprivation (small area deprivation statistic) deciles. We received 922 (56%) open-text responses, with 733 (44%) detailing at least one factor that would increase their likelihood of receiving a vaccine. The most common concerns expressed was the safety and efficacy of a vaccine, particularly potential side-effects. Participants wanted to see the evidence that supported vaccine approval as many were worried about how quickly vaccines had been developed. Distrust in the Government, specific ministers, and the pharmaceutical companies was a consideration. Some stipulated that it would take mandating for them to have a vaccine. Others wanted it to be free and easy to access. The broader implications of an immunisation programme were of interest, participants wanted to know if the vulnerable would be prioritised and protected and that restrictive conditions would be removed enabling them to engage in a greater range of social activities.ConclusionPromotional campaigns that focus on COVID-19 vaccine safety and effectiveness, should be prioritised. Provision of accessible comprehendible information that accurately and transparently reports the findings from COVID-19 vaccine trials through a trusted source will be required. Contextualising how vaccines will support the ending of the pandemic and increasing personal and population benefits will be of value.