INTER-BRAND COVID-19 VACCINE PREFERENCES AND VACCINE HESITANCY: A SURVEY OF A CONVENIENCE SAMPLE

ABSTRACT

BACKGROUND: Delay in acceptance or refusal of vaccination despite vaccine availability comprise a continuum of attitudes known as vaccine hesitancy. To date, three COVID-19 vaccines have been granted emergency use authorization in the U.S.;yet hesitancy to accept vaccination against COVID-19 remains common. Understanding the nature of inter-brand preferences amongst7 these vaccines may help inform vaccine allocation and outreach strategies. METHODS: In April 2021, a de-identified, web-based survey was administered to a convenience sample of respondents across forty-eight states, assessing standard demographics and presence of COVID-19 vaccine brand preference. Those indicating a preference then ranked four COVID-19 vaccine brands presented in random order. Vaccine hesitancy due to brand preference was assessed as the time length for which the respondent was willing to postpone vaccination if their preferred brand of vaccine was unavailable. RESULTS: Of 1,068 respondents, 55.4% endorsed a preference for a particular COVID-19 vaccine brand. On univariate analysis, preference presence differed significantly by age (p=0.011) and religion (p=0.012). The 50-64 age group had the lowest presence of preference (47.9%) while the 18-29 (61.5%, p=0.002) age group had the highest preference presence. The religious group with the least presence of preference was Jewish (45.2%) while the Atheist/ Agnostic (60.0%, p<0.001) and Catholic (59.2%, p=0.012) groups had the highest preference presence. Upon multivariable analysis however, only age was found to be an independent predictor of preference presence (p=0.027). 45.9% (490/1,068) of all respondents would postpone vaccination if their preferred brand was unavailable, with 14.6% (156/1,068) willing to wait three weeks or longer. Willingness to postpone vaccination based on brand availability varied significantly only by religion on both univariate (p=0.022) and multivariable analysis (p=0.043), with the lowest rates of postponement among the Jewish (43.4%) and the highest among Atheists (63.0%, p<0.001) and Catholics (53.1%, p=0.073). Respondents ranked brands in one predominant order (χ2=765.64, p<0.001). Pfizer was preferred over Moderna (Z=-9.405, p<0.001), JnJ (Z=-15.545, p<0.001), and AstraZeneca (Z=-17.399, p<0.001). Moderna was preferred over JnJ (Z=-11.658, p<0.001) and AstraZeneca (Z=-16.782, p<0.001), and JnJ over AstraZeneca (Z=-10.492, p<0.001). Besides the 65+ subgroup which did not have a significant preference between Pfizer or Moderna vaccines (p=0.773), all age and religious groups had the same rank preferences with all paired comparisons similarly significant, p≤0.001. CONCLUSIONS: Age independently predicted the presence of COVID-19 vaccine brand preference while religion independently predicted vaccine hesitancy due to said preference. Further evaluation of the causes and consequences of such inter-brand preferences may inform efforts to increase vaccination among vaccine-curious individuals and facilitate progress towards herd immunity.