The Impact of Socioeconomic Status, Perceived Threat and Healthism on Vaccine Hesitancy

ABSTRACT

The ideology of healthism and low perceptions of the threat of vaccine-preventable diseases may explain the positive link between socioeconomic status (SES) and vaccine hesitancy in high-income countries. The present study aimed to examine the effect of three measures of SES (education, income and family economic status), the perceived threat of infectious diseases and two dimensions of healthism (personal responsibility for own health and distrust in healthcare institutions) on vaccine hesitancy, adjusting for sociodemographic variables. A cross-sectional quantitative study was performed in 2019. Non-probability sampling was employed by sending invitations to respondents over the age of 18 to participate in the study. The snowball technique was used, employing e-mails and digital social networks (Facebook, Twitter and Instagram). Data from 661 respondents were collected via 1 ka.si, an online survey tool. Multivariate regression analysis indicated that vaccine hesitancy was significantly more likely to be expressed by women (β = 0.09;p < 0.001), high-income respondents (β = 0.09;p < 0.01), those who have lower perceptions of the threat of vaccine-preventable diseases (β = 0.39;p < 0.001) and those scoring high on two healthism measures (expressing high perceived control of their own health (β = 0.18;p < 0.001) and high distrust in the Slovenian healthcare system and institutions (β = 0.37;p < 0.001)). The findings indicate that among the examined predictors, low perceived threat of vaccine-preventable diseases and low trust in the healthcare system are among the strongest predictors of vaccine hesitancy among the Slovenian public. Policymakers, physicians and other healthcare workers should be especially attentive to the public's and patients' perceptions of the risk of infectious diseases and distrust in medical institutions, including during doctor–patient communication and through public health campaigns and policies.