Vaccination hesitancy: fear, trust, and exposure expectancy of an Ebola outbreak.

The purpose of this paper is to examine the relationship between vaccination hesitancy and fear, trust, and expectation of a potential imminent and proximate outbreak of Ebola. Our hypothesis is that people engage in self-protective behavior against an infectious disease when they are: fearful about things in general; trustful of government's ability to control the disease outbreak; and anticipating a direct threat to their health. The self-protective behavior we examine is the intention to accept a prospective anti-Ebola vaccination. We examine these relationships with basic demographic variables taken into account: gender, age, ethnicity, race and education. The data source is a national random sample of 1,018 United States adults interviewed early during the 2014 Ebola outbreak. We constructed a new three-item Exposure Expectancy Scale (alpha = 0. 635) to measure the degree of respondents' expectancy of a potential nearby Ebola outbreak. Our data analysis employs multiple logistic regressions. The findings support our hypothesis: willingness to take the Ebola vaccination is positively associated with a generalized sense of fear, trust in the government's ability to control an outbreak of the disease, and expectation of a potential Ebola outbreak that is imminent and proximate. The addition of the exposure expectancy variable in this analysis adds significantly to our understanding of contributors to vaccine hesitancy.

Social and political determinants of vaccine hesitancy: Lessons learned from the H1N1 pandemic of 2009-2010.

BACKGROUND: Public acceptance of vaccination programs is essential for vaccine preventable diseases. However, increasing sectors of the population have expressed hesitancy about participating in such programs, leading to the re-emergence of vaccine preventable diseases. In this study we rely on a recreancy hypothesis to test the association between confidence in the government and local hospitals and the willingness to take the vaccine. METHODS: A secondary analysis of a survey that used a large sample of the U.S. population conducted in October 2009 was used (N = 968). RESULTS: The results indicate that 36.1% of the respondents expressed willingness to be vaccinated. Those with the greatest trust in the government were the most likely to be vaccinated (43.4%), and those least confident were the least willing (15.8%). From the ones reporting being confident in the local health system, 38.4% were willing to be vaccinated, and from those not confident, only 23.5% were willing to be vaccinated. CONCLUSION: The decision to get vaccinated in the midst of a contagious outbreak involves many considerations. Trust in the government's technical and organization skill to deal with the infectious outbreak along with trust in medical organizations predict the adoption of recommended protection measures. The results indicate that public compliance with vaccination plans in health crisis requires the development of social and institutional trust.

Confidence in government and vaccination willingness in the USA.

The most recent internationally widespread disease outbreak occurred during the flu season of 2009 and 2010. On April 2009, the first cases of influenza A (H1N1) (Popularly called, Swine Flu) were confirmed in the USA and UK following a novel virus that was first identified in Mexico. As the virus spread rapidly, the risk of morbidity and mortality increased in several countries. In this paper, we rely on the social cognitive theory of risk to assess the willingness of the US public to comply with vaccination and reduce the risk of sickness and death from the flu. We conduct a secondary data analysis of the Pew Research for the People and Press October 2009 and investigate the factors associated with willingness to take the swine flu vaccine (n = 1000). The findings indicate that the decision to take the swine flu vaccination was highly polarized across partisan lines. Controlling for education, income and demographic factors, the likelihood of taking the vaccine was associated with party identification. Individuals that identified themselves as Democrats were more likely to be willing to take the swine vaccine than individuals that identify themselves as Republicans and Independents. Confidence in the ability of the government to deal with the swine flu crisis seems to explain party identification differences in the willingness to take the vaccine. The implications of the findings are discussed.

Attention to the media and worry over becoming infected: the case of the Swine Flu (H1N1) Epidemic of 2009.

This paper examines the relationship between attention to the mass media and concern about becoming infected with H1N1 in two nationwide random samples interviewed during the flu epidemic of 2009. The first sample (N = 1004) was taken at the end of the first wave of the outbreak in the US and the second sample (N = 1006) was taken as the second wave was accelerating. The data were gathered by the Pew Research Center for the People & the Press. Over the period studied, the percentage worried about becoming infected increased in almost all social categories of respondents. With social category controlled, both those who followed the H1N1 outbreak closely and those who were more interested in reports about it were more likely to be worried about becoming infected. As time went on, interest in media reports declined, but worry over infection continued to increase. Our findings imply that despite the decrease in the percentage of the population expressing interest and following the news, media exposure was the most important factor as it explained the likelihood of being concerned about the possibility of infection.