Public Health Student Forum Abstract
Analyzing the Social Determinants of COVID-19 Vaccine Hesitancy in Massachusetts
Names
Samira Dias, Kaneza Kadambaya, Jordana Mangan, MPH, Amelia Tyen, Hunter Thorne, MPH, Marzia Maliha, Daniel Gu, MPH, Raksha Kothari, Janice Sze, Virginia Liu, Senila Yasmin
Background and Objectives
The COVID-19 pandemic has exacerbated underlying systemic health inequities, as reflected in the disproportionate distribution of cases amongst racial/ethnic minorities. In 2019, the World Health Organization declared vaccine hesitancy as one of the top ten threats to global health (WHO, 2019). The rapid development and controversial political discourse of the COVID-19 vaccines have contributed further to vaccine hesitancy and mistrust in public health. The Health Equity Team of the Academic Public Health Volunteer Corps (APHVC) works to address such health inequities and has developed a Vaccine Hesitancy Survey (VHS) to analyze vaccine hesitancy in Massachusetts.
Specifically, the objective of this survey was to assess the concerns of the Massachusetts general public concerning the recently developed COVID-19 vaccines, to gauge what additional information could help promote vaccine uptake, and to use the results to develop upcoming communications content that will be distributed throughout the state via local boards of health and other community-based organizations.
Methods
Integrating vaccine hesitancy questions from the World Health Organization (WHO), the Massachusetts COVID Community Impact Survey, and the COVID Collaboration study in California, we designed a sixty-question online survey distributed via REDCap.
Three questions of interest were: “What additional information do you need to help you decide whether or not to get the COVID-19 vaccine?”, “What questions do you have about the COVID-19 vaccine development, approval process, and/or distribution?”, and “Where do you get your information about vaccines?”. These questions were coded in Dedoose and themes of concern were used to form the basis of upcoming social media and poster infographic content.
Results
The survey ran from February 2, 2021 to March 31, 2021, lasting 58 days and collecting 2,511 responses overall. Demographic data was collected across 18 social determinants of health indicators including race, ethnicity, age, education, sexuality, gender identity, profession, and prior infection with COVID-19. Major concerns that were indicated include (but are not limited to): fear of overall side effects and in particular long-term side effects; safety for pregnant, breastfeeding, and postpartum women, and women who plan to become pregnant; vaccine cost and who will pay for it; how to get an appointment and issues of accessibility; “rushed vaccine”; allergies; ingredients; which vaccine is best; how the vaccines work; the overall effectiveness, effectiveness against variants and the potential need for boosters; risk for people with comorbidities; unfair distribution by race/ethnicity/socioeconomic; mistrust of government and healthcare and the need for transparency; overall safety; and desire for more studies and long term research. Respondents said they got their information from sources including the CDC; healthcare providers; news; “reliable sources”; family/friends/word-of-mouth, medical journals/peer-reviewed journals, scientists, Google/internet/online, magazines, TV, media, NIH, classes, reading, Reddit, MDPH, FDA, vaccine pamphlets.
By far the most common responses were that people were looking forward to or had already taken the vaccine and got their information primarily from their health care providers, and from the CDC. Preliminary findings were used to develop social media graphics and other forms of vaccine communications materials in an effort to promote vaccine uptake and incorporate aspects of cultural competency. Example materials will be showcased in our presentation.