Study reveals top reasons for COVID-19 vaccine refusal

Reviewed by Emily Henderson, B.Sc.Jan 6 2021

A survey of approximately 5,000 Americans suggests that 31.1 percent of the U.S. public does not intend to get the COVID-19 vaccine once it becomes available to them - and the likelihood of vaccine refusal is highest among Black Americans, women and conservatives.

Timothy Callaghan, assistant professor at the Texas A&M University School of Public Health, led the study with the aim of better understanding the intentions of the American public regarding vaccines. The results were recently published in Social Science and Medicine.

According to the study, survey respondents answered a series of questions about their behaviors and attitudes about COVID-19, including why or why not they intend to pursue vaccination. Women are 71 percent more likely to not to pursue vaccination, researchers found, followed by Blacks at 41 percent.

Survey results also showed that politics play a role: each one-point increase in conservatism increases the odds of vaccine refusal by 18 percent. Those who said they intended to vote for President Donald Trump in the presidential election - the survey was conducted in mid-2020 - were 29 percent more likely to refuse vaccination.

The study revealed two top reasons for vaccine refusal: concerns about safety and effectiveness. However, reasons for vaccine reluctance varied across sub-populations.

For instance, women who were surveyed said they are hesitant based on safety concerns and effectiveness, while surveyed Black Americans said their hesitancy stems from similar concerns plus a lack of financial resources or health insurance.

For conservatives, Callaghan points to previous studies that have shown these people are generally less trusting of vaccines, as well as medical and scientific professionals.

The finding that most surprised Callaghan is that Black individuals, who are being infected with COVID-19 and dying at higher rates, are less likely to vaccinate because of a combination of concerns, including those related to safety and affordability.

This points to the need for the medical community and policymakers to find ways to both build trust in the vaccine in the African American community and to ensure that it is delivered affordably."

Timothy Callaghan, Assistant Professor, Texas A&M University School of Public Health

The authors of the study also state that anti-vaccine advocacy groups "have made a concerted effort" to target Black Americans, writing that if they are successful in framing COVID-19 vaccination in terms of past medical abuses against minority groups, it could decrease the likelihood that racial minorities will pursue COVID-19 vaccination, particularly in light of recent findings emphasizing the implications of peripheral trauma."

Now that COVID-19 vaccine-hesitant populations have been identified, Callaghan plans to explore what kind of health interventions and health promotion efforts are most effective in promoting the vaccine to these populations. Additionally, he said it is important to explore the similarities and differences between populations that are generally vaccine hesitant and populations that are hesitant specifically toward the COVID-19 vaccine.