Vaccines (May 2022)

Serious Underlying Medical Conditions and COVID-19 Vaccine Hesitancy: A Large Cross-Sectional Analysis from Australia

  • Daphne Day,
  • Lisa Grech,
  • Mike Nguyen,
  • Nathan Bain,
  • Alastair Kwok,
  • Sam Harris,
  • Hieu Chau,
  • Bryan Chan,
  • Richard Blennerhassett,
  • Louise Nott,
  • Nada Hamad,
  • Annette Tognela,
  • David Hoffman,
  • Amelia McCartney,
  • Kate Webber,
  • Jennifer Wong,
  • Craig Underhill,
  • Brett Sillars,
  • Antony Winkel,
  • Mark Savage,
  • Bao Sheng Loe,
  • Daniel Freeman,
  • Eva Segelov,
  • on behalf of the CANVACCS, DIABVACCS and MSVACCS Investigators

DOI
https://doi.org/10.3390/vaccines10060851
Journal volume & issue
Vol. 10, no. 6
p. 851

Abstract

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As COVID-19 vaccinations became available and were proven effective in preventing serious infection, uptake amongst individuals varied, including in medically vulnerable populations. This cross-sectional multi-site study examined vaccine uptake, hesitancy, and explanatory factors amongst people with serious and/or chronic health conditions, including the impact of underlying disease on attitudes to vaccination. A 42-item survey was distributed to people with cancer, diabetes, or multiple sclerosis across ten Australian health services from 30 June to 5 October 2021. The survey evaluated sociodemographic and disease-related characteristics and incorporated three validated scales measuring vaccine hesitancy and vaccine-related beliefs generally and specific to their disease: the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale and the Disease Influenced Vaccine Acceptance Scale-Six. Among 4683 participants (2548 [54.4%] female, 2108 [45.0%] male, 27 [0.6%] other; mean [SD] age, 60.6 [13.3] years; 3560 [76.0%] cancer, 842 [18.0%] diabetes, and 281 [6.0%] multiple sclerosis), 3813 (81.5%) self-reported having at least one COVID-19 vaccine. Unvaccinated status was associated with younger age, female sex, lower education and income, English as a second language, and residence in regional areas. Unvaccinated participants were more likely to report greater vaccine hesitancy and more negative perceptions toward vaccines. Disease-related vaccine concerns were associated with unvaccinated status and hesitancy, including greater complacency about COVID-19 infection, and concerns relating to vaccine efficacy and impact on their disease and/or treatment. This highlights the need to develop targeted strategies and education about COVID-19 vaccination to support medically vulnerable populations and health professionals.

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