A Comparison of Vaccine Hesitancy of COVID-19 Vaccination in China and the United States.

Taoran Liu,Casper J P Zhang,Babatunde O Akinwunmi,Jian Huang,Ni Yan,Omolola M Akinwunmi,Qian Chen,Wai-Kit Ming,Yibo Wu,Fengqiu Huang,Zonglin He,Yuejia Zhang

doi:10.3390/vaccines9060649

Abstract

Objectives: To investigate the differences in vaccine hesitancy and preference of the currently available COVID-19 vaccines between two countries, namely, China and the United States (U.S.). Method: A cross-national survey was conducted in both China and the United States, and discrete choice experiments, as well as Likert scales, were utilized to assess vaccine preference and the underlying factors contributing to vaccination acceptance. Propensity score matching (PSM) was performed to enable a direct comparison between the two countries. Results: A total of 9077 (5375 and 3702 from China and the United States, respectively) respondents completed the survey. After propensity score matching, over 82.0% of respondents from China positively accepted the COVID-19 vaccination, while 72.2% of respondents from the United States positively accepted it. Specifically, only 31.9% of Chinese respondents were recommended by a doctor to have COVID-19 vaccination, while more than half of the U.S. respondents were recommended by a doctor (50.2%), local health board (59.4%), or friends and families (64.8%). The discrete choice experiments revealed that respondents from the United States attached the greatest importance to the efficacy of COVID-19 vaccines (44.41%), followed by the cost of vaccination (29.57%), whereas those from China held a different viewpoint, that the cost of vaccination covered the largest proportion in their trade-off (30.66%), and efficacy ranked as the second most important attribute (26.34%). Additionally, respondents from China tended to be much more concerned about the adverse effect of vaccination (19.68% vs. 6.12%) and have a lower perceived severity of being infected with COVID-19. Conclusion: Although the overall acceptance and hesitancy of COVID-19 vaccination in both countries are high, underpinned distinctions between these countries were observed. Owing to the differences in COVID-19 incidence rates, cultural backgrounds, and the availability of specific COVID-19 vaccines in the two countries, vaccine rollout strategies should be nation-dependent.

Highlights

A pneumonia-like disease outbreak, named the 2019 coronavirus disease (COVID19), caused by a newly identified coronavirus, severe acute respiratory syndrome (SARS)CoV-2, swept the globe in early 2020 [1]
After Propensity score matching (PSM) for age, sex, education, annual income, and occupation, no statistically significant discrepancies could be discerned between the respondents from the two countries in demographic characteristics (P = 1.00 for age, sex, education, annual income and occupation)
After PSM, we found that respondents from the United States attached the greatest importance to the efficacy of COVID-19 vaccines (44.41%), followed by the cost of vaccination (29.57%), whereas those from China held a different viewpoint: the cost of vaccination covered the largest proportion in their trade-off (30.66%), and efficacy ranked as the second most important attribute (26.34%)

Summary

Introduction

A pneumonia-like disease outbreak, named the 2019 coronavirus disease (COVID19), caused by a newly identified coronavirus, severe acute respiratory syndrome (SARS)CoV-2, swept the globe in early 2020 [1]. Its exact origin remains unknown, and detailed knowledge of its transmission is still limited, this global pandemic has become the most serious public health threat from a respiratory virus since the 1918 H1N1 influenza pandemic [2,3]. Non-pharmaceutical interventions (NPIs) that showed effectiveness in previous infection outbreaks (e.g., mass facemask use, social distancing, and home quarantine), have been implemented by governments to contain the spread of SARS-CoV-2 [2,9,10]. The effectiveness of these public health measures in this outbreak remains to be determined, these NPIs may carry a high economic cost, leading to a long war of attrition in society [11]

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Conclusion