Abstract
Vaccine hesitancy is among the major threats to the effectiveness of vaccination programmes. This study aimed to report the trend in response to willingness to accept the COVID-19 vaccine between two waves of the local epidemic and examine differences among occupations. Two cross-sectional surveys were conducted online during the first wave (February) and third wave (August to September) of the local epidemic in 2020. Acceptance of the COVID-19 vaccine was measured along with personal protection behaviours and occupations. A total of 2047 participants provided valid responses. The willingness to accept the COVID-19 vaccine among the participants was lower in the third wave (34.8%) than the first wave (44.2%). There were more concerns over vaccine safety in the third wave. Clerical/service/sales workers were less likely to accept the vaccine (adjusted odds ratio: 0.62, 95% confidence interval: 0.43–0.91). A high-level compliance of facemask wearing was found, and more people maintained social distancing and used alcohol hand rub in the third wave. Decreasing willingness to accept the COVID-19 vaccine may be associated with increasing concerns about vaccine safety and growing compliance of personal protection behaviours. The rush of vaccine development with higher risks of safety issues may jeopardize the public’s trust and lower uptake rates. Education and favourable policy should be provided to the general working population for the vaccination, especially for those who are not professional and are frequently exposed to crowds.
Highlights
As the daily number of confirmed coronavirus disease 2019 (COVID-19) cases increased worldwide throughout the year of 2020, global disease burden posed by the pandemic is heavy [1,2], while there is no specific medical treatment of COVID-19 to date [3]
This study comprised two cross-sectional online surveys among the working population in Hong Kong (HK), China. This first survey was conducted from 17 to 27 February 2020 when the “first wave” of the local COVID-19 epidemic occurred and before declaration of the pandemic by World Health Organization (WHO) on 14 March 2020 [24]; the second survey was conducted from 24 August to 7 September 2020 when the “third wave” of the local epidemic was coming to an end [25,26]
In the multiple regressions (Table 3), it was found that participants were less likely to usually or always wear a facemask outdoors in the second survey than the first one (AOR: 0.47, 95% confidence interval (CI): 0.32–0.69), while more likely to maintain social distancing (AOR: 1.54, 95% CI: 1.27–1.86) and use alcohol hand rub (AOR: 1.67, 95% CI: 1.39–2.02)
Summary
As the daily number of confirmed coronavirus disease 2019 (COVID-19) cases increased worldwide throughout the year of 2020, global disease burden posed by the pandemic is heavy [1,2], while there is no specific medical treatment of COVID-19 to date [3]. In addition to the efficacy of the vaccines, their uptake rate is important to the effectiveness of preventing the spread of COVID-19 in future [7,8], as it needs to achieve certain levels to create herd immunity among the population [9]. It has been reported that vaccine refusal and hesitancy have been increasing in recent years [10]. This vaccine hesitancy, which could lead to refusal or delay of the vaccination, may eventually cause a reduction in coverage rate of the vaccine and affect its effectiveness [11,12,13]. There is a need to ascertain the level of willingness to accept the COVID-19 vaccine when the potential one becomes available
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