Abstract
BackgroundThe approved COVID-19 vaccines have shown great promise in reducing disease transmission and severity of outcomes. However, the success of the COVID-19 vaccine rollout is dependent on public acceptance and willingness to be vaccinated. In this study, we aim to examine how the attitude towards public sector officials and the government impact vaccine willingness. The secondary aim is to understand the impact of ethnicity on vaccine-willingness after we explicitly account for trust in public institutions.MethodsThis cross-sectional study used data from a UK population based longitudinal household survey (Understanding Society COVID-19 study, Understanding Society: the UK Household Longitudinal Study) between April 2020-January 2021. Data from 22,421 participants in Waves 6 and 7 of the study were included after excluding missing data. Demographic details in addition to previous survey responses relating to public sector/governmental trust were included as covariates in the main analysis. A logit model was produced to describe the association between public sector/governmental mistrust and the willingness for vaccination with interaction terms included to account for ethnicity/socio-economic status.ResultsIn support of existing literature, we identified those from BAME groups were more likely to be unwilling to take the COVID-19 vaccine. We found that positive opinions towards public sector officials (OR 2.680: 95% CI 1.888 – 3.805) and the UK government (OR 3.400; 95% CI 2.454—4.712) led to substantive increase in vaccine willingness. Most notably we identified this effect to vary across ethnicity and socio-economic status with those from South Asian background (OR 4.513; 95% CI 1.012—20.123) and possessing a negative attitude towards public officials and the government being the most unwilling to be vaccinated.ConclusionsThese findings suggests that trust in public sector officials play a key factor in the low vaccination rates particularly seen in at-risk groups. Given the additional morbidity/mortality risk posed by COVID-19 to those from lower socio-economic or ethnic minority backgrounds, there needs to be urgent public health action to review how to tailor health promotion advice given to these groups and examine methods to improve trust in public sector officials and the government.
Highlights
The approved COVID-19 vaccines have shown great promise in reducing disease transmission and severity of outcomes
By early April, Public Health England estimated that the vaccines had prevented over 10,000 deaths in people over the age of sixty and in Israel, initial evidence demonstrated a marked reduction in the Sars-CoV-2 infection rate and related morbidity and mortality due to vaccination. [3]
In summary we found that COVID-19 vaccine willingness varied substantially based on individual demographics and personal opinions about public sector officials/ government
Summary
The approved COVID-19 vaccines have shown great promise in reducing disease transmission and severity of outcomes. Similar mistrust was noted amongst a higher risk category namely the ‘keyworkers’ with 23.9% of the 579 keyworkers surveyed responding that they are uncertain or will refuse to take the vaccine [7] These rates of COVID-19 vaccine hesitancy have remained relatively stable since earlier studies conducted by January 2021 suggesting around 50–60% of individuals would be willing to receive a vaccine [8, 9]. When examining the UK data, 1) those of Black and ethnic minority background and 2) lower socioeconomic households or those currently unemployed, have indicated even greater rates of hesitancy [4] Such findings corroborates results from the US and France [15,16,17]. These groups are at greater risk of transmission of COVID-19 as well as subsequent morbidity and mortality. [18]
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