Abstract
COVID-19 vaccines are crucial for achieving sufficient immunisation coverage to manage the pandemic, but vaccine hesitancy persists. This study aimed to investigate the prevalence and determinants of vaccine hesitancy in adults and in parents for vaccinating their children using an integrated social cognition model. A community-based cohort in Singapore [N = 1623] completed a survey (wave 25) between June and July 2021 which measured their risk perceptions, distress, trust, vaccination beliefs, and vaccine intentions/behaviours. Results indicated low rates of hesitancy (9.9%) for own vaccination, with most concerns citing side effects, safety, and hasty development. Remaining respondents were vaccinated (69%) or intended to vaccinate (21%). The multivariable model (non-vaccinated respondents) indicated that, living with people in poor health, subjective norm, moral norm, benefits, and necessity of vaccination were associated with lower vaccine hesitancy (R2 Cox & Snell: 51.4%; p < 0.001). Hesitancy rates were higher for children’s vaccination (15.9%), with male gender, lower perceived vaccine benefits, high COVID-19 risk perceptions, vaccination concerns, and necessity beliefs associated with higher odds of parental vaccine hesitancy (R2 Cox & Snell = 36.4%; p < 0.001). While levels of vaccine acceptance are high, more targeted messages are needed. For adults’ vaccination, more emphasis should be on benefits and social gains, while for parental hesitancy, messages related to safety should be prioritised.
Highlights
As of August 2021, the COVID-19 pandemic saw over 200 million positive cases worldwide and over 60,000 people in Singapore infected [1,2]
The vaccination program in Singapore was launched in December 2020 and initially prioritised individuals considered at high risk for COVID-19 [9,10]
The aims of this study are threefold: (1) To document the rates of COVID-19 vaccine hesitancy in adults in Singapore focusing on those that have yet to take the vaccine; (2) to determine the hesitancy rate for parents in vaccinating their children between 12 and 18 years old as part of the newly launched children vaccination program; and (3) to identify sociodemographic and psychosocial factors associated with vaccine hesitancy towards own and children COVID-19 vaccination
Summary
As of August 2021, the COVID-19 pandemic saw over 200 million positive cases worldwide and over 60,000 people in Singapore infected [1,2]. With COVID-19 vaccines reportedly able to effectively reduce the spread and severity of the disease [3,4,5], vaccination has been widely considered a key preventive measure in infection control, disease eradication, and in reducing mortality and morbidity rates [6,7,8]. As of June 2021, the Ministry of Health (MOH) of Singapore had authorised two COVID-19 mRNA vaccines for administration under its National Vaccine Programme: Comirnaty (by Pfizer–BioNTech; Pfizer, New York, US; BioNTech, Mainz, Germany) [14] and Moderna (by Moderna Inc., Cambridge, MA, USA) [15]. Adverse events related to the mRNA vaccines were reportedly low, and accounted for only 0.12% of all administered doses in Singapore as of July 2021 [17]. Despite the timely provision and accessibility of COVID-19 vaccines in Singapore and low adverse event incidence rate, vaccine hesitancy could undermine uptake rates for main and booster vaccination and result in insufficient immunisation coverage against COVID-19
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