Abstract
The purpose of this paper is to examine the relationship between vaccination hesitancy and fear, trust, and expectation of a potential imminent and proximate outbreak of Ebola. Our hypothesis is that people engage in self-protective behavior against an infectious disease when they are: fearful about things in general; trustful of government's ability to control the disease outbreak; and anticipating a direct threat to their health. The self-protective behavior we examine is the intention to accept a prospective anti-Ebola vaccination. We examine these relationships with basic demographic variables taken into account: gender, age, ethnicity, race and education. The data source is a national random sample of 1,018 United States adults interviewed early during the 2014 Ebola outbreak. We constructed a new three-item Exposure Expectancy Scale (alpha = 0. 635) to measure the degree of respondents' expectancy of a potential nearby Ebola outbreak. Our data analysis employs multiple logistic regressions. The findings support our hypothesis: willingness to take the Ebola vaccination is positively associated with a generalized sense of fear, trust in the government's ability to control an outbreak of the disease, and expectation of a potential Ebola outbreak that is imminent and proximate. The addition of the exposure expectancy variable in this analysis adds significantly to our understanding of contributors to vaccine hesitancy.
Highlights
Vaccination has become a principal public health response to the growing number of contagious diseases that infect the worlds’ population
While many specific factors have been shown to have significant relationships to vaccine hesitancy (Dube et al, 2013), in this paper we suggest that, in addition to the basic variables of fear and trust of government (Heymann, 2017; Hofman and Au, 2017) another important factor correlates with vaccine hesitancy that has not been explicit in prior studies
Each of this study's three hypotheses is supported by the data; that is willingness to take a prospective Ebola vaccine is related to a generalized sense of fear, to trust in the federal government's ability to prevent an outbreak of a little known killer disease, and to the extent to which an Ebola outbreak is anticipated to occur in the local environment
Summary
Vaccination has become a principal public health response to the growing number of contagious diseases that infect the worlds’ population. Hesitancy refers to the delay in acceptance or refusal of accepting vaccine despite the availability of vaccination services (MacDonald and SAGE Working Group on Vaccination Hesitancy, 2015). The Sage Working Group has suggested that there are three major domains of variables that influence vaccine hesitancy; they are convenience or the ease of access, confidence or trust in the safety or efficacy of the vaccine, and complacency or risk of disease and importance of immunization (Larson et al, 2015). Pro-vaccine and vaccination groups have emerged to contend with the anti-vaccination movement they do not get as much media coverage (Vanderslott, 2019). The conflict between pro and anti-vaccination movements is not limited to the US but has emerged in many other countries as well including the UK, Japan, Canada, France, Philippians, and Kenya (MacDonald, 2017). The World Health Organization has listed both the anti-vaccination movement and Ebola among the top ten threats to global health in 2019 (Aranda, 2019)
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