Factors Influencing COVID-19 Vaccine Hesitancy among Patients with Serious Chronic Illnesses during the Initial Australian Vaccine Rollout: A Multi-Centre Qualitative Analysis Using the Health Belief Model.

Choi, Tammie; Chan, Bryan; Grech, Lisa; Kwok, Alastair; Webber, Kate; Wong, Jennifer; Nguyen, Mike; Bain, Nathan; Day, Daphne; McCartney, Amelia; Hamer, Ruby; Segelov, Eva (2023). Factors Influencing COVID-19 Vaccine Hesitancy among Patients with Serious Chronic Illnesses during the Initial Australian Vaccine Rollout: A Multi-Centre Qualitative Analysis Using the Health Belief Model. Vaccines, 11(2), p. 239. MDPI 10.3390/vaccines11020239

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Background: People with chronic illnesses have increased morbidity and mortality associated with COVID-19 infection. The influence of a person's serious and/or comorbid chronic illness on COVID-19 vaccine uptake is not well understood. Aim: To undertake an in-depth exploration of factors influencing COVID-19 vaccine uptake among those with various serious and/or chronic diseases in the Australian context, using secondary data analysis of a survey study. Methods: Adults with cancer, diabetes and multiple sclerosis (MS) were recruited from 10 Australian health services to undertake a cross-sectional online survey (30 June to 5 October 2021) about COVID-19 vaccine uptake, vaccine hesitancy, confidence and complacency and disease-related decision-making impact. Free-text responses were invited regarding thoughts and feelings about the interaction between the participant's disease, COVID-19, and vaccination. Qualitative thematic analysis was undertaken using an iterative process and representative verbatim quotes were chosen to illustrate the themes. Results: Of 4683 survey responses (cancer 3560, diabetes 842, and MS 281), 1604 (34.3%) included free-text comments for qualitative analysis. Participants who provided these were significantly less likely to have received a COVID-19 vaccination than those who did not comment (72.4% and 86.2%, respectively). People with diabetes were significantly less likely to provide free-text comments than those with cancer or MS (29.0%, 35.1% and 39.9%, respectively). Four key themes were identified from qualitative analysis, which were similar across disease states: (1) having a chronic disease heightened perceived susceptibility to and perceived severity of COVID-19; (2) perceived impact of vaccination on chronic disease management and disease-related safety; (3) uncertain benefits of COVID-19 vaccine; and (4) overwhelming information overload disempowering patients. Conclusions: This qualitative analysis highlights an additional layer of complexity related to COVID-19 vaccination decision making in people with underlying health conditions. Appreciation of higher susceptibility to severe COVID-19 outcomes appears to be weighed against uncertain impacts of the vaccine on the progression and management of the comorbid disease. Interactions by clinicians addressing individual factors may alleviate concerns and maximise vaccine uptake in people with significant underlying health conditions.

Item Type:

Journal Article (Original Article)

UniBE Contributor:

Segelov, Eva

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2076-393X

Publisher:

MDPI

Language:

English

Submitter:

Pubmed Import

Date Deposited:

02 Mar 2023 11:18

Last Modified:

04 Oct 2023 10:49

Publisher DOI:

10.3390/vaccines11020239

PubMed ID:

36851117

Uncontrolled Keywords:

COVID-19 cancer chronic illness diabetes health belief model multiple sclerosis qualitative analysis vaccine hesitancy

BORIS DOI:

10.48350/179359

URI:

https://boris.unibe.ch/id/eprint/179359

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