Our report, Living in Boston during COVID-19: Vaccine Hesitancy, estimated the percentage of adult residents who are definitely planning to get a COVID-19 vaccine and those who were probably or definitely not planning for vaccination. In a mail and web-based survey of adult Boston residents conducted during the fall of 2020, we asked, “If a vaccine against the coronavirus becomes available, do you plan to get vaccinated?” We found that about 1 in 5 respondents were not planning to get vaccinated: almost 9% stated they were “definitely not” and about 12% stated they were “probably not” getting vaccinated.
In our earlier survey of the same people from the summer of 2020, we asked respondents, “How worried are you about you or someone in your family being infected with the COVID-19 coronavirus?” Our expectation was that people who are more worried about infection would be most enthusiastic about vaccination. And for the most part, this proved to be true: as worries about COVID-19 infection rose, the percentage of respondents definitely planning to get a vaccine increased.
Figure 1 shows the association of worries about being infected with the coronavirus with plans to get the vaccine.[1] The percentage of respondents “definitely” planning to get the vaccine appears to be associated with respondents’ worries about COVID-19 infection. The more worried respondents were about infection, the more likely they were to plan for vaccination but only up to a point.
Figure 1. Worried about COVID-19 infection and plans to get the vaccine
What was unexpected in our results is that respondents who were “extremely worried” about either themselves or family members getting the coronavirus were least likely to “definitely” plan to get vaccinated. We believe that respondents who were extremely worried about infection were ambivalent about
the vaccine; for example, 40% said they probably plan on getting the vaccine and 1 in 3 respondents who were extremely worried said they are not planning for vaccination. There is something about feelings of extreme worry about infection that may reflect some respondents having stronger concerns about feared hazards of vaccines as well.
The Living in Boston during COVID-19 survey conducted during the summer of 2020 asked about respondents’ personal characteristics, such as. age and education.
Figure 2. Bostonians’ Personal Characteristics Associated with being “Extreme Worried” about COVID-19 Infection. (Source: Living in Boston during COVID-19 Survey, Summer 2020)
Figure 2 shows that 24% or almost 1 in 4 Boston respondents were “extremely worried” about COVID-19 infecting either themselves or family members. Personal characteristics associated with being extremely worried include race, gender, age, education, and presence of children in the household. Specifically, the respondents with extreme worries were likely to have high school education or less, be older, or Black.
Black and Latinx respondents stated that they were extremely worried at much higher rates than Whites. Almost 1 in 3 Latinx respondents and over one-half of Black respondents were extremely worried, compared to almost 1 in 6 of Whites and others who were extremely worried.
Women were somewhat more likely than men to be extremely worried (29% compared to 23%). Age is associated with extreme worries about infection. Respondents with high school education or less were more worried than those with more education (48% extremely worried, compared to less than 17% among more educated respondents).
In summary, these the four groups were most worried about the virus—women, those over 65, those with less formal education, and those who are Black or Latinx.
Conclusions
Using responses to our Living in Boston during COVID-19 follow-up survey, we provide information about which Boston residents are clearly likely to get vaccinated and those who are more likely to hesitate. Many respondents to our survey had substantial worries about contracting the COVID-19 virus, either family members or themselves. For some respondents, worries about the infection may help to explain their plans to get vaccinated. For these respondents, community leaders and public health professionals may need to listen to their reasons for hesitating to get the vaccine, understand their concerns, and provide information from trusted sources to alleviate apprehensions about vaccination.
One approach to address vaccine hesitancy, for example, uses motivational interviewing in which community health workers and other trusted professionals have an open-ended discussion with individuals and groups, ask people for permission to share information that might help with their decision making, focus on facts, and have a conversation to address any concerns.[2],[3] This approach does not rely on lectures, rather it employs empathy and understanding to achieve health-related goals.
[1] Two responses, “Not at all” and “Not too worried,” were combined into “Not worried” due to only 3.5% of respondents selecting the “Not at all” worried response option.
[2] McClure, C. C., Cataldi, J. R., & O’Leary, S. T. (2017). Vaccine hesitancy: where we are and where we are going. Clinical therapeutics, 39(8), 1550-1562.
[3] Somsanith, D. (2009). “The role of CHWs. Foundations for community health workers,” Pages 3-22, Chapter One in Berthold T., Miller J., and Avila-Esparza A (eds). Foundations for Community Health Workers. San Francisco: John Wiley & Sons.
The content of this post is drawn from the Living in Boston during COVID survey conducted by the Boston Area Research Initiative, the Center for Survey Research at UMass Boston, and the Boston Public Health Commission. It was funded by the National Science Foundation’s Human-Environment and Geographical Sciences (HEGS) program through a grant for rapid-response research (RAPID; Award #2032384). The results presented here were part of a longer report on Vaccination Planning and Hesitancy.
