Primary Submission Category: Health behaviors
Watchful, Skeptical, and System Distrusters: Characteristics Associated with Different Types of COVID-19 Vaccine Hesitancy among U.S. Working-Age Adults
Authors: Xue Zhang Shannon Monnat
Presenting Author: Xue Zhang*
COVID-19 vaccine hesitancy is complex, with adults identifying various reasons for not getting the vaccine. Using data from the National Wellbeing Survey (a demographically representative survey of U.S. working-age adults (18-64) collected in 2022, N=7,612), we identified demographic, socioeconomic, and political characteristics associated with different types of vaccine hesitancy (age, sex, race/ethnicity, marital status, income, education, metro status, and 2020 Presidential vote). We categorized unvaccinated adults into three non-mutually exclusive groups: 1) watchful adults who were concerned about vaccine side effects and efficacy; 2) skeptics who mistrusted the vaccine, and 3) system distrusters who mistrusted the government. A third of the sample had not received at least one dose. Among those, 65% are classified as watchful, 53% are skeptics, and 32% are system distrusters. Results from logistic regression showed that compared to vaccinated adults, the unvaccinated are younger, have lower education and income, and are more likely to have voted for Trump. Among those who are not vaccinated, we found that females (OR=1.20, CI=1.01,1.43) and those with a bachelor’s degree or higher (OR=1.50, CI=1.13, 1.99) were significantly more likely to be watchful. Respondents with household incomes of $75,000-$124,999 (compared to <$25,000) and Trump voters (OR=1.47, CI=1.17,1.85) were significantly more likely, and urban residents (OR=0.76, CI=0.61,0.95) were significantly less likely, to be vaccine skeptics. Those with incomes of $50,000-74,999 (OR=1.36, CI=1.08,1.71) and $75,000-$124,999 (OR=1.56, CI=1.12,2.18) (compared to <$25,000) and Trump voters (OR=1.75, CI=1.43,2.16) were significantly more likely to be system distrusters. Our findings suggest that universal messaging and intervention strategies are unlikely to be effective in increasing vaccine uptake. Different messages, messengers, and tactics must be used with different groups.