Socioeconomic determinants and reasons for non-acceptance to vaccination recommendations during the 3
Humans
Hungary
COVID-19
/ prevention & control
Male
Female
Adult
Middle Aged
Vaccination Hesitancy
/ psychology
COVID-19 Vaccines
/ administration & dosage
Socioeconomic Factors
Young Adult
Adolescent
Aged
Surveys and Questionnaires
Pandemics
/ prevention & control
Vaccination
/ statistics & numerical data
Patient Acceptance of Health Care
/ statistics & numerical data
COVID-19
Cross-sectional survey
Socioeconomic determinants
Vaccination hesitancy
Vaccine coverage
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
05 Jul 2024
05 Jul 2024
Historique:
received:
05
03
2024
accepted:
25
06
2024
medline:
6
7
2024
pubmed:
6
7
2024
entrez:
5
7
2024
Statut:
epublish
Résumé
In Hungary, although six types of vaccines were widely available, the percentage of people receiving the primary series of COVID-19 vaccination remained below the EU average. This paper investigates the reasons for Hungary's lower vaccination coverage by exploring changing attitudes towards vaccination, socio-demographic determinants, and individual reasons for non-acceptance during the 3 The study's empirical analysis is based on representative surveys conducted in Hungary between February 19, 2021, and June 30, 2022. The study used a total of 17 surveys, each with a sample size of at least 1000 respondents. Binomial logistic regression models were used to investigate which socio-demographic characteristics are most likely to influence vaccine hesitancy in Hungary. The study analysed 2506 open-ended responses to identify reasons for vaccine non-acceptance. The responses were categorised into four main categories and 13 sub-categories. Between the third and fifth wave of the pandemic, attitudes towards COVID-19 vaccination have significantly changed. Although the proportion of vaccinated individuals has increased steadily, the percentage of individuals who reported not accepting the vaccine has remained almost unchanged. Socio-demographic characteristics were an important determinant of the observed vaccine hesitancy, although they remained relatively stable over time. Individuals in younger age groups and those with lower socioeconomic status were more likely to decline vaccination, while those living in the capital city were the least likely. A significant reason behind vaccine refusal can undoubtedly be identified as lack of trust (specifically distrust in science), facing an information barrier and the perception of low personal risk. Although compulsory childhood vaccination coverage is particularly high in Hungary, voluntary adult vaccines, such as the influenza and COVID-19 vaccines, are less well accepted. Vaccine acceptance is heavily affected by the social-demographic characteristics of people. Mistrust and hesitancy about COVID-19 vaccines, if not well managed, can easily affect people's opinion and acceptance of other vaccines as well. Identifying and understanding the complexity of how vaccine hesitancy evolved during the pandemic can help to understand and halt the decline in both COVID-19 and general vaccine confidence by developing targeted public health programs to address these issues.
Sections du résumé
BACKGROUND
BACKGROUND
In Hungary, although six types of vaccines were widely available, the percentage of people receiving the primary series of COVID-19 vaccination remained below the EU average. This paper investigates the reasons for Hungary's lower vaccination coverage by exploring changing attitudes towards vaccination, socio-demographic determinants, and individual reasons for non-acceptance during the 3
METHODS
METHODS
The study's empirical analysis is based on representative surveys conducted in Hungary between February 19, 2021, and June 30, 2022. The study used a total of 17 surveys, each with a sample size of at least 1000 respondents. Binomial logistic regression models were used to investigate which socio-demographic characteristics are most likely to influence vaccine hesitancy in Hungary. The study analysed 2506 open-ended responses to identify reasons for vaccine non-acceptance. The responses were categorised into four main categories and 13 sub-categories.
RESULTS
RESULTS
Between the third and fifth wave of the pandemic, attitudes towards COVID-19 vaccination have significantly changed. Although the proportion of vaccinated individuals has increased steadily, the percentage of individuals who reported not accepting the vaccine has remained almost unchanged. Socio-demographic characteristics were an important determinant of the observed vaccine hesitancy, although they remained relatively stable over time. Individuals in younger age groups and those with lower socioeconomic status were more likely to decline vaccination, while those living in the capital city were the least likely. A significant reason behind vaccine refusal can undoubtedly be identified as lack of trust (specifically distrust in science), facing an information barrier and the perception of low personal risk.
CONCLUSION
CONCLUSIONS
Although compulsory childhood vaccination coverage is particularly high in Hungary, voluntary adult vaccines, such as the influenza and COVID-19 vaccines, are less well accepted. Vaccine acceptance is heavily affected by the social-demographic characteristics of people. Mistrust and hesitancy about COVID-19 vaccines, if not well managed, can easily affect people's opinion and acceptance of other vaccines as well. Identifying and understanding the complexity of how vaccine hesitancy evolved during the pandemic can help to understand and halt the decline in both COVID-19 and general vaccine confidence by developing targeted public health programs to address these issues.
Identifiants
pubmed: 38969991
doi: 10.1186/s12889-024-19267-2
pii: 10.1186/s12889-024-19267-2
doi:
Substances chimiques
COVID-19 Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1796Subventions
Organisme : Hungarian National Laboratory for Health Security
ID : RRF-2.3.1-21-2022-00006
Organisme : Hungarian National Laboratory for Health Security
ID : RRF-2.3.1-21-2022-00006
Organisme : Hungarian National Laboratory for Health Security
ID : RRF-2.3.1-21-2022-00006
Organisme : Hungarian National Laboratory for Health Security
ID : RRF-2.3.1-21-2022-00006
Organisme : Hungarian National Laboratory for Health Security
ID : RRF-2.3.1-21-2022-00006
Organisme : Hungarian National Laboratory for Health Security
ID : RRF-2.3.1-21-2022-00006
Informations de copyright
© 2024. The Author(s).
Références
Watson OJ, Barnsley G, Toor J, Hogan AB, Winskill P, Ghani AC. Global impact of the first year of COVID-19 vaccination: a mathematical modelling study. Lancet Infect Dis. 2022;22(9):1293–302. https://doi.org/10.1016/S1473-3099(22)00320-6 .
doi: 10.1016/S1473-3099(22)00320-6
pubmed: 35753318
pmcid: 9225255
COVID-19 Vaccine Tracker. European Centre for Disease Prevention and Control. 2024. https://www.ecdc.europa.eu/en/publications-data/covid-19-vaccine-tracker . Accessed 30 May 2024.
Oroszi B, Juhász A, Nagy C, Horváth JK, Komlós KE, Túri G, et al. Characteristics of the Third COVID-19 Pandemic Wave with Special Focus on Socioeconomic Inequalities in Morbidity, Mortality and the Uptake of COVID-19 Vaccination in Hungary. J Personal Med. 2022;12(3):388. https://doi.org/10.3390/jpm12030388 .
doi: 10.3390/jpm12030388
Kutasi K, Koltai J, Szabó-Morvai Á, Röst G, Karsai M, Biró P, et al. Understanding hesitancy with revealed preferences across COVID-19 vaccine types. Sci Rep. 2022;12(1):13293.
doi: 10.1038/s41598-022-15633-5
pubmed: 35918372
pmcid: 9345393
MacDonald NE. Vaccine Hesitancy: Definition, Scope and Determinants. Vaccine. 2015;33(34):4161–4. https://doi.org/10.1016/j.vaccine.2015.04.036 .
doi: 10.1016/j.vaccine.2015.04.036
pubmed: 25896383
Gostin LO, Hodge JG, Bloom BR, El-Mohandes A, Fielding J, Hotez P, et al. The public health crisis of underimmunisation: a global plan of action. Lancet Infect Dis. 2020;20(1):e11–6.
doi: 10.1016/S1473-3099(19)30558-4
pubmed: 31706795
Friedrich M. WHO’s Top Health Threats for 2019. JAMA. 2019;321(11):1041. https://doi.org/10.1001/jama.2019.1934 .
doi: 10.1001/jama.2019.1934
pubmed: 30874765
Lane S, MacDonald NE, Marti M, Dumolard L. Vaccine hesitancy around the globe: Analysis of three years of WHO/UNICEF Joint Reporting Form data-2015-2017. Vaccine. 2018;36(26):3861–7.
doi: 10.1016/j.vaccine.2018.03.063
pubmed: 29605516
pmcid: 5999354
Tostrud L, Thelen J, Palatnik A. Models of determinants of COVID-19 vaccine hesitancy in non-pregnant and pregnant population: Review of current literature. Hum Vaccines I Immunotherapeutics. 2022;18(6):2138047. https://doi.org/10.1080/21645515.2022.2138047 .
doi: 10.1080/21645515.2022.2138047
Turner PJ, Larson H, Dube E, Fisher A. Vaccine Hesitancy: Drivers and How the Allergy Community Can Help. J Allergy Clin Immunol Pract. 2021;9(10):3568–74. https://doi.org/10.1016/j.jaip.2021.06.035 .
doi: 10.1016/j.jaip.2021.06.035
pubmed: 34242848
pmcid: 8416028
Geiger M, Rees F, Lilleholt L, Santana AP, Zettler I, Wilhelm O, et al. Measuring the 7Cs of vaccination readiness. Eur J Psychol Assess. 2021;38(4):239–345. https://doi.org/10.1027/1015-5759/a000663 .
doi: 10.1027/1015-5759/a000663
Bíró É, Vincze F, Nagy-Pénzes G, Ádány R. Investigation of the relationship of general and digital health literacy with various health-related outcomes. Front Public Health. 2023;11:1229734.
doi: 10.3389/fpubh.2023.1229734
pubmed: 37588120
pmcid: 10426797
Kouvari K, Hadjikou A, Heraclidou I, Heraclides A. Health literacy, consciousness, and locus of control in relation to vaccine hesitancy and refusal. Eur J Public Health. 2022;32:ckac129–640. https://doi.org/10.1093/eurpub/ckac129.640 .
Lazarus JV, Wyka K, White TM, Picchio CA, Rabin K, Ratzan SC, et al. Revisiting COVID-19 Vaccine Hesitancy around the World Using Data from 23 Countries in 2021. Nat Commun. 2022;13(1):3801. https://doi.org/10.1038/s41467-022-31441-x .
doi: 10.1038/s41467-022-31441-x
pubmed: 35778396
pmcid: 9247969
Toshkov D. What accounts for the variation in COVID-19 vaccine hesitancy in Eastern, Southern and Western Europe? Vaccine. 2023;41(20):3178–88.
doi: 10.1016/j.vaccine.2023.03.030
pubmed: 37059674
pmcid: 10070781
Sapienza A, Falcone R. The role of trust in COVID-19 vaccine acceptance: considerations from a systematic review. Int J Environ Res Public Health. 2022;20(1):665. https://doi.org/10.3390/ijerph20010665 .
doi: 10.3390/ijerph20010665
pubmed: 36612982
pmcid: 9819668
Carrieri V, Guthmuller S, Wübker A. Trust and COVID-19 vaccine hesitancy. Sci Rep. 2023;13(1):9245. https://doi.org/10.1038/s41598-023-35974-z .
doi: 10.1038/s41598-023-35974-z
pubmed: 37286569
pmcid: 10245358
Lun P, Ning K, Wang Y, Ma TSW, Flores FP, Xiao X, et al. COVID-19 Vaccination Willingness and Reasons for Vaccine Refusal. JAMA Netw Open. 2023;6(10):e2337909–e2337909. https://doi.org/10.1001/jamanetworkopen.2023.37909 .
doi: 10.1001/jamanetworkopen.2023.37909
pubmed: 37856125
pmcid: 10587797
Krastev S, Krajden O, Vang ZM, Juárez FPG, Solomonova E, Goldenberg MJ, et al. Institutional trust is a distinct construct related to vaccine hesitancy and refusal. BMC Public Health. 2023;23(1):2481.
doi: 10.1186/s12889-023-17345-5
pubmed: 38082287
pmcid: 10714562
Koltai J, Vásárhelyi O, Röst G, Karsai M. Reconstructing social mixing patterns via weighted contact matrices from online and representative surveys. Sci Rep. 2022;12(1):4690.
doi: 10.1038/s41598-022-07488-7
pubmed: 35304478
pmcid: 8931780
Dudley MZ, Privor-Dumm L, Dubé È, MacDonald NE. Words Matter: Vaccine Hesitancy, Vaccine Demand, Vaccine Confidence. Herd Immunity and Mandatory Vaccination Vaccine. 2020;38(4):709–11. https://doi.org/10.1016/j.vaccine.2019.11.056 .
doi: 10.1016/j.vaccine.2019.11.056
pubmed: 31836257
R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing; 2022.
Mood C. Logistic regression: Why we cannot do what we think we can do, and what we can do about it. Eur Sociol Rev. 2010;26(1):67–82.
doi: 10.1093/esr/jcp006
Leeper TJ. Interpreting regression results using average marginal effects with R’s margins. Comprehensive R Archive Network (CRAN); 2017.
Leeper TJ, Arnold J, Arel-Bundock V, Long JA, Bolker, B. Package ‘margins’: Marginal Effects for Model Objects. 2024. R package version 0.3.26. https://cran.r-project.org/web/packages/margins/ . Accessed 05 June 2024.
Betsch C, Schmid P, Heinemeier D, Korn L, Holtmann C, Böhm R. Beyond Confidence: Development of a Measure Assessing the 5C Psychological Antecedents of Vaccination. PLoS ONE. 2018;13(12):e0208601. https://doi.org/10.1371/journal.pone.0208601 .
doi: 10.1371/journal.pone.0208601
pubmed: 30532274
pmcid: 6285469
Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics. 1977;33(1):159–74. https://doi.org/10.2307/2529310 .
doi: 10.2307/2529310
pubmed: 843571
OECD; European Union. Health at a Glance: Europe 2022: State of Health in the EU Cycle. 2022. https://doi.org/10.1787/507433b0-en .
Dombrádi V, Joó T, Palla G, Pollner P, Belicza É. Comparison of hesitancy between COVID-19 and seasonal influenza vaccinations within the general Hungarian population: A cross-sectional study. BMC Public Health. 2021;21(1):2317. https://doi.org/10.1186/s12889-021-12386-0 .
doi: 10.1186/s12889-021-12386-0
pubmed: 34949176
pmcid: 8697540
Eörsi D, Gács Z, Kun E. Influenza vaccination: pros and cons? Views of general practitioners and the general population. Orv Hetil. 2022;163(6):222–8. https://doi.org/10.1556/650.2022.32405 .
doi: 10.1556/650.2022.32405
pubmed: 35124572
Andrejko KL, Myers JF, Fukui N, Nelson L, Zhao R, Openshaw J, et al. Real-world uptake of COVID-19 vaccination among individuals expressing vaccine hesitancy: A registry-linkage study. Vaccine. 2023;41(10):1649–56. https://doi.org/10.1016/j.vaccine.2023.01.066 .
doi: 10.1016/j.vaccine.2023.01.066
pubmed: 36746740
pmcid: 9889259
Wolter F, Mayerl J, Andersen HK, Wieland T, Junkermann J. Overestimation of COVID-19 Vaccination Coverage in Population Surveys Due to Social Desirability Bias: Results of an Experimental Methods Study in Germany. Socius. 2022;8:23780231221094748. https://doi.org/10.1177/23780231221094749 .
doi: 10.1177/23780231221094749
Bagić D, Šuljok A, Ančić B. Determinants and reasons for coronavirus disease 2019 vaccine hesitancy in Croatia. Croat Med J. 2022;63(1):89–97.
doi: 10.3325/cmj.2022.63.89
pubmed: 35230010
pmcid: 8895326
Gołębiowska J, Zimny-Zając A, Dróżdż M, Makuch S, Dudek K, Mazur G, et al. Evaluation of the Approach towards Vaccination against COVID-19 among the Polish Population — In Relation to Sociodemographic Factors and Physical and Mental Health. Vaccines. 2023;11(3):700. https://doi.org/10.3390/vaccines11030700 .
doi: 10.3390/vaccines11030700
pubmed: 36992284
pmcid: 10058603
Reiter PL, Pennell ML, Katz ML. Acceptability of a COVID-19 vaccine among adults in the United States: How many people would get vaccinated? Vaccine. 2020;38(42):6500–7.
doi: 10.1016/j.vaccine.2020.08.043
pubmed: 32863069
pmcid: 7440153
Malik AA, McFadden SM, Elharake J, Omer SB. Determinants of COVID-19 vaccine acceptance in the US. EClinicalMedicine. 2020;26:100495.
doi: 10.1016/j.eclinm.2020.100495
pubmed: 32838242
pmcid: 7423333
Miao Y, Shen Z, Li Q, Ma M, Xu D, Tarimo CS, et al. Understanding the impact of chronic diseases on COVID-19 vaccine hesitancy using propensity score matching: internet-based cross-sectional study. J Clin Nurs. 2024;33(6):2165–77. https://doi.org/10.1111/jocn.16958 .
Boda Z, Medve-Bálint G. Does institutional trust in East Central Europe differ from Western Europe? Eur Q Polit Attitudes Mentalities. 2014;3(2):1–17.
Yaddanapudi L, Hahn J, Ladikas M. Decreasing trust in health institutions in EU during COVID-19: A Spatio-temporal analysis. Eur J Pub Health. 2023;33:160–594. https://doi.org/10.1093/eurpub/ckad160.594 .
doi: 10.1093/eurpub/ckad160.594
WHO SAGE roadmap for prioritizing uses of COVID-19 vaccines: an approach to optimize the global impact of COVID-19 vaccines, based on public health goals, global and national equity, and vaccine access and coverage scenarios, first issued 20 October 2020, updated: 13 November 2020, updated: 16 July 2021, latest update: 21 January 2022. World Health Organization; 2022.
Interim statement on hybrid immunity and increasing population seroprevalence rates. World Health Organization; 2022.
Horváth JK, Komlós KE, Krisztalovics K, Röst G, Oroszi B. A COVID-19 világjárvány első két éve Magyarországon. Népegészségügy. 2022;99(1):6–19.
Assessment of the further spread and potential impact of the SARS-CoV-2 Omicron variant of concern in the EU/EEA, 19th update. Rapid Risk Assessment; 2022.
Singanayagam A, Hakki S, Dunning J, Madon KJ, Crone MA, Koycheva A, et al. Community transmission and viral load kinetics of the SARS-CoV-2 delta (B. 1.617. 2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study. Lancet Infect Dis. 2022;22(2):183–195.
Feikin DR, Higdon MM, Abu-Raddad LJ, Andrews N, Araos R, Goldberg Y, et al. Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: results of a systematic review and meta-regression. Lancet. 2022;399(10328):924–44.
doi: 10.1016/S0140-6736(22)00152-0
pubmed: 35202601
pmcid: 8863502