- Vaccine hesitancy is an issue with concerns related to the risk and benefits of being vaccinated. 
- Hesitancy has many different levels to it depending on the time, place, vaccine, person, etc, so there is no one simple strategy to address hesitancy at all levels. 
- Vaccine information campaigns that focus on facts have a limited impact on hesitancy because risk perception and vaccine decisions are often made at the unconscious level and more influenced by emotions and beliefs than facts. Anti-vaccine ideas and beliefs can also spread very easily. 

Risk Perception and Vaccine Hesitancy in regards to Vaccination Uptake 

Emotions play a role in decision making and how we interpret numerical information. 
- If the fact conflicts with one’s beliefs, the fact is rejected. 
- If the fact is consistent with one’s beliefs, the fact is accepted. 
- If the fact is “reshaped,” the fact is accepted, changing one’s beliefs. 

Emotions and Beliefs in regards to Vaccination Uptake 

Health care workers and immunization program managers should recognize and address vaccination hesitancy at all levels while actively supporting immunization acceptors in order to build and support a community of immunization acceptors. 
- Accepting vaccines does not necessarily mean hesitancy does not exist, so setting the social environment to accept vaccination is important. 
- Specific complex strategies are more effective than single interventions addressed towards a broad population. 
- Respecting and empathizing with those with different perspectives on immunizations are important regardless of the environment of the conversation (online, one one one in a clinic, or at a social event). This is because people are unlikely to change their opinions because someone is arguing aggressively with them. 


Solutions regarding knowledge, attitudes, and beliefs, and how to increase vaccine uptake 

- Risk Perception and Hesitancy 
- Emotions and Beliefs

Saint Louis University

We can explore factors that affect the uptake of established adult vaccinations to inform efforts of COVID-19 vaccine acceptance. 

- Social Factors 
- Knowledge, Attitudes, and Beliefs
- Racial Factors
- Age

COVID-19 Vaccination Uptake

- Ongoing vaccination disparities, with Hispanic populations consistently having the lowest coverage for influenza and pneumococcal vaccines
- Door-to-door, population-based survey was conducted in ten Chicago communities from 2015 to 2016
- 1543 adults that completed the survey
- Study participants who received the influenza vaccination were more likely to be female, older, and insured
- Black study participants who had high confidence and trust in their doctor were more likely to be vaccinated (45% vs 20%; P < .01)
- Trust or confidence had no effect on influenza vaccination for Hispanic participants. 

Racial Factors that Affect Adult Vaccination Uptake

- Physician Recommendation
- Socioeconomic Status
- Occupation and Income
- Health care insurance and accessibility
- Education


Social Factors that Affect Adult Vaccination Uptake

- Overall, vaccinated group were younger, predominantly not married, and students compared to the unvaccinated group 


Age as a Factor of Adult Vaccination Uptake

Knowledge, Attitudes, and Beliefs that Affect Adult Vaccination Uptake 

- In surveys conducted by the CDC, intent is defined as being absolutely certain, very likely, or somewhat likely to be vaccinated.
- Uptake is the proportion of the eligible population who received a vaccine during a specific time period

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