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Psychobehavioral Responses & Vaccine Hesitancy

Updated: Aug 10, 2022

【Vaccine Hesitancy】Inducements provided by the Hong Kong government and business companies could help encourage citizens who were initially hesitant to receive the COVID-19 vaccine to reconsider the jab, said Professor Kin-on Kwok, Assistant Professor of CUHK JC School of Public Health and Primary Care. The rise of “vaccine hesitancy” changed the landscape of the disease transmission and has posed a challenge to herd immunity. The validated 5C scale, that assesses five psychological antecedents of vaccination including confidence, complacency, constraints, calculation and collective responsibility, could be effective in exploring COVID-19 vaccination behaviour and hesitancy.

A local population-based longitudinal study led by Professor Samuel Yeung Shan Wong, Director of CUHK JC School of Public Health and Primary Care, and Professor Kin-on Kwok suggested that factors associated with the likelihood to receive vaccination of Hong Kong citizens included confidence and complacency towards vaccines and the disease. This study consisted of five rounds of online survey recruitments since the first COVID-19 case reported in January 2020. An average of 48.7% of citizens expressed their intentions to receive COVID-19 vaccines during the third epidemic from mid-July to mid-August, which was substantially lower than the global estimate of 71.5%[1].

“Most people did not absolutely reject the jabs. They adopted a wait-and-see approach to the COVID-19 vaccine. This phenomenon may be explained by low infection rate and low self-perceived severity of the disease weakening the urgency for vaccination” said Professor Kwok.

Older adults aged 55 years old or above were the least willing group for vaccination. The low projected overall vaccine uptake rate in this study might be insufficient for the community to reach herd immunity, relatively small-scale upcoming epidemics were expected.

Proportion of citizens who believed the disease to be serious or very serious dropped from 97.4% to 77.2% in the first nine months of local outbreak, while more participants considered they could be cured when infected. Yet more than 90% of the respondents adopted personal protective measures including masks wearing, hands washing and covering mouth and nose when coughing or sneezing. Notably, an upward significant trend from 63.8% to 85.7% was observed among respondents in avoiding social activities.

Study results are now published in Emerging Infectious Diseases and full article can be accessed with the following URL:

1.Lazarus, Jeffrey V., Scott C. Ratzan, Adam Palayew, Lawrence O. Gostin, Heidi J. Larson, Kenneth Rabin, Spencer Kimball, and Ayman El-Mohandes. 2021. “A Global Survey of Potential Acceptance of a COVID-19 Vaccine.” Nature Medicine 27 (2): 225–28.

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