Regional Differences in COVID-19 Vaccine Hesitancy in December 2020: A Natural Experiment in the French Working-Age Population

Fanny Velardo; Verity Watson; Pierre Arwidson; François Alla; Stéphane Luchini; Michaël Schwarzinger; CoVaMax Study Group

doi:10.3390/vaccines9111364

Regional Differences in COVID-19 Vaccine Hesitancy in December 2020: A Natural Experiment in the French Working-Age Population

Fanny Velardo, Verity Watson, Pierre Arwidson, François Alla, Stéphane Luchini, Michaël Schwarzinger, CoVaMax Study Group

Health Economics Research Unit

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

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Abstract

It can be assumed that higher SARS-CoV-2 infection risk is associated with higher COVID-19 vaccination intentions, although evidence is scarce. In this large and representative survey of 6007 adults aged 18–64 years and residing in France, 8.1% (95% CI, 7.5–8.8) reported a prior SARS-CoV-2 infection in December 2020, with regional variations according to an East–West gradient (p < 0.0001). In participants without prior SARS-CoV-2 infection, COVID-19 vaccine hesitancy was substantial, including 41.3% (95% CI, 39.8–42.8) outright refusal of COVID-19 vaccination. Taking into account five characteristics of the first approved vaccines (efficacy, duration of immunity, safety, country of the vaccine manufacturer, and place of administration) as well as the initial setting of the mass vaccination campaign in France, COVID-19 vaccine acceptance would reach 43.6% (95% CI, 43.0–44.1) at best among working-age adults without prior SARS-CoV-2 infection. COVID-19 vaccine acceptance was primarily driven by vaccine characteristics, sociodemographic and attitudinal factors. Considering the region of residency as a proxy of the likelihood of getting infected, our study findings do not support the assumption that SARS-CoV-2 infection risk is associated with COVID-19 vaccine acceptance.

Original language	English
Article number	1364
Number of pages	13
Journal	Vaccines
Volume	9
Issue number	11
Early online date	20 Nov 2021
DOIs	https://doi.org/10.3390/vaccines9111364
Publication status	Published - 20 Nov 2021

Bibliographical note

Funding: Online survey experiments were funded by Santé publique France. This research was funded by Agence Nationale de la Recherche (ANR-21-CO16-0006-01).
Acknowledgments: The Department of methodology and innovation in prevention (SSMIP) of the teaching hospital of Bordeaux is partially funded by Agence Régionale de Santé (ARS) NouvelleAquitaine, France. Health Economics Research Unit (HERU) is funded by the Chief Scientist Office (CSO) of the Scottish Government Health and Social Care Directorates. Centre de Calcul Intensif
d’Aix-Marseille is acknowledged for granting access to its high performance computing resources. The CoVaMax Study Group includes: François Alla, Angela Baron, Coline Bourreau, Léo Donzel Godinot, Michaël Schwarzinger, Fanny Velardo (Department of methodology and innovation in prevention, Bordeaux university hospital, 33000 Bordeaux, France); Marcela Benavides, Linda Cambon,
Laurence Kotobi, Elodie Richard (University of Bordeaux, Inserm UMR 1219-Bordeaux Population Health, 33000 Bordeaux, France); Pierre Arwidson, Isabelle Bonmarin, Stéphanie Vandentorren (Santé Publique France, 94410 Saint Maurice, France); Stéphane Luchini (Aix-Marseille Univ, CNRS, EHESS, Centrale Marseille, AMSE, 13001 Marseille, France); Verity Watson (Health Economics Research Unit
(HERU), University of Aberdeen, Aberdeen AB25 2ZD, UK).

Keywords

SARS-CoV-2
COVID-19
mass vaccination
anti-vaccinations behavior
vaccine hesitancy
survey experiment
discrete choice experiment
France

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

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title = "Regional Differences in COVID-19 Vaccine Hesitancy in December 2020: A Natural Experiment in the French Working-Age Population",

abstract = "It can be assumed that higher SARS-CoV-2 infection risk is associated with higher COVID-19 vaccination intentions, although evidence is scarce. In this large and representative survey of 6007 adults aged 18–64 years and residing in France, 8.1% (95% CI, 7.5–8.8) reported a prior SARS-CoV-2 infection in December 2020, with regional variations according to an East–West gradient (p < 0.0001). In participants without prior SARS-CoV-2 infection, COVID-19 vaccine hesitancy was substantial, including 41.3% (95% CI, 39.8–42.8) outright refusal of COVID-19 vaccination. Taking into account five characteristics of the first approved vaccines (efficacy, duration of immunity, safety, country of the vaccine manufacturer, and place of administration) as well as the initial setting of the mass vaccination campaign in France, COVID-19 vaccine acceptance would reach 43.6% (95% CI, 43.0–44.1) at best among working-age adults without prior SARS-CoV-2 infection. COVID-19 vaccine acceptance was primarily driven by vaccine characteristics, sociodemographic and attitudinal factors. Considering the region of residency as a proxy of the likelihood of getting infected, our study findings do not support the assumption that SARS-CoV-2 infection risk is associated with COVID-19 vaccine acceptance.",

keywords = "SARS-CoV-2, COVID-19, mass vaccination, anti-vaccinations behavior, vaccine hesitancy, survey experiment, discrete choice experiment, France",

author = "Fanny Velardo and Verity Watson and Pierre Arwidson and Fran{\c c}ois Alla and St{\'e}phane Luchini and Micha{\"e}l Schwarzinger and Group, {CoVaMax Study}",

note = "Funding: Online survey experiments were funded by Sant{\'e} publique France. This research was funded by Agence Nationale de la Recherche (ANR-21-CO16-0006-01). Acknowledgments: The Department of methodology and innovation in prevention (SSMIP) of the teaching hospital of Bordeaux is partially funded by Agence R{\'e}gionale de Sant{\'e} (ARS) NouvelleAquitaine, France. Health Economics Research Unit (HERU) is funded by the Chief Scientist Office (CSO) of the Scottish Government Health and Social Care Directorates. Centre de Calcul Intensif d{\textquoteright}Aix-Marseille is acknowledged for granting access to its high performance computing resources. The CoVaMax Study Group includes: Fran{\c c}ois Alla, Angela Baron, Coline Bourreau, L{\'e}o Donzel Godinot, Micha{\"e}l Schwarzinger, Fanny Velardo (Department of methodology and innovation in prevention, Bordeaux university hospital, 33000 Bordeaux, France); Marcela Benavides, Linda Cambon, Laurence Kotobi, Elodie Richard (University of Bordeaux, Inserm UMR 1219-Bordeaux Population Health, 33000 Bordeaux, France); Pierre Arwidson, Isabelle Bonmarin, St{\'e}phanie Vandentorren (Sant{\'e} Publique France, 94410 Saint Maurice, France); St{\'e}phane Luchini (Aix-Marseille Univ, CNRS, EHESS, Centrale Marseille, AMSE, 13001 Marseille, France); Verity Watson (Health Economics Research Unit (HERU), University of Aberdeen, Aberdeen AB25 2ZD, UK). ",

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doi = "10.3390/vaccines9111364",

language = "English",

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T2 - A Natural Experiment in the French Working-Age Population

AU - Velardo, Fanny

AU - Watson, Verity

AU - Arwidson, Pierre

AU - Alla, François

AU - Luchini, Stéphane

AU - Schwarzinger, Michaël

AU - Group, CoVaMax Study

N1 - Funding: Online survey experiments were funded by Santé publique France. This research was funded by Agence Nationale de la Recherche (ANR-21-CO16-0006-01). Acknowledgments: The Department of methodology and innovation in prevention (SSMIP) of the teaching hospital of Bordeaux is partially funded by Agence Régionale de Santé (ARS) NouvelleAquitaine, France. Health Economics Research Unit (HERU) is funded by the Chief Scientist Office (CSO) of the Scottish Government Health and Social Care Directorates. Centre de Calcul Intensif d’Aix-Marseille is acknowledged for granting access to its high performance computing resources. The CoVaMax Study Group includes: François Alla, Angela Baron, Coline Bourreau, Léo Donzel Godinot, Michaël Schwarzinger, Fanny Velardo (Department of methodology and innovation in prevention, Bordeaux university hospital, 33000 Bordeaux, France); Marcela Benavides, Linda Cambon, Laurence Kotobi, Elodie Richard (University of Bordeaux, Inserm UMR 1219-Bordeaux Population Health, 33000 Bordeaux, France); Pierre Arwidson, Isabelle Bonmarin, Stéphanie Vandentorren (Santé Publique France, 94410 Saint Maurice, France); Stéphane Luchini (Aix-Marseille Univ, CNRS, EHESS, Centrale Marseille, AMSE, 13001 Marseille, France); Verity Watson (Health Economics Research Unit (HERU), University of Aberdeen, Aberdeen AB25 2ZD, UK).

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Y1 - 2021/11/20

N2 - It can be assumed that higher SARS-CoV-2 infection risk is associated with higher COVID-19 vaccination intentions, although evidence is scarce. In this large and representative survey of 6007 adults aged 18–64 years and residing in France, 8.1% (95% CI, 7.5–8.8) reported a prior SARS-CoV-2 infection in December 2020, with regional variations according to an East–West gradient (p < 0.0001). In participants without prior SARS-CoV-2 infection, COVID-19 vaccine hesitancy was substantial, including 41.3% (95% CI, 39.8–42.8) outright refusal of COVID-19 vaccination. Taking into account five characteristics of the first approved vaccines (efficacy, duration of immunity, safety, country of the vaccine manufacturer, and place of administration) as well as the initial setting of the mass vaccination campaign in France, COVID-19 vaccine acceptance would reach 43.6% (95% CI, 43.0–44.1) at best among working-age adults without prior SARS-CoV-2 infection. COVID-19 vaccine acceptance was primarily driven by vaccine characteristics, sociodemographic and attitudinal factors. Considering the region of residency as a proxy of the likelihood of getting infected, our study findings do not support the assumption that SARS-CoV-2 infection risk is associated with COVID-19 vaccine acceptance.

AB - It can be assumed that higher SARS-CoV-2 infection risk is associated with higher COVID-19 vaccination intentions, although evidence is scarce. In this large and representative survey of 6007 adults aged 18–64 years and residing in France, 8.1% (95% CI, 7.5–8.8) reported a prior SARS-CoV-2 infection in December 2020, with regional variations according to an East–West gradient (p < 0.0001). In participants without prior SARS-CoV-2 infection, COVID-19 vaccine hesitancy was substantial, including 41.3% (95% CI, 39.8–42.8) outright refusal of COVID-19 vaccination. Taking into account five characteristics of the first approved vaccines (efficacy, duration of immunity, safety, country of the vaccine manufacturer, and place of administration) as well as the initial setting of the mass vaccination campaign in France, COVID-19 vaccine acceptance would reach 43.6% (95% CI, 43.0–44.1) at best among working-age adults without prior SARS-CoV-2 infection. COVID-19 vaccine acceptance was primarily driven by vaccine characteristics, sociodemographic and attitudinal factors. Considering the region of residency as a proxy of the likelihood of getting infected, our study findings do not support the assumption that SARS-CoV-2 infection risk is associated with COVID-19 vaccine acceptance.

KW - SARS-CoV-2

KW - COVID-19

KW - mass vaccination

KW - anti-vaccinations behavior

KW - vaccine hesitancy

KW - survey experiment

KW - discrete choice experiment

KW - France

U2 - 10.3390/vaccines9111364

DO - 10.3390/vaccines9111364

M3 - Article

SN - 2076-393X

VL - 9

JO - Vaccines

JF - Vaccines

IS - 11

M1 - 1364

ER -

Regional Differences in COVID-19 Vaccine Hesitancy in December 2020: A Natural Experiment in the French Working-Age Population

Abstract

Bibliographical note

Keywords

UN SDGs

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