Associations of COVID-19 risk perception with vaccine hesitancy over time for Italian residents

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Abstract

Rationale

Many countries were and are still struggling with the COVID-19 emergency. Despite efforts to limit the viral transmission, the vaccine is the only solution to ending the pandemic. However, vaccine hesitancy could reduce coverage and hinder herd immunity.

Objective

People's intention to get vaccinated can be shaped by several factors, including risk perception which, in turn, is influenced by affect. The present work aimed at investigating how risk perception and some factors associated with the decision to comply with vaccination modulated vaccine acceptance for COVID-19 as compared to seasonal influenza, and how these have varied during the lockdown phases.

Method

The study followed the main phases of the emergency in Italy, investigating the intention to get vaccinated against flu and against SARS-CoV-2 (if a vaccine was available) before, during and after the first national lockdown, covering the period from the end of February to the end of June 2020. We investigated the effect of risk perception and other predictors on the decision of getting vaccinated.

Results

Compared to the pre-lockdown phase, during the lockdown more people were willing to get vaccinated for COVID-19, regardless of their beliefs about vaccines, and as risk perception increased, so did the intention to accept the vaccine. The acceptance of the flu vaccine increased after the re-opening phase. In addition, the intention to get vaccinated against COVID-19 and against flu increased if there was previous flu vaccination behavior but decreased with increasing doubts about the vaccines in general.

Conclusions

The observation of vaccination intentions across the three main phases of the emergency allows important considerations regarding psychological, affect, and demographic determinants useful to tailor public health communication to improve public response to future epidemics.

Research Highlights

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Acceptance of a COVID-19 vaccine was assessed from February to June 2020 in Italy.
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Risk perception is associated with the acceptance of a COVID-19 vaccine.
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Hesitancy to vaccinate against COVID-19 decreased during the lockdown.
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Acceptance of a COVID-19 vaccine might be hindered by reference to the flu vaccine.

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Most cited references 37

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The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Samantha K. Brooks, Rebecca K Webster, Louise E. Smith … (2022)

Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

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Vaccine hesitancy: Definition, scope and determinants.

Noni MacDonald (2015)

The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.

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Risk as analysis and risk as feelings: some thoughts about affect, reason, risk, and rationality.

Paul Slovic, Melissa L Finucane, Ellen Peters … (2004)

Modern theories in cognitive psychology and neuroscience indicate that there are two fundamental ways in which human beings comprehend risk. The "analytic system" uses algorithms and normative rules, such as probability calculus, formal logic, and risk assessment. It is relatively slow, effortful, and requires conscious control. The "experiential system" is intuitive, fast, mostly automatic, and not very accessible to conscious awareness. The experiential system enabled human beings to survive during their long period of evolution and remains today the most natural and most common way to respond to risk. It relies on images and associations, linked by experience to emotion and affect (a feeling that something is good or bad). This system represents risk as a feeling that tells us whether it is safe to walk down this dark street or drink this strange-smelling water. Proponents of formal risk analysis tend to view affective responses to risk as irrational. Current wisdom disputes this view. The rational and the experiential systems operate in parallel and each seems to depend on the other for guidance. Studies have demonstrated that analytic reasoning cannot be effective unless it is guided by emotion and affect. Rational decision making requires proper integration of both modes of thought. Both systems have their advantages, biases, and limitations. Now that we are beginning to understand the complex interplay between emotion and reason that is essential to rational behavior, the challenge before us is to think creatively about what this means for managing risk. On the one hand, how do we apply reason to temper the strong emotions engendered by some risk events? On the other hand, how do we infuse needed "doses of feeling" into circumstances where lack of experience may otherwise leave us too "coldly rational"? This article addresses these important questions.

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Author and article information

Journal

Journal ID (nlm-ta): Soc Sci Med

Journal ID (iso-abbrev): Soc Sci Med

Title: Social Science & Medicine (1982)

Publisher: Elsevier Ltd.

ISSN (Print): 0277-9536

ISSN (Electronic): 1873-5347

Publication date PMC-release: 7 January 2021

Publication date (Electronic): 7 January 2021

Electronic Location Identifier: 113688

Affiliations

[a ]Department of Developmental Psychology and Socialization, University of Padova, Italy

[b ]Department of Humanities, University of Ferrara, Italy

[c ]Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Italy

Author notes

[∗ ]Correspondence concerning this article should be addressed to Marta Caserotti, University of Padova, Department of Developmental Psychology and Socialization, Via Venezia, 8 – 35131, Padova, Italy. .

Article

Publisher Item ID: S0277-9536(21)00020-4 Publisher ID: 113688

DOI: 10.1016/j.socscimed.2021.113688

PMC ID: 7788320

PubMed ID: 33485215

SO-VID: 65ec662f-a481-41bc-b9b4-2498623ce963

License:

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Associations of COVID-19 risk perception with vaccine hesitancy over time for Italian residents

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Abstract

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Objective

Method

Results

Conclusions

Research Highlights

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Novel Coronavirus Disease COVID-19

Most cited references 37

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Vaccine hesitancy: Definition, scope and determinants.

Risk as analysis and risk as feelings: some thoughts about affect, reason, risk, and rationality.

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