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Barriers and motivators associated with COVID-19 vaccination-a vaccine acceptance scoring system based on a population survey in southern Sweden

Mitchell, Adam LU ; Hassan, Mariam LU orcid ; Kahn, Fredrik LU ; Litins'ka, Yana LU orcid ; Almgren, Matilda LU ; Malmqvist, Ulf LU ; Östergren, Per-Olof LU ; Inghammar, Malin LU ; Björk, Jonas LU orcid and Bennet, Louise LU orcid (2025) In European Journal of Public Health
Abstract

Low vaccination coverage against SARS-CoV-2 (COVID-19) is a public health concern. The aim of this study was to identify barriers and motivators associated with COVID-19 vaccination and develop a vaccine acceptance scoring system. From the overall population residing in Skåne county Sweden in 2022 (n = 1 384 531), 3600 randomly selected individuals (aged ≥18 years) received a survey. Questions were grouped into six domains reflecting trust in vaccines and institutions, benefit-risk balance, injunctive and descriptive norms and accessibility. Responses were scored as either assenting (1 p) or dissenting (0 p) in relation to its domain. A score between 1 and 5 p was constructed for each domain and a total vaccine acceptance score was... (More)

Low vaccination coverage against SARS-CoV-2 (COVID-19) is a public health concern. The aim of this study was to identify barriers and motivators associated with COVID-19 vaccination and develop a vaccine acceptance scoring system. From the overall population residing in Skåne county Sweden in 2022 (n = 1 384 531), 3600 randomly selected individuals (aged ≥18 years) received a survey. Questions were grouped into six domains reflecting trust in vaccines and institutions, benefit-risk balance, injunctive and descriptive norms and accessibility. Responses were scored as either assenting (1 p) or dissenting (0 p) in relation to its domain. A score between 1 and 5 p was constructed for each domain and a total vaccine acceptance score was analysed. Internal consistency overall and within domains was assessed with Cronbach's alpha. Associations with vaccination status and vaccine acceptance scores in relation to domains were modelled with logistic regression. 820 responses were received, 646 vaccinated (response rate 36%), and 174 unvaccinated (response rate 10%), with relatively high internal consistency overall (α = 0.76). Domains markedly associated with vaccination were injunctive norms OR 5.06 (95% CI 3.27, 7.83), descriptive norms OR 2.64 (1.63, 4.30) and trust in vaccines OR 1.66 (1.15, 2.40). Vaccine acceptance was measured with sufficient reliability in a Swedish population. Norms, in this context, general perceptions of acceptable/unacceptable behaviours and notion on actual performed behaviours, were together with trust in vaccines most strongly associated with vaccination. Future pandemic responses should consider these aspects in communication strategies and targeted interventions to increase and equalize vaccination uptake.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Medicinsk rätt
in
European Journal of Public Health
publisher
Oxford University Press
external identifiers
  • pmid:40246290
ISSN
1101-1262
DOI
10.1093/eurpub/ckaf030
project
Improved preparedness for future pandemics and other health crises through large-scale disease surveillance
language
English
LU publication?
yes
id
b3198a5f-d12a-49b9-a61e-5f542908d3d9
date added to LUP
2025-04-29 09:14:16
date last changed
2025-05-05 09:50:38
@article{b3198a5f-d12a-49b9-a61e-5f542908d3d9,
  abstract     = {{<p>Low vaccination coverage against SARS-CoV-2 (COVID-19) is a public health concern. The aim of this study was to identify barriers and motivators associated with COVID-19 vaccination and develop a vaccine acceptance scoring system. From the overall population residing in Skåne county Sweden in 2022 (n = 1 384 531), 3600 randomly selected individuals (aged ≥18 years) received a survey. Questions were grouped into six domains reflecting trust in vaccines and institutions, benefit-risk balance, injunctive and descriptive norms and accessibility. Responses were scored as either assenting (1 p) or dissenting (0 p) in relation to its domain. A score between 1 and 5 p was constructed for each domain and a total vaccine acceptance score was analysed. Internal consistency overall and within domains was assessed with Cronbach's alpha. Associations with vaccination status and vaccine acceptance scores in relation to domains were modelled with logistic regression. 820 responses were received, 646 vaccinated (response rate 36%), and 174 unvaccinated (response rate 10%), with relatively high internal consistency overall (α = 0.76). Domains markedly associated with vaccination were injunctive norms OR 5.06 (95% CI 3.27, 7.83), descriptive norms OR 2.64 (1.63, 4.30) and trust in vaccines OR 1.66 (1.15, 2.40). Vaccine acceptance was measured with sufficient reliability in a Swedish population. Norms, in this context, general perceptions of acceptable/unacceptable behaviours and notion on actual performed behaviours, were together with trust in vaccines most strongly associated with vaccination. Future pandemic responses should consider these aspects in communication strategies and targeted interventions to increase and equalize vaccination uptake.</p>}},
  author       = {{Mitchell, Adam and Hassan, Mariam and Kahn, Fredrik and Litins'ka, Yana and Almgren, Matilda and Malmqvist, Ulf and Östergren, Per-Olof and Inghammar, Malin and Björk, Jonas and Bennet, Louise}},
  issn         = {{1101-1262}},
  keywords     = {{Medicinsk rätt}},
  language     = {{eng}},
  month        = {{04}},
  publisher    = {{Oxford University Press}},
  series       = {{European Journal of Public Health}},
  title        = {{Barriers and motivators associated with COVID-19 vaccination-a vaccine acceptance scoring system based on a population survey in southern Sweden}},
  url          = {{http://dx.doi.org/10.1093/eurpub/ckaf030}},
  doi          = {{10.1093/eurpub/ckaf030}},
  year         = {{2025}},
}