Covid19
Conditions
Keywords
Covid-19, Vaccination
Brief summary
The goal of this study is to develop evidence-based messages that effectively mitigate concerns of people at risk for not being vaccinated against COVID-19, with the ultimate goal of maximizing vaccine uptake in vulnerable populations. The investigators will collect data on COVID-19 disease and vaccine knowledge, beliefs, and intent to be vaccinated from an existing online panel. Results from this data collection will be used to develop effective messages and communication strategies. The investigators will test alternate versions of messages intended to reduce vaccine hesitancy and promote vaccine uptake among vaccine-hesitant individuals. This project will ultimately result in a set of tested, evidence-derived messages about vaccination for COVID-19.
Detailed description
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly instigated a global pandemic. As of this writing, there are approximately 65 million documented cases of infection worldwide, and over 1.5 million deaths. In the United States (US), coronavirus disease 2019 (COVID-19) has disrupted the economy, overwhelmed healthcare system, led to widespread school cancellations, and caused more than 274,000 deaths since March 2020. A vaccine against COVID-19 is widely viewed as the key to controlling the pandemic and enabling a return to normal life. Vaccine development is proceeding at an unprecedented pace with 10 vaccines currently in phase 3 trials. Experts have projected that a safe and effective vaccine may be available by mid-2021. At the same time, a growing body of evidence indicates that a significant proportion of adults in the U.S. may not accept vaccination against COVID-19. Even more alarming, COVID-19 vaccine hesitancy (refusal or reluctance to accept a vaccine) appears to be increasing as the vaccine approval process becomes increasingly politicized. Just as efforts to develop vaccine production and delivery capacity have been undertaken in advance of having a proven effective vaccine, parallel efforts are needed to identify effective messages and communication strategies to overcome COVID-19 vaccine hesitancy. The study team recently surveyed a nationally representative sample of approximately 1,000 adults in the United States and found that only 57% intended to be vaccinated when a coronavirus vaccine becomes available. This percentage was even lower among people who identified as Black or Hispanic (39% and 43% respectively), those with a high school education or less (46%), and those in the lowest income groups (49% of those reporting a household income of $30,000 or less, compared to 72% of those reporting a household income of $100,000 or more). The investigators asked those who indicated they would not or might not get vaccinated for their reasons and found that some individuals may be willing to be vaccinated if provided specific information about the vaccine such as side effects and effectiveness. Others expressed generalized skepticism, fear, and distrust of vaccines, with some even referring to anti-vaccine conspiracy theories. These findings are consistent with an extensive body of research documenting that people often do not behave rationally and highlight the urgent need to proactively develop and test interventions to maximize vaccination rates when a coronavirus vaccine becomes available. To address this need, in the present study, the investigators aim to create and test targeted messages to address the concerns of subgroups of people at risk for not being vaccinated, with the ultimate goal of maximizing vaccine uptake when a vaccine for COVID-19 becomes available. The investigators will accomplish this by working with an existing online panel of volunteers, which will allow efficient, focused data gathering. Results of the survey will provide a nuanced, current description of how vulnerable adults perceive the coronavirus and available vaccines, which will be used as the basis for developing messages and communication strategies. Participants will be randomized to receive one of five different versions of a message from a healthcare provider regarding vaccination. Specific wording and content of these messages will vary systematically in order to address concerns of those at risk for not being vaccinated. This project will ultimately result in a set of tested, evidence-derived messages about vaccination for COVID-19. The investigators will make these messages available, together with evidence of how these influence members of vulnerable populations' understanding of vaccination, and disease risk, as well as intent to be vaccinated. The messages will be freely available for use by organizations and providers seeking to improve communication about a coronavirus vaccine.
Interventions
Participants who expressed hesitation about getting vaccinated against COVID-19 were randomized to receive one of five different versions of messages from a physician. The messages that participants in each group received varied slightly and systematically. Specific content and wording of these messages were developed to address and mitigate concerns of those at risk for not being vaccinated.
Sponsors
Study design
Eligibility
Inclusion criteria
* Adult (age 18 and over) who are members of an online panel (Prolific). Members of this panel joined the panel specifically to receive invitations to participate in research surveys and similar activities. * Able to complete an online survey in English.
Exclusion criteria
• None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message | Through survey completion, an average of 12 minutes | All participants were asked about their intent to be vaccinated against COVID-19 prior to exposure to one of the five physician messages (Response options: Yes, No, Not sure). After participants were randomly assigned to receive one of the five physician messages, reduction in COVID-19 vaccine hesitancy was assessed with the question: Would you get vaccinated at this visit. Response options included yes, no, not sure. For participants whose initial vaccination intent was not sure, a response of yes on re-assessment was defined as less hesitant. Response of not sure or yes were defined as less hesitant for participants whose initial vaccination intent was no. |
Countries
United States
Participant flow
Recruitment details
Participants were recruited on Prolific.co from 01/12/21-02/01/21. Eligible panel members were \>= 18, English speaking, and U.S residents. Panel members were restricted to include White, Black, or Hispanic; Blacks and Hispanics were oversampled. Participants who responded no or not sure to If you could get vaccinated for COVID-19 today, would you? were classified as vaccine hesitant and randomized to receive 1 of 5 physician messages, after which their intent was reassessed.
Participants by arm
| Arm | Count |
|---|---|
| Message 1 Participants were randomized to receive version #1 of 5 different versions of a message from a physician regarding the COVID-19 vaccination. All messages included a statement that the vaccine is very safe and very effective. In Message 1, this statement was followed by a participatory-style recommendation (What do you think?) | 172 |
| Message 2 Participants were randomized to receive version #2 of 5 different versions of a message from a physician regarding vaccination. All messages included a statement that the vaccine is very safe and very effective. In Message 2, this statement was followed by a comparison of the COVID-19 vaccine to the flu shot and an explicit recommendation (I recommend that you get it). | 121 |
| Message 3 Participants were randomized to receive version #3 of 5 different versions of a message from a physician regarding vaccination. All messages included a statement that the vaccine is very safe and very effective. In Message 3, this statement was followed by a statement that millions of people have already received the COVID-19 vaccine and an explicit recommendation (I recommend that you get it). | 164 |
| Message 4 Participants were randomized to receive version #4 of 5 different versions of a message from a physician regarding vaccination. All messages included a statement that the vaccine is very safe and very effective. In Message 4, this statement was followed by an acknowledgement of concerns and reassurance that the physician personally reviewed the safety data and an explicit recommendation (I recommend that you get it). | 145 |
| Message 5 Participants were randomized to receive version #5 of 5 different versions of a message from a physician regarding vaccination. All messages included a statement that the vaccine is very safe and very effective. In Message 5, this statement was followed by an emphasis on protecting others an explicit recommendation (I recommend that you get it). | 150 |
| Total | 752 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 |
|---|---|---|---|---|---|---|
| Overall Study | Participants did not provide respond to the question re-assessing vaccination intent | 0 | 0 | 1 | 1 | 2 |
Baseline characteristics
| Characteristic | Total | Message 1 | Message 2 | Message 3 | Message 4 | Message 5 |
|---|---|---|---|---|---|---|
| Age, Customized Age 25 - 34 years | 184 Participants | 40 Participants | 32 Participants | 42 Participants | 28 Participants | 42 Participants |
| Age, Customized Age 35 - 44 years | 191 Participants | 50 Participants | 27 Participants | 31 Participants | 50 Participants | 33 Participants |
| Age, Customized Age 45 - 54 years | 107 Participants | 22 Participants | 21 Participants | 27 Participants | 17 Participants | 20 Participants |
| Age, Customized Age 55 - 64 years | 58 Participants | 13 Participants | 4 Participants | 20 Participants | 10 Participants | 11 Participants |
| Age, Customized Age 65 years or older | 15 Participants | 3 Participants | 5 Participants | 3 Participants | 2 Participants | 2 Participants |
| Age, Customized Age Less than 24 years | 190 Participants | 43 Participants | 31 Participants | 37 Participants | 38 Participants | 41 Participants |
| Age, Customized Age Missing | 7 Participants | 1 Participants | 1 Participants | 4 Participants | 0 Participants | 1 Participants |
| Education 4-year college or more | 160 Participants | 42 Participants | 25 Participants | 25 Participants | 36 Participants | 32 Participants |
| Education High School or Less | 224 Participants | 44 Participants | 40 Participants | 53 Participants | 38 Participants | 49 Participants |
| Education Missing | 3 Participants | 0 Participants | 0 Participants | 1 Participants | 1 Participants | 1 Participants |
| Education Some college | 365 Participants | 86 Participants | 56 Participants | 85 Participants | 70 Participants | 68 Participants |
| Employment Disabled | 28 Participants | 6 Participants | 3 Participants | 10 Participants | 4 Participants | 5 Participants |
| Employment Employed | 394 Participants | 88 Participants | 64 Participants | 83 Participants | 83 Participants | 76 Participants |
| Employment Homemaker | 64 Participants | 16 Participants | 12 Participants | 9 Participants | 14 Participants | 13 Participants |
| Employment Missing | 2 Participants | 0 Participants | 1 Participants | 1 Participants | 0 Participants | 0 Participants |
| Employment Other | 22 Participants | 4 Participants | 3 Participants | 10 Participants | 1 Participants | 4 Participants |
| Employment Retired | 21 Participants | 3 Participants | 3 Participants | 7 Participants | 4 Participants | 4 Participants |
| Employment Student | 92 Participants | 25 Participants | 15 Participants | 15 Participants | 19 Participants | 18 Participants |
| Employment Unemployed | 129 Participants | 30 Participants | 20 Participants | 29 Participants | 20 Participants | 30 Participants |
| Geographic region Midwest | 131 Participants | 28 Participants | 17 Participants | 34 Participants | 31 Participants | 21 Participants |
| Geographic region Northeast | 110 Participants | 26 Participants | 17 Participants | 27 Participants | 24 Participants | 16 Participants |
| Geographic region South | 391 Participants | 90 Participants | 66 Participants | 80 Participants | 75 Participants | 80 Participants |
| Geographic region West | 120 Participants | 28 Participants | 21 Participants | 23 Participants | 15 Participants | 33 Participants |
| History of flu shot Ever, in the last 5 years | 332 Participants | 73 Participants | 40 Participants | 70 Participants | 78 Participants | 71 Participants |
| History of flu shot Missing | 1 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants | 0 Participants |
| History of flu shot Not sure or no | 419 Participants | 99 Participants | 81 Participants | 93 Participants | 67 Participants | 79 Participants |
| Household Income $30,000 - $60,000 | 255 Participants | 53 Participants | 41 Participants | 57 Participants | 51 Participants | 53 Participants |
| Household Income $60,000 - $100,000 | 159 Participants | 44 Participants | 27 Participants | 35 Participants | 26 Participants | 27 Participants |
| Household Income Less than $30,000 | 242 Participants | 47 Participants | 43 Participants | 55 Participants | 40 Participants | 57 Participants |
| Household Income Missing | 4 Participants | 1 Participants | 1 Participants | 1 Participants | 0 Participants | 1 Participants |
| Household Income More than $100,000 | 67 Participants | 21 Participants | 7 Participants | 11 Participants | 19 Participants | 9 Participants |
| Household Income Prefer not to answer | 25 Participants | 6 Participants | 2 Participants | 5 Participants | 9 Participants | 3 Participants |
| Initial Vaccination Intent Initially No | 411 Participants | 103 Participants | 66 Participants | 83 Participants | 78 Participants | 81 Participants |
| Initial Vaccination Intent Initially Not Sure | 341 Participants | 69 Participants | 55 Participants | 81 Participants | 67 Participants | 69 Participants |
| Race/Ethnicity, Customized Black/African American | 326 Participants | 79 Participants | 52 Participants | 66 Participants | 64 Participants | 65 Participants |
| Race/Ethnicity, Customized Hispanic/Latino | 177 Participants | 35 Participants | 31 Participants | 41 Participants | 33 Participants | 37 Participants |
| Race/Ethnicity, Customized Missing | 1 Participants | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized White | 248 Participants | 58 Participants | 37 Participants | 57 Participants | 48 Participants | 48 Participants |
| Region of Enrollment United States | 752 participants | 172 participants | 121 participants | 164 participants | 145 participants | 150 participants |
| Self-rated overall health Excellent | 69 Participants | 22 Participants | 12 Participants | 13 Participants | 9 Participants | 13 Participants |
| Self-rated overall health Fair | 137 Participants | 27 Participants | 19 Participants | 34 Participants | 33 Participants | 24 Participants |
| Self-rated overall health Good | 309 Participants | 69 Participants | 51 Participants | 66 Participants | 58 Participants | 65 Participants |
| Self-rated overall health Missing | 2 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants |
| Self-rated overall health Poor | 30 Participants | 9 Participants | 5 Participants | 3 Participants | 5 Participants | 8 Participants |
| Self-rated overall health Very good | 205 Participants | 44 Participants | 34 Participants | 48 Participants | 40 Participants | 39 Participants |
| Self-rated overall mental health Excellent | 91 Participants | 22 Participants | 17 Participants | 22 Participants | 12 Participants | 18 Participants |
| Self-rated overall mental health Fair | 185 Participants | 51 Participants | 20 Participants | 39 Participants | 35 Participants | 40 Participants |
| Self-rated overall mental health Good | 225 Participants | 42 Participants | 38 Participants | 48 Participants | 47 Participants | 50 Participants |
| Self-rated overall mental health Missing | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants |
| Self-rated overall mental health Poor | 76 Participants | 14 Participants | 15 Participants | 18 Participants | 17 Participants | 12 Participants |
| Self-rated overall mental health Very good | 174 Participants | 43 Participants | 31 Participants | 37 Participants | 33 Participants | 30 Participants |
| Sex/Gender, Customized Gender Female | 449 Participants | 108 Participants | 78 Participants | 88 Participants | 93 Participants | 82 Participants |
| Sex/Gender, Customized Gender Male | 291 Participants | 62 Participants | 41 Participants | 71 Participants | 52 Participants | 65 Participants |
| Sex/Gender, Customized Gender Missing | 5 Participants | 1 Participants | 0 Participants | 1 Participants | 0 Participants | 3 Participants |
| Sex/Gender, Customized Gender Other | 6 Participants | 0 Participants | 2 Participants | 4 Participants | 0 Participants | 0 Participants |
| Sex/Gender, Customized Gender Prefer not to say | 1 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk |
|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 |
Outcome results
Number of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message
All participants were asked about their intent to be vaccinated against COVID-19 prior to exposure to one of the five physician messages (Response options: Yes, No, Not sure). After participants were randomly assigned to receive one of the five physician messages, reduction in COVID-19 vaccine hesitancy was assessed with the question: Would you get vaccinated at this visit. Response options included yes, no, not sure. For participants whose initial vaccination intent was not sure, a response of yes on re-assessment was defined as less hesitant. Response of not sure or yes were defined as less hesitant for participants whose initial vaccination intent was no.
Time frame: Through survey completion, an average of 12 minutes
Population: Four participants were excluded from the analyses because they did not respond to the question re-assessing vaccination intent following exposure to a physician recommendation.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Message 1 | Number of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message | 23 Participants |
| Message 2 | Number of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message | 26 Participants |
| Message 3 | Number of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message | 43 Participants |
| Message 4 | Number of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message | 35 Participants |
| Message 5 | Number of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message | 40 Participants |