Barriers to vaccination for coronavirus disease 2019 (COVID-19) control: experience from the United States

Yanjie Zhang, Rebecca J Fisk, Yanjie Zhang, Rebecca J Fisk

Abstract

To date, the United States (U.S.) has been the most heavily impacted country by the coronavirus disease 2019 (COVID-19). By November 30, 2020, when this paper was written, 13.5 million cases were reported in the U.S. with over 268 000 deaths. Historically, vaccines have been one of the most effective and efficient technical tools for controlling a communicable disease. While the development of these vaccines has certainly been a challenge, it could be more challenging to achieve robust vaccine uptake because of many barriers. In this review, we focused on two types of barriers documented from long-term experience in the U.S.: structural and attitudinal. Structural barriers are systemic issues that impact one's ability to access a service, and they include time, transportation, cost, and clinic or outlet location; while attitudinal barriers are beliefs or perceptions that impact the willingness of at-risk individuals to seek out and/or accept a service. In the context of vaccination they include beliefs about the communicable disease, beliefs about vaccines, fear, and trust in healthcare and governmental agencies. Of the attitudinal barriers, public trust is a barrier that is of particular importance. In addition to affecting reception of vaccines, it may exacerbate disparities and reduce the likelihood of success of a vaccination program. Recommendations are made to overcome attitudinal barriers to help improve the effectiveness of vaccination programs for COVID-19 control in the U.S., such as building public support through bipartisan endorsements and leveraging social media platforms to promote vaccination.

Keywords: Attitudinal barriers; Coronavirus disease 2019 (COVID-19); Structural barriers; The United States; Vaccination.

Copyright © 2021 People's Medical Publishing House Co. Ltd. Publishing service by Elsevier B.V. on behalf of KeAi Communications Co. Ltd.

References

    1. CDC COVID-19 Response Team, Jorden MA, Rudman SL, CDC COVID-19 Response Team Evidence for limited early spread of COVID-19 within the United States, January-February 2020. MMWR Morb Mortal Wkly Rep. 2020;69(22):680–684. doi: 10.15585/mmwr.mm6922e1.
    1. COVID-19 United States cases by County. Johns Hopkins Coronavirus Resource Center website. . Accessed October 4, 2020.
    1. FDA Takes Key Action in Fight Against COVID-19 by Issuing Emergency Use Authorization for First COVID-19 Vaccine. U.S. Food & Drug Administration website. . Accessed December 22, 2020.
    1. FDA Takes Additional Action in Fight Against COVID-19 by Issuing Emergency Use Authorization for second COVID-19 Vaccine. U.S. Food & Drug Administration website. . Accessed December 24, 2020.
    1. Chen G, Kazmi M, Chen D, Phillips J. Identifying associations between influenza vaccination status and access, beliefs, and sociodemographic factors among the uninsured population in Suffolk County, NY. J Community Health. 2020;45(6):1236–1241. doi: 10.1007/s10900-020-00873-1.
    1. Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of influenza vaccination intention and behavior ‒ A systematic review of influenza vaccine hesitancy, 2005‒2016. PLoS One. 2017;12(1):e0170550. doi: 10.1371/journal.pone.0170550.
    1. Beshears J, Choi JJ, Laibson DI, Madrian BC, Reynolds GI. Vaccination rates are associated with functional proximity but not base proximity of vaccination clinics. Med Care. 2016;54(6):578–583. doi: 10.1097/MLR.0000000000000523.
    1. Worksite Health: Seasonal Influenza Vaccinations Using Interventions with On-Site, Reduced Cost, Actively Promoted Vaccinations non-Healthcare Workers. The Community Preventive Services Task Force website. . Accessed December 6, 2020.
    1. Harris K, Maurer J, Black C, Euler G, Kadiyala S. Workplace efforts to promote influenza vaccination among healthcare personnel and their association with uptake during the 2009 pandemic influenza A (H1N1) Vaccine. 2011;29(16):2978–2985. doi: 10.1016/j.vaccine.2011.01.112.
    1. Black CL, Yue X, Ball SW. Influenza vaccination coverage among health care personnel—United States, 2017–18 Influenza Season. Morb Mortal Wkly Rep. 2018;67(38):1050–1054. doi: 10.15585/mmwr.mm6738a2.
    1. Luz PM, Johnson RE, Brown HE. Workplace availability, risk group and perceived barriers predictive of 2016-17 influenza vaccine uptake in the United States: a cross-sectional study. Vaccine. 2017;35(43):5890–5896. doi: 10.1016/j.vaccine.2017.08.078.
    1. What Vaccination Rates in Rural America tell Us About the Advent of COVID Vaccines. USA Today website.. Accessed December 6, 2020.
    1. The Flu Vaccine is Delayed This Year, and Doctors Are Worried It May Impact Youngest Patients. Newsweek website. . Accessed December 6, 2020.
    1. O’Donnell C. Pfizer says supply chain challenges contributed to slashed target for COVID-19 vaccine doses in 2020. Reuters website. . Accessed December 6, 2020.
    1. Operation Warp Speed, U.S. Department of Health and Human Services, U.S. Department of Defense. From the Factory to the Frontlines: The Operation Warp Speed Strategy for Distributing a COVID-19 Vaccine. . Accessed December 6, 2020.
    1. Trump Administration Partners with Chain and Independent Community Pharmacies to Increase Access to Future COVID-19 Vaccines. HHS Press Office, U.S. Department of Health and Human Services website.. Accessed December 4, 2020.
    1. Kirkdale CL, Nebout G, Megerlin F, Thornley T. Benefits of pharmacist-led flu vaccination services in community pharmacy. Ann Pharm Fr. 2017;75(1):3–8. doi: 10.1016/j.pharma.2016.08.005.
    1. Chun GJ, Sautter JM, Patterson BJ, McGhan WF. Diffusion of pharmacy-based influenza vaccination over time in the United States. Am J Public Health. 2016;106(6):1099–1100. doi: 10.2105/AJPH.2016.303142.
    1. Trump's Operation Warp Speed promised a flood of covid vaccines. Instead, states are expecting a trickle. Washington Post website. . Accessed December 6, 2020.
    1. Ding H, Kahn KE, Black CL, O’Halloran A, Lu PJ, Williams WW. Influenza vaccination coverage among pregnant women in the U.S., 2012–2015. Am J Prev Med. 2019;56(4):477–486. doi: 10.1016/j.amepre.2018.11.020.
    1. MacDonald NE. Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015;33(34):4161–4164. doi: 10.1016/j.vaccine.2015.04.036.
    1. Nowak GJ, Sheedy K, Bursey K, Smith TM, Basket M. Promoting influenza vaccination: insights from a qualitative meta-analysis of 14 years of influenza-related communications research by U.S. Centers for Disease Control and Prevention (CDC) Vaccine. 2015;33(24):2741–2756. doi: 10.1016/j.vaccine.2015.04.064.
    1. Quinn SC, Jamison A, Freimuth VS, An J, Hancock GR, Musa D. Exploring racial influences on flu vaccine attitudes and behavior: results of a National Survey of African American and White Adults. Vaccine. 2017;35(8):1167–1174. doi: 10.1016/j.vaccine.2016.12.046.
    1. Freimuth VS, Jamison AM, An J, Hancock GR, Quinn SC. Determinants of trust in the flu vaccine for African Americans and Whites. Soc Sci Med. 2017;193:70–79. doi: 10.1016/j.socscimed.2017.10.001.
    1. Guidry JPD, Austin LL, O’Donnell NH, Coman IA, Lovari A, Messner M. Tweeting the #flushot: beliefs, barriers, and threats during different periods of the 2018 to 2019 flu seasoN. J Prim Care Community Health. 2020;11 doi: 10.1177/2150132720932722. :2150132720932722.
    1. Lu P, Srivastav A, Santibanez TA. Knowledge of influenza vaccination recommendation and early vaccination uptake during the 2015-16 season among adults aged ≥18 years – United States. Vaccine. 2017;35(34):4346–4354. doi: 10.1016/j.vaccine.2017.06.074.
    1. Earnshaw VA, Eaton LA, Kalichman SC, Brousseau NM, Hill EC, Fox AB. COVID-19 conspiracy beliefs, health behaviors, and policy support. Transl Behav Med. 2020;10(4):850–856. doi: 10.1093/tbm/ibaa090.
    1. Romer D, Jamieson KH. Conspiracy theories as barriers to controlling the spread of COVID-19 in the U.S. Soc Sci Med. 2020;263:113356. doi: 10.1016/j.socscimed.2020.113356.
    1. Kreps S, Prasad S, Brownstein JS. Factors associated with US adults’ likelihood of accepting COVID-19 vaccination. JAMA Netw Open. 2020;3(10):e2025594. doi: 10.1001/jamanetworkopen.2020.25594.
    1. Reiter PL, Pennell ML, Katz ML. Acceptability of a COVID-19 vaccine among adults in the United States: how many people would get vaccinated? Vaccine. 2020;38(42):6500–6507. doi: 10.1016/j.vaccine.2020.08.043.
    1. Fisher KA, Bloomstone SJ, Walder J, Crawford S, Fouayzi H, Mazor KM. Attitudes toward a potential SARS-CoV-2 vaccine: a survey of U.S. adults. Ann Intern Med. 2020;173(12):964–973. doi: 10.7326/M20-3569.
    1. Intent to Get a COVID-19 Vaccine Rises to 60% As Confidence in Research and Development Process Increases. Pew Research Center Science & Society website.. Accessed December 4, 2020.
    1. Jamison AM, Quinn SC, Freimuth VS. You don’t trust a government vaccine”: narratives of institutional trust and influenza vaccination among African American and white adults. Soc Sci Med. 2019;221:87–94. doi: 10.1016/j.socscimed.2018.12.020.
    1. Malik AA, McFadden SM, Elharake J, Omer SB. Determinants of COVID-19 vaccine acceptance in the US. EClinicalMedicine. 2020;26:100495. doi: 10.1016/j.eclinm.2020.100495.
    1. CDC Digital Media Toolkit: 2020-21 Flu Season. U.S. Centers for Disease Control and Prevention website. . Accessed December 6, 2020.
    1. COVID-19 Vaccination. U.S. Centers for Disease Control and Prevention website. . Accessed December 30, 2020.
    1. Dooling K, Marin M, Wallace M. The Advisory Committee on immunization practices’ updated interim recommendation for allocation of COVID-19 vaccine — United States, December 2020. MMWR Morb Mortal Wkly Rep. 2021;69(5152):1657–1660. doi: 10.15585/mmwr.mm695152e2.
    1. Thomson K, Nachlis H. Emergency use authorizations during the COVID-19 pandemic: lessons from hydroxychloroquine for vaccine authorization and approval. JAMA. 2020;324(13):1282. doi: 10.1001/jama.2020.16253.
    1. Burki T. The online anti-vaccine movement in the age of COVID-19. Lancet Digit Health. 2020;2(10):e504–e505. doi: 10.1016/S2589-7500(20)30227-2.
    1. Taylor S, Landry CA, Paluszek MM, Groenewoud R, Rachor GS, Asmundson GJG. A proactive approach for managing COVID-19: the importance of understanding the motivational Roots of Vaccination Hesitancy for SARS-CoV2. Front Psychol. 2020;11:575950. doi: 10.3389/fpsyg.2020.575950.
    1. Bonnevie E, Rosenberg SD, Kummeth C, Goldbarg J, Wartella E, Smyser J. Using social media influencers to increase knowledge and positive attitudes toward the flu vaccine. PLoS One. 2020;15(10):e0240828. doi: 10.1371/journal.pone.0240828.
    1. Need a Coronavirus Test? Being Rich and Famous May Help. The New York Times website. . Accessed January 1, 2021.
    1. Schoch-Spana M, Brunson EK, Long R. The public’s role in COVID-19 vaccination: human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States. Vaccine. 2020;S0264-410X(20):31368-2. doi: 10.1016/j.vaccine.2020.10.059.
    1. Guide to COVID-19 Vaccine Communications – A practitioner's Guide to the Principles of COVID-19 Vaccine communications. Center for Public Interest Communications, University of Florida website.. Accessed December 6, 2020.
    1. MacDonald NE, Butler R, Dubé E. Addressing barriers to vaccine acceptance: an overview. Hum Vaccines Immunother. 2017;14(1):218–224. doi: 10.1080/21645515.2017.1394533.
    1. Trump Claims the Worsening U.S. Coronavirus Outbreak is a “Fake News Media Conspiracy” Even As Hospitalizations Rise. CNBC website.. Accessed December 8, 2020.
    1. “It will disappear”: the disinformation Trump spread about the coronavirus – timeline. The Guardian website. . Accessed December 8, 2020.
    1. Texas Lt. Gov. blasts Fauci as state coronavirus cases rise: ‘I don’t need his advice’. Fort Worth Star-Telegram website. . Accessed December 8, 2020.
    1. States Vow Extra Scrutiny of Coronavirus Vaccine. The New York Times website.. Accessed December 8, 2020.
    1. Trump admin has yet to launch push to promote trust in Covid vaccines. NBC News website. . Accessed December 8, 2020.
    1. Biden Says He'll Publicly Get a COVID-19 vaccine, Keep Fauci. Reuters website. . Accessed December 8, 2020.
    1. Former Presidents Obama, Bush and Clinton volunteer to Get Coronavirus Vaccine Publicly to Prove It's Safe. CNN website.. Accessed December 8, 2020.
    1. Pelosi, McConnell get COVID-19 vaccine, Urge Others to Do so. AP News website.. Accessed December 30, 2020.
    1. Washington HA. Doubleday; New York, N.Y.: 2006. Medical Apartheid: The Dark History of Medical Experimentation On Black Americans from Colonial Times to the Present.

Source: PubMed

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