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- Title
A Discrete Choice Analysis Comparing COVID-19 Vaccination Decisions for Children and Adults.
- Authors
Prosser, Lisa A.; Wagner, Abram L.; Wittenberg, Eve; Zikmund-Fisher, Brian J.; Rose, Angela M.; Pike, Jamison
- Abstract
This survey study assesses preferences for attributes of adult and pediatric COVID-19 vaccination among US adults. Key Points: Question: Do preferences for COVID-19 vaccination vary across pediatric and adult vaccination? Findings: In this survey study of 1040 US adults, all included attributes (vaccine effectiveness, mild side effects, rare adverse events, number of doses, regulatory approval, waiting time) were important factors in choosing to vaccinate with little difference in magnitude when comparing adult and pediatric vaccination. Latent class analyses identified 4 distinct subgroups, including 1 subgroup sensitive to convenience (waiting time and number of doses). Meaning: These findings suggest that providing more convenient vaccination options may represent an actionable strategy to increase vaccination uptake for a subgroup of the population. Importance: COVID-19 vaccination rates in the US remain below optimal levels. Patient preferences for different attributes of vaccine products and the vaccination experience can be important in determining vaccine uptake decisions. Objective: To assess preferences for attributes of adult and pediatric COVID-19 vaccination among US adults. Design, Setting, and Participants: An online survey of a national panel of 1040 US adults was conducted in May and June 2021. A discrete choice analysis was used to measure the relative value of each attribute in the decision to choose a COVID-19 vaccination option for adults or children. Six attributes were used to described hypothetical vaccination options: vaccine effectiveness, mild side effects, rare adverse events, number of doses, time required for vaccination, and regulatory approval. Respondents chose between hypothetical vaccination profiles or no vaccination. Additional survey questions asked about vaccination beliefs, COVID-19 illness experience, COVID-19 risk factors, vaccination status, and opinions about the risk of COVID-19. Exposures: Respondents chose which vaccine profile they would prefer to receive for themselves (or no vaccination). Respondents then considered an identical set of profiles for a hypothetical child aged 0 to 17 years. Main Outcomes and Measures: Relative value of vaccination-related attributes were estimated using Bayesian logit regression. Preference profiles for subgroups were estimated using latent class analyses. Results: A total of 1040 adults (610 [59%] female; 379 participants [36%] with an age of 55 years and older years) responded to the survey. When asked about vaccination choices for themselves, participants indicated that vaccine effectiveness (95% vs 60%) was a significant attribute (β, 9.59 [95% CrI, 9.20-10.00] vs β, 0.41 [95% CrI, 0-0.80]). Respondents also preferred fewer rare adverse events (β, 6.35 [95% CrI, 5.74-6.86), fewer mild side effects (β, 5.49; 95% CrI, 5.12-5.87), 1 dose (β, 5.41; 95% CrI, 5.04-5.78), FDA approval (β, 6.01; 95% CrI, 5.64-6.41), and shorter waiting times (β, 5.67; 95% CrI, 4.87-6.48). Results were very similar when framing the question as adult or child vaccination, with slightly stronger preference for fewer rare adverse events for children. Latent class analysis revealed 4 groups of respondents: (1) individuals sensitive to safety and regulatory status, (2) individuals sensitive to convenience, (3) individuals who carefully considered all attributes in making their choices, and (4) individuals who rejected the vaccine. Conclusions and Relevance: In this survey study of US adults, the identification of 4 distinct preference groups provides new information to guide communications to support vaccine decision making. In particular, the group that prioritize convenience (less time required for vaccination and fewer doses) may present an opportunity to create actionable strategies to increase vaccination uptake for both adult and pediatric populations.
- Subjects
UNITED States; VACCINATION; IMMUNIZATION; CONFIDENCE intervals; COVID-19 vaccines; ATTITUDE (Psychology); REGRESSION analysis; QUESTIONNAIRES; RESEARCH funding; VACCINATION status
- Publication
JAMA Network Open, 2023, Vol 6, Issue 1, pe2253582
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2022.53582