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Public health
Original research
Attitudes towards vaccines and intention to vaccinate against COVID-19: a cross-sectional analysis—implications for public health communications in Australia
  1. Joanne Enticott1,2,
  2. Jaskirath Singh Gill1,
  3. Simon L. Bacon3,4,
  4. Kim L. Lavoie3,5,
  5. Daniel S. Epstein6,
  6. Shrinkhala Dawadi1,
  7. Helena J Teede1,2,
  8. Jacqueline Boyle1,7
  9. for the iCARE Study Team
    1. 1Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
    2. 2Monash Partners Academic Health Science Centre, Melbourne, Victoria, Australia
    3. 3Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Ile-de-Montreal, Montreal, Québec, Canada
    4. 4Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Québec, Canada
    5. 5Department of Psychology, University of Quebec in Montreal, Montreal, Québec, Canada
    6. 6Department of General Practice, Monash University, Clayton, Victoria, Australia
    7. 7School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
    1. Correspondence to Dr Joanne Enticott; joanne.enticott{at}monash.edu

    Abstract

    Objective To examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults as part of the iCARE Study.

    Design and setting Cross-sectional online survey conducted when free COVID-19 vaccinations first became available in Australia in February 2021.

    Participants Total of 1166 Australians from general population aged 18–90 years (mean 52, SD of 19).

    Main outcome measures Primary outcome: responses to question ‘If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated?’.

    Secondary outcome: analyses of putative drivers of uptake, including vaccine confidence, socioeconomic status and sources of trust, derived from multiple survey questions.

    Results Seventy-eight per cent reported being likely to receive a SARS-CoV-2 vaccine. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 2.01 (95% CI 1.77 to 2.77)), being male (1.37 (95% CI 1.08 to 1.72)), residing in least disadvantaged area quintile (2.27 (95% CI 1.53 to 3.37)) and a self-perceived high risk of getting COVID-19 (1.52 (95% CI 1.08 to 2.14)). However, 72% did not believe they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level and rurality. Knowing that the vaccine is safe and effective and that getting vaccinated will protect others, trusting the company that made it and vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight per cent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing, etc) postvaccine.

    Conclusions Most Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified (eg, knowing vaccine is safe and effective, and doctor’s recommendation to get vaccinated) can inform public health messaging to enhance vaccination rates.

    • COVID-19
    • infection control
    • public health
    • preventive medicine
    • respiratory infections

    Data availability statement

    Data are available in a public, open access repository. Data can be made available to approved researchers by contacting the corresponding author. The iCARE study is an open access study. Data access procedures are available at https://mbmc-cmcm.ca/covid19/apl/. Planned analyses are logged at https://mbmc-cmcm.ca/covid19/apl/log/.

    http://creativecommons.org/licenses/by-nc/4.0/

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    https://doi.org/10.1136/bmjopen-2021-057127

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      Data availability statement

      Data are available in a public, open access repository. Data can be made available to approved researchers by contacting the corresponding author. The iCARE study is an open access study. Data access procedures are available at https://mbmc-cmcm.ca/covid19/apl/. Planned analyses are logged at https://mbmc-cmcm.ca/covid19/apl/log/.

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      Supplementary materials

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        This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

      Footnotes

      • JE and JSG are joint first authors.

      • Twitter @EnticottJo

      • Collaborators iCARE Study Team iCARE Study Collaborators: lead investigators: Kim L Lavoie, PhD, University of Quebec at Montreal (UQAM) and CIUSSS-NIM, Canada; Simon L Bacon, PhD, Concordia University and CIUSSS-NIM, Canada. Collaborators (in alphabetical order by country): Abu Dhabi: Zahir Vally, PhD, United Arab Emirates University; Argentina: Analía Verónica Losada, PhD, University of Flores; Australia: Jacqueline Boyle, PhD, Monash University; Joanne Enticott, PhD, Monash University; Shajedur Rahman Shawon, PhD, Centre for Big Data Research in Health, UNSW Medicine; Helena Teede, MD, Monash University; Austria: Alexandra Kautzky-Willer, MD, Medizinische Universität Wien; Bangladesh: Arobindu Dash, MS, International University of Business, Agriculture; Brazil: Marilia Estevam Cornelio, PhD, University of Campinas; Marlus Karsten, Universidade do Estado de Santa Catarina – UDESC; Darlan Lauricio Matte, PhD, Universidade do Estado de Santa Catarina – UDESC; Canada: Ahmed Abou-Setta, PhD, University of Manitoba; Shawn Aaron, PhD, Ottawa Hospital Research Institute; Angela Alberga, PhD, Concordia University; Tracie Barnett, PhD, McGill University; Silvana Barone, MD, Université de Montréal; Ariane Bélanger-Gravel, PhD, Université Laval; Sarah Bernard, PhD, Université Laval; Lisa Maureen Birch, PhD, Université Laval; Susan Bondy, PhD, University of Toronto – Dalla Lana School of Public Health; Linda Booij, PhD, Concordia University; Roxane Borgès Da Silva, PhD, Université de Montréal; Jean Bourbeau, MD, McGill University; Rachel Burns, PhD, Carleton University; Tavis Campbell, PhD, University of Calgary; Linda Carlson, PhD, University of Calgary; Kim Corace, PhD, University of Ottawa; Olivier Drouin, MD, CHU Sainte-Justine/Université de Montréal; Francine Ducharme, MD, Université de Montréal; Mohsen Farhadloo, Concordia University; Carl Falk, PhD, McGill University; Richard Fleet MD, PhD, Université Laval; Michel Fournier, MSc, Direction de la Santé Publique de Montréal; Gary Garber, MD, University of Ottawa/Public Health Ontario; Lise Gauvin, PhD, Université de Montréal; Jennifer Gordon, PhD, University of Regina; Roland Grad, MD, McGill University; Samir Gupta, MD, University of Toronto; Kim Hellemans, PhD, Carleton University; Catherine Herba PhD, UQAM; Heungsun Hwang, PhD, McGill University; Jack Jedwab, PhD, Canadian Institute for Identities and Migration and the Association for Canadian Studies; Keven Joyal-Desmarais, PhD, Concordia University; Lisa Kakinami, PhD, Concordia University; Eric Kennedy, PhD, York University; Sunmee Kim, PhD, University of Manitoba; Joanne Liu, PhD, McGill University; Colleen Norris, PhD, University of Alberta; Sandra Pelaez, PhD, Université de Montréal; Louise Pilote, MD, McGill University; Paul Poirier, MD, Université Laval; Justin Presseau, PhD, University of Ottawa; Eli Puterman, PhD, University of British Columbia; Joshua Rash, PhD, Memorial University; Paula AB Ribeiro, PhD, MBMC; Mohsen Sadatsafavi, PhD, University of British Columbia; Paramita Saha Chaudhuri, PhD, McGill University; Jovana Stojanovic, PhD, Concordia University; Eva Suarthana, MD, PhD, Université de Montréal/McGill University; Sze Man Tse, MD, CHU Sainte-Justine; Michael Vallis, PhD, Dalhousie University; Chile: Nicolás Bronfman Caceres, PhD, Universidad Andrés Bello; Manuel Ortiz, PhD, Universidad de La Frontera; Paula Beatriz Repetto, PhD, Universidad Católica de Chile; Colombia: Mariantonia Lemos-Hoyos, PhD, Universidad EAFIT; Cyprus: Angelos Kassianos, PhD, University of Cyprus; Denmark: Naja Hulvej Rod, PhD, University of Copenhagen; France: Mathieu Beraneck, PhD, Université de Paris; CNRS; Gregory Ninot, PhD, Université de Montpellier; Germany: Beate Ditzen, PhD, Heidelberg University; Thomas Kubiak, PhD, Mainz University; Ghana: Sam Codjoe, MPhil,MSc, University of Ghana; Lily Kpobi, PhD, University of Ghana; Amos Laar, PhD, University of Ghana; India: Naorem Kiranmala Devi, PhD, University of Delhi; Sanjenbam Meitei, PhD, Manipur University; Suzanne Tanya Nethan, MDS, ICMR-National Institute of Cancer Prevention; Lancelot Pinto, MD, PhD, Hinduja Hospital and Medical Research Centre; Kallur Nava Saraswathy, PhD, University of Delhi; Dheeraj Tumu, MD, World Health Organization (WHO); Indonesia: Silviana Lestari, MD, PhD, Universitas Indonesia; Grace Wangge, MD, PhD, SEAMEO Regional Center for Food and Nutrition; Ireland: Molly Byrne, PhD, National University of Ireland, Galway; Hannah Durand, PhD, National University of Ireland, Galway; Jennifer McSharry, PhD, National University of Ireland, Galway; Oonagh Meade, PhD, National University of Ireland, Galway; Gerry Molloy, PhD, National University of Ireland, Galway; Chris Noone, PhD, National University of Ireland, Galway; Israel: Hagai Levine, MD, Hebrew University; Anat Zaidman-Zait, PhD, Tel-Aviv University; Italy: Stefania Boccia, PhD, Università Cattolica del Sacro Cuore; Ilda Hoxhaj, MD, Università Cattolica del Sacro Cuore; Stefania Paduano, MSc, PhD, University of Modena and Reggio Emilia; Valeria Raparelli, PhD, Sapienza – University of Rome; Drieda Zaçe, MD, MSc, PhDc, Università Cattolica del Sacro Cuore; Jordan: Ala’S Aburub, PhD, Isra University; Kenya: Daniel Akunga, PhD, Kenyatta University; Richard Ayah, PhD, University of Nairobi, School Public Health; Chris Barasa, MPH, University of Nairobi, School Public Health; Pamela Miloya Godia, PhD, University of Nairobi; Elizabeth W Kimani-Murage, PhD, African Population and Health Research Center; Nicholas Mutuku, PhD, University of Kenya; Teresa Mwoma, PhD, Kenyatta University; Violet Naanyu, PhD, Moi University; Jackim Nyamari, PhD, Kenyatta University; Hildah Oburu, PhD, Kenyatta University; Joyce Olenja, PhD, University of Nairobi; Dismas Ongore, PhD, University of Nairobi; Abdhalah Ziraba, PhD, African Population and Health Research Center; Malawi: Chiwoza Bandawe, PhD, University of Malawi; Malaysia: Loh Siew Yim, PhD, Faculty of medicine, University of Malaya; New Zealand: Andrea Herbert, PhD, University of Canterbury; Daniela Liggett, PhD, University of Canterbury; Nigeria: Ademola Ajuwon, PhD, University of Ibadan; Pakistan: Nisar Ahmed Shar, PhD, CoPI-National Center in Big Data; Bilal Ahmed Usmani, PhD, NED University of Engineering and Technology; Peru: Rosario Mercedes Bartolini Martínez, PhD, Instituto de Investigacion Nutricional; Hilary Creed-Kanashiro, M.Phil., Instituto de Investigacion Nutricional; Portugal: Paula Simão, MD, S. Pneumologia de Matosinhos; Rwanda: Pierre Claver Rutayisire, PhD, University Rwanda; Saudi Arabia: Abu Zeeshan Bari, PhD, Taibah University; Slovakia: Iveta Nagyova, PhD, PJ Safarik University – UPJS; South Africa: Jason Bantjes, PhD, University of Stellenbosch; Brendon Barnes, PhD, University of Johannesburg; Bronwyne Coetzee, PhD, University of Stellenbosch; Ashraf Khagee, PhD, University of Stellenbosch; Tebogo Mothiba, PhD, University of Limpopo; Rizwana Roomaney, PhD, University of Stellenbosch; Leslie Swartz, PhD University of Stellenbosch; South Korea: Juhee Cho, PhD, Sungkyunkwan University; Man-gyeong Lee, PhDc, Sungkyunkwan University; Sweden: Anne Berman, PhD, Karolinska Institutet; Nouha Saleh Stattin, MD, Karolinska Institutet; Switzerland: Susanne Fischer, PhD, University of Zurich; Taiwan: Debbie Hu, MD, MSc, Tainan Municipal Hospital; Turkey: Yasin Kara, MD, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul; Ceprail Şimşek, MD Health Science University; Bilge Üzmezoğlu, MD, University of Health Science; Uganda: John Bosco Isunju, PhD, Makerere University School of Public Health; James Mugisha, PhD, University of Uganda; UK: Lucie Byrne-Davis, PhD, University of Manchester; Paula Griffiths, PhD, Loughborough University; Joanne Hart, PhD, University of Manchester; Will Johnson, PhD, Loughborough University; Susan Michie, PhD, University College London; Nicola Paine, PhD, Loughborough University; Emily Petherick, PhD, Loughborough University; Lauren Sherar, PhD, Loughborough University; USA: Robert M Bilder, PhD, ABPP-CN, University of California, Los Angeles; Matthew Burg, PhD, Yale; Susan Czajkowski, PhD, NIH – National Cancer Institute; Ken Freedland, PhD, Washington University; Sherri Sheinfeld Gorin, PhD, University of Michigan; Alison Holman, PhD, University of California, Irvine; Jiyoung Lee, PhD, University of Alabama; Gilberto Lopez, ScD, MA, MPH, Arizona State University and University of Rochester Medical Center; Sylvie Naar, PhD, Florida State University; Michele Okun, PhD, University of Colorado, Colorado Springs; Lynda Powell, PhD, Rush University; Sarah Pressman, PhD, University of California, Irvine; Tracey Revenson, PhD, University of New York City; John Ruiz, PhD, University ofArizona; Sudha Sivaram, PhD, NIH, Center for Global Health; Johannes Thrul, PhD, Johns Hopkins; Claudia Trudel-Fitzgerald, PhD, Harvard T.H. Chan School of Public Health; Abehaw Yohannes, PhD, Azusa Pacific University. Students: Australia: Rhea Navani, BSc, Monash University; Kushnan Ranakombu, PhD, Monash University; Brazil: Daisuke Hayashi Neto, Unicamp; Canada: Tair Ben-Porat, PhD, Tel Aviv University; Anda Dragomir, University of Quebec at Montreal (UQAM) and CIUSSS-NIM; Amandine Gagnon-Hébert, BA, UQAM; Claudia Gemme, MSc, UQAM; Vincent Gosselin Boucher, University of Quebec at Montreal (UQAM) and CIUSSS-NIM; Mahrukh Jamil, Concordia University and CIUSSS-NIM; Lisa Maria Käfer, McGill University; Ariany Marques Vieira, MSc, Concordia University; Tasfia Tasbih, Concordia University and CIUSSS-NIM; Maegan Trottier, University of Lethbridge; Robbie Woods, MSc, Concordia University; Reyhaneh Yousefi, Concordia University and CIUSSS-NIM; France: Tamila Roslyakova, Université de Montpellier; Germany: Lilli Priesterroth, Mainz University; Israel: Shirly Edelstein, Hebrew University-Hadassah School of Public Health; Tanya Goldfrad, Hebrew University-Hadassah School of Public Health; Ruth Snir, Hebrew University-Hadassah School of Public Health; Yifat Uri, Hebrew University-Hadassah School of Public Health; New Zealand: Mohsen Alyami, University of Auckland; Nigeria: Comfort Sanuade; Serbia: Katarina Vojvodic, University of Belgrade. Community Participants: Canada: Olivia Crescenzi; Kyle Warkentin; Denmark: Katya Grinko; India: Lalita Angne; Jigisha Jain; Nikita Mathur, Syncorp Clinical Research; Anagha Mithe; Sarah Nethan, Community Empowerment Lab.

      • Contributors SLB and KLL led study conceptualisation. JE, SD and JSG were responsible for the statistical analyses. JSG and JE wrote the first draft of the paper, with early input from DE. JB and HJT are the senior authors and guarantors. All authors contributed to the development of the research question, study design in relation to the Australian data analysis, interpretation of the results, critical revision of the manuscript for important intellectual content and approved the final version of the manuscript. JB attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

      • Funding The primary source of funding for the iCARE study has been provided by the Canadian Institutes of Health Research (MS3‐173099, co-PI’s: SLB and KLL) and the Fonds de Recherche du Québec: Société et Culture (2019-SE1-252541, PI: SLB). Additional support has been provided through redirected funding associated with Montreal Behavioural Medicine Centre, including funds from the Canada Research Chairs Program (950-232522, chair holder: KLL), a Canadian Institutes of Health Research-Strategy for Patient Oriented Research Mentoring Chair (SMC-151518, PI: SLB), a Fonds de Recherche du Québec: Santé Chair (251618, PI: SLB) and a Fonds de Recherche du Québec: Santé Senior Research Award (34757, PI: KLL).

      • Competing interests SLB has received consultancy fees from Merck for the development of behavior change continuing education modules, speaker fees from Novartis and Janssen and has served on advisory boards for Bayer, Sanofi and Sojecci Inc, none of which are related to the current article. KLL has served on the advisory board for Schering-Plough, Takeda, AbbVie, Almirall, Janssen, GSK, Novartis, Boehringer Ingelheim (BI) and Sojecci Inc, and has received sponsorship for investigator-generated research grants from GlaxoSmithKline (GSK) and AbbVie, speaker fees from GSK, AstraZeneca, Astellas, Novartis, Takeda, AbbVie, Merck, Boehringer Ingelheim, Bayer, Pfizer, Xfacto and Air Liquide, and support for educational materials from Merck, none of which are related to the current article. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

      • Provenance and peer review Not commissioned; externally peer reviewed.

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