Academic Journal
Distinct differences between COVID-19 vaccine refusers and vaccine hesitant in the United States: Results from a population-based survey and latent class analysis.
| Τίτλος: | Distinct differences between COVID-19 vaccine refusers and vaccine hesitant in the United States: Results from a population-based survey and latent class analysis. |
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| Συγγραφείς: | Huang K; Division of the Social Sciences, University of Chicago, Chicago, IL, United States., Taylor BG; NORC at the University of Chicago, Chicago IL, United States., Hotton AL; Department of Medicine, University of Chicago, Chicago IL, United States; The University of Chicago Center for HIV Elimination, Chicago, IL, United States., Brewer RA; Department of Medicine, University of Chicago, Chicago IL, United States; The University of Chicago Center for HIV Elimination, Chicago, IL, United States., Sheng Y; Division of the Social Sciences, University of Chicago, Chicago, IL, United States., Motley DN; Department of Medicine, University of Chicago, Chicago IL, United States; The University of Chicago Center for HIV Elimination, Chicago, IL, United States., McNulty MC; Department of Medicine, University of Chicago, Chicago IL, United States; The University of Chicago Center for HIV Elimination, Chicago, IL, United States., Pollack HA; Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL, United States; University of Chicago Crime Lab, Chicago, IL, United States; University of Chicago Health Lab, Chicago, IL, United States; Center for Health Administration Studies (CHAS) at the University of Chicago, Chicago, IL, United States., Schneider JA; Department of Medicine, University of Chicago, Chicago IL, United States; The University of Chicago Center for HIV Elimination, Chicago, IL, United States; NORC at the University of Chicago, Chicago IL, United States; Department of Public Health Sciences, University of Chicago, Chicago IL, United States; Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL, United States. Electronic address: jschnei1@medicine.bsd.uchicago.edu. |
| Πηγή: | Annals of epidemiology [Ann Epidemiol] 2026 Aug; Vol. 120, pp. 110118. Date of Electronic Publication: 2026 May 16. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 9100013 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2585 (Electronic) Linking ISSN: 10472797 NLM ISO Abbreviation: Ann Epidemiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Elsevier, c1990- |
| Ιατρικοί όροι (MeSH): | COVID-19 Vaccines*/administration & dosage , Vaccination Hesitancy*/statistics & numerical data , Vaccination Hesitancy*/psychology , COVID-19*/prevention & control , COVID-19*/epidemiology , Vaccination Refusal*/psychology , Vaccination Refusal*/statistics & numerical data, United States/epidemiology ; Humans ; Female ; Male ; Cross-Sectional Studies ; Latent Class Analysis ; Middle Aged ; Adult ; Aged ; Motivation ; Surveys and Questionnaires ; SARS-CoV-2 ; Young Adult |
| Περίληψη: | Purpose: The vaccine refuser (VR) and vaccine hesitant (VH) populations are often conflated, despite likely differing motivations. This study characterizes these subgroups in the U.S. during the COVID-19 pandemic to inform targeted public health messaging for current and future vaccination efforts. Methods: We analyzed data from a probability-based, cross-sectional AmeriSpeak survey (October-November 2021) of 6515 non-institutionalized U.S. adults. Latent class analysis (LCA) identified motivational clusters, and multinomial regression assessed predictors of class membership. Results: Of 6515 respondents, 1167 were classified as VH (n = 409) or VR (n = 758). VR individuals were more likely to be White, married, and Republican (all p < 0.05). VH participants reported significantly lower medical mistrust (2.9% vs. 6.6%, p = 0.012) and less racist attitudes (3.27 vs. 3.55, p < 0.001). LCA revealed three motivational classes: Multi-issue dominant, Side-effect dominant, and Non-dominant. Class distributions differed between groups (e.g., Multi-issue: 10.8% VH vs. 21.4% VR). Race/ethnicity, gender, and marital status significantly predicted class membership (p < 0.05). Conclusions: VH and VR individuals differ in sociodemographic traits and underlying motivations. Notably, about one-third of VRs fall within the VH spectrum. Tailoring public health messages to address specific concerns, such as side effects versus broader mistrust, may improve vaccine uptake among these distinct subgroups. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of Competing Interest Dr. Moira McNulty has served on an advisory board for Gilead Sciences, no other known conflict of interest to disclose. |
| Contributed Indexing: | Keywords: Attribute intersectionality; COVID-19; Latent Class Analysis (LCA); Pandemic; Vaccine hesitant; Vaccine refuser |
| Substance Nomenclature: | 0 (COVID-19 Vaccines) |
| Entry Date(s): | Date Created: 20260517 Date Completed: 20260612 Latest Revision: 20260612 |
| Update Code: | 20260612 |
| DOI: | 10.1016/j.annepidem.2026.110118 |
| PMID: | 42144042 |
| Βάση Δεδομένων: | MEDLINE |
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