Vaccine hesitancy and COVID-19 immunization among rural young adults

Sara Mann · Kaila Christini · Yan Chai · Chun-Pin Chang · Mia Hashibe · Deanna Kepka

22 citations0/0 files storedPreventive Medicine Reports

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Vaccine Coverage and Hesitancy SARS-CoV-2 and COVID-19 Research COVID-19 and Mental Health

Abstract

Rural young adults may be more averse to receiving a COVID-19 immunization than urban young adults. We aimed to assess differences in COVID-19 vaccine hesitancy for rural, compared with urban, young adults and characterize modifiable factors. This cross-sectional online survey collected demographic data, vaccination attitudes, and COVID-19 impacts from 2937 young adults, ages 18-26 years, across the western U.S. from October 2020 to April 2021. Rurality was determined by participants' zip code and classified using the rural and urban continuum codes (RUCC). Multivariable logistic regression described adjusted (age, gender, race and ethnicity, being a current student, and month of survey) odds of self-reported intent to receive the COVID-19 vaccination by rurality. Mediation analysis was used to decompose total effects into average direct effects and average causal mediation (indirect) effects. Rural participants had 40% lower odds than urban participants of intending to receive the COVID-19 vaccine after adjustments (adjusted odds ratio, 0.62 [95% CI, 0.50-0.76]). The direct effect remained (P < 0.001), but was mediated by both education (8.3%, P < 0.001) and month in which the survey was taken (23.5%, P < 0.001). We observed a divergence after December 2020 in vaccination intent between rural and urban young adults that widened over time. Hesitancy to receive the COVID-19 vaccine was greater among rural, compared with urban young adults, and grew disproportionally after December 2020. Mediation by whether one was a current student or not suggests differences in sources of information for vaccination decision-making, and highlights areas for addressing vaccine hesitancy.

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References

2001Social Cognitive Theory: An Agentic Perspective 2021COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates 2020Determinants of COVID-19 vaccine acceptance in the US 2020Attitudes Toward a Potential SARS-CoV-2 Vaccine 2020Social media and vaccine hesitancy: new updates for the era of COVID-19 and globalized infectious diseases 2020Acceptability of a COVID-19 vaccine among adults in the United States: How many people would get vaccinated?2021COVID-19 Vaccination Hesitancy in the United States: A Rapid National Assessment 2021Predictors of intention to vaccinate against COVID-19: Results of a nationwide survey

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