Determinants of COVID-19 vaccine acceptance in a high infection-rate country: a cross-sectional study in Russia

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COVID-19 Vaccines, Immunization Programs, Vaccination, Vaccination Refusal, Attitude, Health Knowledge, Attitudes, Practice, COVID-19, SARS-CoV-2, Pandemics, Multivariate Analysis, Surveys and Questionnaires, Russia


Background: COVID-19 vaccine development is proceeding at an unprecedented pace. Once COVID-19 vaccines become widely available, it will be necessary to maximize public vaccine acceptance and coverage.

Objective: This research aimed to analyze the predictors of COVID-19 vaccine acceptance in Russia.

Methods: A cross-sectional online survey was conducted among Russian adults from September 26th to November 9th, 2020. Predictors of the intent to take up COVID-19 vaccination were explored using logistic regression.

Results: Out of 876 participants, 365 (41.7%) would be willing to receive the vaccine if it became available. Acceptance increased for a vaccine with verified safety and effectiveness (63.2%). Intention to receive the COVID-19 vaccine was relatively higher among males (aOR=2.37, 95% CI 1.41-4.00), people with lower monthly income (aOR=2.94, 95%CI 1.32-6.57), and with positive trust in the healthcare system (aOR=2.73, 95% CI 1.76-4.24). The Russian people were more likely to accept the COVID-19 vaccine if they believed that the vaccine reduces the risk of virus infection (aOR=8.80, 95%CI 5.21-14.87) or relieves the complications of the disease (aOR=10.46, 95%CI 6.09-17.96). Other barriers such as being unconcerned about side-effects (aOR=1.65, 95%CI 1.03-2.65) and the effectiveness and safety of the vaccination (aOR=2.55, 95%CI 1.60-4.08), also affected acceptance.

Conclusions: The study showed the usefulness of the health belief model constructs in understanding the COVID-19 vaccination acceptance rate in the Russian population. This rate was influenced by sociodemographic and health-related characteristics, and health beliefs. These findings might help guide future efforts for policymakers and stakeholders to improve vaccination rates by enhancing trust in the healthcare system.

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1. Verity R, Okell LC, Dorigatti I, et al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis. 2020;20(6):669-677.
2. Weekly operational update on COVID-19 - 30 November 2020. (accessed Mar 10, 2021).
3. Chhetri JK, Chan P, Arai H, et al. Prevention of COVID-19 in Older Adults: A Brief Guidance from the International Association for Gerontology and Geriatrics (IAGG) Asia/Oceania region. J Nutr Health Aging. 2020;24(5):471-472.
4. Lim WS, Liang CK, Assantachai P, et al. COVID-19 and older people in Asia: Asian Working Group for Sarcopenia calls to actions. Geriatr Gerontol Int. 2020;20(6):547-558.
5. Harapan H, Wagner AL, Yufika A, et al. Acceptance of a COVID-19 Vaccine in Southeast Asia: A Cross-Sectional Study in Indonesia. Front Public Health. 2020;8:381.
6. Barberia LG, Gómez EJ. Political and institutional perils of Brazil's COVID-19 crisis. Lancet. 2020;396(10248):367-368.
7. Alfano V, Ercolano S. The Efficacy of Lockdown Against COVID-19: A Cross-Country Panel Analysis. Appl Health Econ Health Policy. 2020;18(4):509-517.
8. Kaur SP, Gupta V. COVID-19 Vaccine: A comprehensive status report. Virus Res. 2020;288:198114.
9. Draft landscape of COVID-19 candidate vaccines. (accessed Mar 10, 2021).
10. Lurie N, Saville M, Hatchett R, Halton J. Developing Covid-19 Vaccines at Pandemic Speed. N Engl J Med. 2020;382(21):1969-1973.
11. The New York Times. Covid-19 Vaccine Tracker: Latest Updates. (accessed Mar 10, 2021).
12. Sharma O, Sultan AA, Ding H, Triggle CR. A Review of the Progress and Challenges of Developing a Vaccine for COVID-19. Front Immunol. 2020;11:585354.
13. Liebowitz D, Gottlieb K, Kolhatkar NS, et al. Efficacy, immunogenicity, and safety of an oral influenza vaccine: a placebo-controlled and active-controlled phase 2 human challenge study. Lancet Infect Dis. 2020;20(4):435-444.
14. Walsh EE, Frenck RW Jr, Falsey AR, et al. Safety and Immunogenicity of Two RNA-Based Covid-19 Vaccine Candidates. N Engl J Med. 2020;383(25):2439-2450.
15. The New York Times. In Coronavirus Vaccine Race, China Strays From the Official Paths. (accessed Mar 10, 2021).
16. The New York Times. Russia Approves Coronavirus Vaccine Before Completing Tests. (accessed Mar 10, 2021).
17. The Lancet. Salient lessons from Russia's COVID-19 outbreak. Lancet. 2020;395(10239):1739.
18. Sun X, Wagner AL, Ji J, et al. A conjoint analysis of stated vaccine preferences in Shanghai, China. Vaccine. 2020;38(6):1520-1525.
19. Lazarus JV, Ratzan SC, Palayew A, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med. 2021;27(2):225-228.
20. Malik AA, McFadden SM, Elharake J, Omer SB. Determinants of COVID-19 vaccine acceptance in the US. EClinicalMedicine. 2020;26:100495.
21. Wong LP, Alias H, Wong PF, Lee HY, AbuBakar S. The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay. Hum Vaccin Immunother. 2020;16(9):2204-2214.
22. Al-Mohaithef M, Padhi BK. Determinants of COVID-19 Vaccine Acceptance in Saudi Arabia: A Web-Based National Survey. J Multidiscip Healthc. 2020;13:1657-1663.
23. García LY, Cerda AA. Contingent assessment of the COVID-19 vaccine. Vaccine. 2020;38(34):5424-5429.
24. Wong LP, Alias H, Wong PF, Lee HY, AbuBakar S. The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay. Hum Vaccin Immunother. 2020;16(9):2204-2214.
25. Dodd RH, Cvejic E, Bonner C, Pickles K, McCaffery KJ; Sydney Health Literacy Lab COVID-19 group. Willingness to vaccinate against COVID-19 in Australia. Lancet Infect Dis. 2021;21(3):318-319.
26. Statista. Would you get vaccinated against the coronavirus with Sputnik V for free in the near future? (accessed Mar 10, 2021).
27. 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.
28. Neumann-Böhme S, Varghese NE, Sabat I, et al. Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19. Eur J Health Econ. 2020;21(7):977-982.
29. Habersaat KB, Jackson C. Understanding vaccine acceptance and demand-and ways to increase them. Akzeptanz und Nachfrage bezüglich Impfungen – wie lassen sie sich erhöhen?. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2020;63(1):32-39.
30. Laursen J, Petersen J, Didriksen M, Iversen K, Ullum H. Prevalence of SARS-CoV-2 IgG/IgM antibodies among Danish and Swedish Falck emergency and non-emergency healthcare workers. (accessed Mar 10, 2021).
31. Paek HJ, Hove T. Risk perceptions and risk characteristics. (accessed Mar 10, 2021).
32. Williams DJ, Noyes JM. How does our perception of risk influence decision-making? Implications for the design of risk information. Theor Issues Ergon Sci. 2007;8(1):1-35.
33. Perlis RH, Lazer D, Ognyanova K, Baum MA, Santillana M. The state of the nation: A 50-state COVID-19 survey: report #9: will americans vaccinate themselves and their children against COVID-19? (accessed Mar 10, 2021).
34. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513.
35. Allington D, Duffy B, Wessely S, Dhavan N, Rubin J. Health-protective behaviour, social media usage and conspiracy belief during the COVID-19 public health emergency. Psychol Med. 2020;1-7.
36. Catholic Health Australia. COVID-19 vaccine rationing and mass immunisation — challenges and solutions. (accessed Mar 10, 2021).
37. Kolff CA, Scott VP, Stockwell MS. The use of technology to promote vaccination: A social ecological model based framework. Hum Vaccin Immunother. 2018;14(7):1636-1646.
38. Hambidge SJ, Davidson AJ, Phibbs SL, et al. Strategies to improve immunization rates and well-child care in a disadvantaged population: a cluster randomized controlled trial. Arch Pediatr Adolesc Med. 2004;158(2):162-169.