Each of the four countries shared similarities in their approach to procurement, distribution, and prioritization plans for the vaccines though they also had differences in their implementation and epidemiologic experience. The survey was limited to individuals aged ≥18 residing in the USA, Canada, Italy, and Sweden. We used a cross-sectional study design and collected data using an online survey through the Pollfish mobile platform. Centers for Disease Control and Prevention found that these concerns persisted even among parents who were vaccinated themselves.
Research from all four countries has documented concerns about the safety of COVID-19 vaccines when administered to children, especially those under 12 years of age. Further, literature from all four countries demonstrates greater rates of vaccine hesitancy among those who have children than those who do not.
Studies from both Canada and Sweden have documented concerns regarding vaccine side effects, particularly allergic reactions, as well as about the country of origin of the vaccine. found that concerns about the vaccine’s efficacy contributed to vaccine hesitancy among young adults. found that concerns over the lack of legal liability of vaccine companies contributed to vaccine hesitancy. In the USA, one of the most persistent concerns has been that vaccines cause infertility, while in Canada, a study conducted by Griffith et al. Our review of research conducted at the national level in Canada, Italy, Sweden, and the USA has identified common narratives contributing to vaccine hesitancy within and across these four countries. This study aims to identify which concerns are country specific, and which concerns, instead, appear to affect vaccine hesitancy consistently across multiple countries. Though the concerns associated with vaccine hesitancy in each of these countries have been examined in a prior study, prior research has not looked at such concerns cross-nationally. Previous research shows that some of the top COVID-19 vaccine concerns in these countries were related to vaccine safety, speed of vaccine production, ingredients in the vaccine, adverse effects of the vaccine, political and financial gains, and limited perceived risk of COVID-19. While most individuals in these countries are now vaccinated, we expect our results to be helpful in guiding vaccination efforts for additional doses, and more in general for other vaccines in the future. The goal of our study is to identify and compare the top vaccine concerns in four countries: Canada, Italy, Sweden, and the USA and how these concerns relate to vaccine hesitancy. This implies that COVID-19 vaccination communications could benefit from global collaboration. The results quantitatively highlight that the same vaccine related concerns permeated multiple countries at the same point in time. We then utilized these results in regression-based modeling to determine how concerns related to vaccine hesitancy and whether there were similar or different concerns by country. We applied CFA and created vaccine concern scales for analysis.
We sought to empirically test whether vaccine related concerns followed similar thematic issues in the four countries included in this study, and then to see how these themes related to vaccine hesitancy using data from a cross-sectional survey conducted in May 2021. Vaccine hesitancy is a key contributor to reduced COVID-19 vaccine uptake and remains a threat to COVID-19 mitigation strategies as many countries are rolling out the campaign for booster shots.
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