COVID-19 vaccine acceptance among adults in four major US metropolitan areas and nationwide.

This study assesses attitudes towards COVID-19 vaccination and the predictive value of COVID-VAC, a novel scale, among adults in the four largest US metropolitan areas and nationally. A 36-item survey of 6037 Americans was conducted in mid-April 2021. The study reports factors for COVID-19 vaccine acceptance among: (1) already vaccinated; (2) unvaccinated but willing to accept a vaccine; and (3) unvaccinated and unwilling to vaccinate. More than 20% were unwilling to vaccinate, expressing concerns about vaccine efficacy and safety and questioning the disease's severity. Poverty, working outside of the home and conservative political views are predictors of unwillingness. Conversely, those who either personally tested positive for COVID-19, or had a family member who did so, were more likely to accept vaccination. Majorities of all respondents supported vaccination mandates for employees and university students. Respondents preferred to receive vaccines in their doctor´s office. Lower income and conservative ideology, but not race, were strongly associated with vaccine unwillingness. The predictive value of COVID-VAC was demonstrated. While vaccination mandates are likely to be accepted, additional effective, targeted interventions to increase vaccine uptake are needed urgently.

COVID-SCORE: A global survey to assess public perceptions of government responses to COVID-19 (COVID-SCORE-10).

BACKGROUND: Understanding public perceptions of government responses to COVID-19 may foster improved public cooperation. Trust in government and population risk of exposure may influence public perception of the response. Other population-level characteristics, such as country socio-economic development, COVID-19 morbidity and mortality, and degree of democratic government, may influence perception. METHODS AND FINDINGS: We developed a novel ten-item instrument that asks respondents to rate key aspects of their government's response to the pandemic (COVID-SCORE). We examined whether the results varied by gender, age group, education level, and monthly income. We also examined the internal and external validity of the index using appropriate predefined variables. To test for dimensionality of the results, we used a principal component analysis (PCA) for the ten survey items. We found that Cronbach's alpha was 0.92 and that the first component of the PCA explained 60% of variance with the remaining factors having eigenvalues below 1, strongly indicating that the tool is both reliable and unidimensional. Based on responses from 13,426 people randomly selected from the general population in 19 countries, the mean national scores ranged from 35.76 (Ecuador) to 80.48 (China) out of a maximum of 100 points. Heterogeneity in responses was observed across age, gender, education and income with the greatest amount of heterogeneity observed between countries. National scores correlated with respondents' reported levels of trust in government and with country-level COVID-19 mortality rates. CONCLUSIONS: The COVID-SCORE survey instrument demonstrated satisfactory validity. It may help governments more effectively engage constituents in current and future efforts to control COVID-19. Additional country-specific assessment should be undertaken to measure trends over time and the public perceptions of key aspects of government responses in other countries.