Factors associated with COVID-19 vaccine hesitancy in Taiwan: Results from a secondary analysis of the Taiwan social change survey

Abstract

Introduction

Vaccination for COVID-19 was recommended by the World Health Organization (WHO) to prevent severe cases and death. However, vaccination uptake could be affected by various attributes. We aimed to identify factors associated with COVID-19 vaccination history in Taiwan.

Material and Methods

A secondary analysis was conducted with the 2022 Taiwan Social Change Survey. Participants were adult Taiwan residents, and were sampled randomly based on the Taiwan Address List. Survey items included sociodemographics, health status, trust and relationship with healthcare professionals, and COVID-19 and influenza vaccination history. Factors associated with COVID-19 vaccination history were assessed using chi-squared and additional independent logistic regression was conducted for factors containing more than two categories of results.

Results

Of 1739 participants, 46.9% were male, 34.8% were 60-year-old or above, 33.8% attained an undergraduate education level or above, and 49.2% were living in city area. About 46.3% had a friend working as a nurse, and 90.9% showed trust in physicians. Overall, the COVID-19 and influenza vaccination rate was 93.7%, and 30.7%, respectively. Univariate analysis results showed that sex (p=0.004), age (p<0.001), and education level (p<0.001) were significantly associated with COVID-19 vaccination history. Participants who had a lower income level (p=0.016), were residing in rural area (p=0.046), and perceived to have a worse health status (p<0.001) were more likely to be unvaccinated, while having a friend working as a nurse (p=0.003), trusting physicians (p<0.001), and having received an influenza vaccine before (p<0.001) were associated with COVID-19 vaccination.

Discussion

Our results showed that there was a discrepancy in accessing COVID-19 vaccination between healthier and wealthier people and those less privileged. While medical professionals played an important role in encouraging the public to receive COVID-19 vaccines, removing structural barriers would be important in boosting the coverage and achieving health equity.