Sociodemographic and Behavioral Predictors of COVID-19 Vaccine Hesitancy in Pakistan

Figures & data

Table 1 Participant Sociodemographic Characteristics (n=1014)

	Number	%
Age
18–30	444	44
31–40	229	23
41–50	182	18
51–60	97	10
>60	62	6
Gender
Female	478	47
Male	536	53
Residence
Urban	682	67
Rural	332	33
Education level
Uneducated	31	3
Intermediate	92	9
Secondary	26	3
University	533	52
Higher education	332	33
Occupation
Employed	463	46
Unemployed	76	8
Housewife	159	16
Students	316	31
Monthly family income (USD)
<131	200	19
131–2083	671	67
> 2083	143	14
History of chronic diseases
None	647	64
One chronic diseases	279	27
≥ two chronic diseases	88	9

Table 2 Participant Beliefs About the COVID-19 Vaccine (n=1014)

Belief	N (%)
Do you think that the COVID-19 vaccine is safe?
Yes	275 (27.1)
No	149 (14.7)
Not sure	590 (58.2)
Do you think that the COVID-19 vaccine is effective?
Yes	337 (33.2)
No	121 (11.9)
Not sure	556 (54.9)
Do you think that the best way to avoid the complications (hospitalization and death) of COVID-19 is by getting the vaccine?
Yes	413 (40.7)
No	212 (20.9)
Not sure	389 (38.4)
Do you think that greater public awareness is needed about COVID-19 vaccine?
Yes	821 (81)
No	63 (6.2)
Not sure	130 (12.8)

Table 3 Unadjusted and Adjusted Analysis of Associations Between Potential Predictors and Vaccine Hesitancy

Variables	Vaccine Hesitancy		Unadjusted OR (95% CI)	P value	Adjusted OR (95% CI)	P value
	Yes n (%) 363 (36)	No n (%) 651 (64)
Age, years
18–30	135 (31)	307 (69)	Reference		Reference
31–40	108 (47)	121 (53)	2.03 (1.46, 2.82)	<0.001	1.74 (0.97, 3.09)	0.059
41–50	63 (35)	119 (65)	1.20 (0.83, 1.74)	0.321	1.39 (0.75, 2057)	0.301
51–60	34 (35)	63 (65)	1.23 (0.77, 1.95)	0.387	1.84 (0.85, 3.98)	0.124
>60	23 (37)	39 (63)	1.34 (0.77, 2.33)	0.299	1.11 (0.35, 3.55)	0.855
Gender
Female	192 (40)	286 (60)	1.43 (1.11, 1.85)	0.006	1.24 (0.83, 1.85)	0.294
Male	171 (32)	365 (68)	Reference		Reference
Residence
Urban	253 (37)	424 (63)	1.22 (0.93, 1.61)	0.158	2.34 (1.54, 3.57)	<0.001
Rural	109 (33)	223 (67)	Reference		Reference
Education level
Uneducated	20 (65)	11 (35)	3.36 (1.58, 7.17)	0.002	1.88 (0.55, 6.37)	0.312
Intermediate	30 (33)	62 (67)	0.89 (0.56, 1.43)	0.645	0.94 (0.47, 1.86)	0.857
Secondary	16 (62)	10 (38)	2.96 (1.32, 6.65)	0.009	2.69 (0.85, 8.49)	0.091
University	187 (35)	346 (65)	Reference		Reference
Higher education	110 (33)	222 (67)	0.92 (0.69, 1.22)	0.557	1.10 (0.69, 1.75)	0.671
Occupation
Employed	164 (35)	299 (65)	Reference		Reference
Unemployed	31 (41)	45 (59)	1.26 (0.77, 2.06)	0.367	1.13 (0.50, 2.53)	0.776
Housewife	74 (47)	85 (53)	1.59 (1.10, 2.29)	0.013	0.84 (0.43, 1.61)	0.596
Students	94 (30)	222 (70)	0.77 (0.57, 1.05)	0.099	0.82 (0.45, 1.49)	0.513
Monthly family income (USD)
<131	248 (37)	415 (63)	Reference		Reference
131–2083	73 (38)	118 (62)	1.04 (0.74, 1.44)	0.838	0.99 (0.61, 1.64)	0.987
> 2083	35 (26)	100 (74)	0.59 (0.39, 0.89)	0.012	0.62 (0.36, 1.05)	0.076
History of chronic diseases
None	239 (37)	408 (63)	Reference		Reference
One chronic diseases	98 (35)	181 (65)	0.92 (0.69, 1.24)	0.599	0.60 (0.39, 0.92)	0.020
≥ two chronic diseases	26 (30)	62 (70)	0.72 (0.44, 1.16)	0.177	0.59 (0.28, 1.25)	0.167
Did you get COVID-19?
No	294 (37)	502 (63)	Reference		Reference
Yes	67 (31)	149 (69)	0.77 (0.56, 1.06)	0.108	1.03 (0.66, 1.60)	0.908
Did anyone in your contacts suffer from covid-19?
No	190 (48)	207 (52)	Reference		Reference
Yes	173 (28)	444 (72)	0.42 (0.33, 0.55)	<0.001	0.56 (0.39, 0.81)	0.002
Do you trust information given by Ministry of Health?
No	154 (56)	121 (44)	Reference		Reference
Yes	208 (28)	530 (72)	0.31 (0.23, 0.41)	<0.001	0.64 (0.41, 0.99)	0.047
Do you trust information given by physicians?
No	86 (74)	30 (26)	Reference		Reference
Yes	275 (31)	620 (69)	0.15 (0.09, 0.24)	<0.001	0.27 (0.13, 0.53)	<0.001
Do you trust information given by news channels?
No	179 (40)	267 (60)	Reference		Reference
Yes	184 (32)	384 (68)	0.71 (0.55, 0.93)	0.011	0.78 (0.52, 1.18)	0.245
Do you trust information given by social media?
No	201 (34)	388 (66)	Reference		Reference
Yes	162 (38)	263 (62)	1.19 (0.92, 1.54)	0.191	1.37 (0.92, 2.03)	0.118
Do you think that COVID-19 vaccine is safe?
Yes	18 (7)	257 (93)	Reference		Reference
No	345 (47)	393 (53)	12.5 (7.61, 20.6)	<0.001	3.29 (1.68, 6.44)	0.001
Do you think that COVID-19 vaccine is effective?
Yes	24 (7)	311 (93)	Reference		Reference
No	339 (50)	340 (50)	12.9 (8.3, 20.1)	<0.001	2.70 (1.50, 4.86)	0.001
Do you think that the best way to avoid hospitalization and death is by getting the vaccine?
Yes	29 (7)	380 (93)	Reference		Reference
No	334 (55)	269 (45)	16.3 (10.8, 24.5)	<0.001	6.39 (4.01, 10.22)	<0.001
Do you think that greater public awareness is needed about COVID-19 vaccine?
Yes	235 (29)	589 (71)	Reference		Reference
No	128 (67)	62 (33)	5.17 (3.69, 7.26)	<0.001	2.02 (1.28, 3.14)	0.003

Table 4 Reasons for COVID-19 Vaccine Hesitancy Cited by Study Participants (n = 363)

Reason	n (%)
Concerns about the vaccine’s side effects	154 (42.4)
Concerns on conspiracy theories about COVID-19 vaccine	73 (20.1)
Belief that the vaccine cannot save from COVID-19 infection	48 (13.2)
No need of vaccine because all the precautions are ensured (washing hands, wearing mask and gloves)	46 (12.6)
No need of vaccine because of perceived protection of participant from COVID-19 due to their young age and good health	22 (6.06)
Fear of needles/syringes	10 (2.7)
Perceived acquisition of immunity against COVID-19 virus after contracting and recovering from COVID-19 infection (in past months)	9 (2.4)
Wait and see the effects of vaccines in others/Insufficient information about vaccine	1 (0.3)