Factors associated with COVID-19 Vaccine Hesitancy in Thai Seniors

Figures & data

Figure 1 Study flow diagram.

Table 1 Baseline Characteristics of All Participants (N=282).

Characteristics	n	%
Age
60–69 years	99	35.1
70–79 years	123	43.6
80+ years	60	21.3
Gender
Male	82	29.1
Female	200	70.9
Ethnicity
Thai	273	96.5
Chinese	9	3.2
Marital status
Single	50	17.7
Married	179	63.5
Divorced	10	3.5
Widowed	43	15.2
Education
Elementary school or below	41	14.5
High school	44	15.6
Bachelor’s degree or higher	197	69.9
Current residence
Bangkok	190	67.4
Other provinces	92	32.6
Employment
Retired	233	82.6
Part-time job	24	8.5
Full-time job	25	8.9
Monthly income (baht) (n=216)
10,000 or less	53	18.8
10,001–20,000	52	18.4
20,001–30,000	44	15.6
30,001 or more	67	23.8
Income loss due to COVID-19
Yes	53	18.8
No	229	81.2
BMI (kg/m^2)
<18.5	12	4.3
18.5–22.9	111	39.4
23–24.9	71	25.2
25–30	68	24.1
>30	20	7.1
Ambulation
Gait aid	14	5.0
Normal	268	95.0
Hearing problem
Hearing impairment	17	6.0%
Normal	265	94.0%
Vision problem
Visual impairment	103	36.5
Normal	179	63.5
History of smoking
No	243	86.2
Yes	39	13.8
History of drinking alcohol
No	256	90.8
Yes	26	9.2
Food allergy
No	259	91.8
Yes	23	8.2
Drug allergy
No	202	71.6
Yes	80	28.4
Vaccination history
Influenza vaccine
No	24	8.5
Yes	258	91.5
Zoster vaccine
No	224	79.4
Yes	58	20.6
Pneumococcal vaccine
No	172	61.0
Yes	110	39.0
DTP vaccine
No	121	42.9
Yes	161	57.1
Underlying disease
Diabetes	52	18.4
Chronic kidney disease	11	3.9
Respiratory disease	17	6.0
Psychiatric illness	15	5.3
Subjective cognitive complaint
No	118	41.8
Yes	164	58.2
Hospitalization in the past year
No	238	84.4
Yes	44	15.6
Overall health perception
Worst/bad	7	2.5
Average	115	40.8
Good/best	160	56.7

Abbreviations: BMI, body mass index; DTP, diphtheria-tetanus-pertussis.

Table 2 Baseline Characteristics Associated with COVID-19 Vaccine Hesitancy.

Characteristics	Acceptance (n=157)		Hesitancy (n=125)		χ^2	p-value
	n	%	n	%
Age
60–69 years	59	37.6	40	32.0	1.78	0.411
70–79 years	63	40.1	60	48.0
80+ years	35	22.3	25	20.0
Gender
Male	50	31.8	32	25.6	1.32	0.251
Female	107	68.2	93	74.4
Ethnicity
Thai	152	96.8	121	96.8	0	1
Chinese	5	3.2	4	3.2
Marital status
Single	27	17.2	23	18.4	0.6	0.898
Married	98	62.4	81	64.8
Divorced	6	3.8	4	3.2
Widowed	26	16.6	17	13.6
Education
Elementary school or below	16	10.2	25	20.0	5.96	0.051
High school	28	17.8	16	12.8
Bachelor’s degree or higher	113	72.0	84	67.2
Current residence
Bangkok	105	66.9	85	68.0	0.04	0.842
Other provinces	52	33.1	40	32.0
Employment
Retired	128	81.5	105	84.0	7.78	0.678
Part-time job	13	8.3	11	8.8
Full-time job	16	10.2	9	7.2
Income loss due to COVID
Yes	29	18.5	24	19.2	0.02	0.876
No	128	81.5	101	80.8
Monthly income (baht) (n=216)
10,000 or less	29	24.2	24	25.0	2.43	0.489
10,001–20,000	33	27.5	19	19.8
20,001–30,000	21	17.5	23	24.0
30,001 or more	37	30.8	30	31.3
BMI (kg/m^2)
<18.5	8	5.1	4	3.2	1.68	0.794
18.5–22.9	62	39.5	49	39.2
23–24.9	41	26.1	30	24.0
25–30	37	23.6	31	24.8
>30	9	5.7	11	8.8
Ambulation
Gait aid	5	3.2	9	7.2	2.38	0.123
Normal	152	96.8	116	92.8
Hearing problem
Hearing impairment	9	5.7	8	6.4	0.06	0.815
Normal	148	94.3	117	93.6
Vision problem
Visual impairment	57	36.3	46	36.8	0.01	0.932
Normal	100	63.7	79	63.2
History of smoking
No	131	83.4	112	89.6	2.22	0.137
Yes	26	16.6	13	10.4
History of drinking alcohol
No	138	87.9	118	94.4	3.52	0.061
Yes	19	12.1	7	5.6
Food allergy
No	150	95.5	109	87.2	6.46	0.011
Yes	7	4.5	16	12.8
Drug allergy
No	116	73.9	86	68.8	0.89	0.347
Yes	41	26.1	39	31.2
Vaccination history
Influenza vaccine
No	15	9.6	9	7.2	0.5	0.482
Yes	142	90.4	116	92.8
Zoster vaccine
No	127	80.9	97	77.6	0.46	0.497
Yes	30	19.1	28	22.4
Pneumococcal vaccine
No	96	61.1	76	60.8	0.004	0.953
Yes	61	38.9	49	39.2
DTP vaccine
No	62	39.5	59	47.2	1.69	0.194
Yes	95	60.5	66	52.8
Underlying disease
Diabetes	25	15.9	27	21.6	1.49	0.222
Chronic kidney disease	3	1.9	8	6.4	2.74	0.066
Respiratory disease	7	4.5	10	8.0	1.54	0.215
Psychiatric illness	6	3.8	9	7.2	1.58	0.209
Subjective cognitive complaint
No	64	40.8	54	43.2	0.17	0.68
Yes	93	59.2	71	56.8
Hospitalization in the past year
No	136	86.6	102	81.6	1.33	0.248
Yes	21	13.4	23	18.4
Overall health perception
Worst/bad	2	1.3	5	4.0	3.02	0.221
Average	61	38.9	54	43.2
Good/best	94	59.9	66	52.8

Abbreviations: BMI, body mass index; DTP, diphtheria-tetanus-pertussis.

Table 3 Logistic Regression Results for COVID-19 Vaccine Hesitancy.

Variable	Univariate			Multivariate
	OR	95% CI	p-value	aOR	95% CI	p-value
Education
Elementary school or below	0.37	0.15–0.88	0.025	2.56	1.06–6.16	0.037
High school	0.48	0.24–0.95	0.034	0.7	0.30–1.65	0.412
Bachelor’s degree or higher	Ref
Food allergy
No	Ref
Yes	0.32	0.13–0.80	0.015	2.66	0.77–9.21	0.122
How confident are you in government and public health agency information on COVID-19?
Not confident	2.55	0.92–7.04	0.072	1.06	0.28–4.07	0.930
Quite not confident	4.32	1.81–10.27	0.001	3.05	0.96–9.72	0.059
Quite confident	1.69	0.78–3.64	0.182	2.07	0.74–5.81	0.169
Confident	Ref
How confident are you in Thailand’s healthcare system’s ability to treat patients with COVID-19?
Not confident	6.22	1.62–23.93	0.008	6.41	1.28–32.10	0.024
Quite not confident	1.81	0.79–4.13	0.159	1.14	0.38–3.44	0.816
Quite confident	1.33	0.78–2.28	0.301	0.79	0.38–1.63	0.517
Confident	Ref
What is your risk of getting COVID-19?
Very low risk	Ref
Low risk	1.55	0.75–3.23	0.237	1.56	0.56–4.29	0.393
High risk	2.88	1.29–6.44	0.01	2.57	0.83–7.99	0.103
Very high risk	2.79	0.90–8.69	0.077	3.05	0.68–13.75	0.147
What is your chance of having severe COVID-19 infection or life-threatening condition if you get COVID-19 infection?
Very low chance	Ref
Low chance	2.44	0.99–6.06	0.054	1.76	0.56–5.51	0.332
High chance	3.06	1.18–7.90	0.021	1.57	0.46–5.42	0.472
Very high chance	6.21	1.93–19.99	0.002	1.76	0.38–8.12	0.467
Do you think the manufacturer of the COVID-19 vaccine influenced your decision to get vaccinated?
No	Ref
Yes	6.20	3.69–10.43	<0.001	5.16	2.65–10.04	<0.001
Do you want to get vaccinated if you are offered a vaccine from a manufacturer that you did not expect?
No	5.20	2.50–10.85	<0.001	3.16	1.26–7.95	0.014
Yes	Ref
Unsure	4.29	2.20–8.38	<0.001	1.95	0.82–4.67	0.133
Number of new COVID-19 patients per day (patients)
Less than 5000	3.89	1.77–8.54	0.001	6.62	2.48–17.68	<0.001
5000–7499	1.26	0.68–2.33	0.465	1.61	0.74–3.54	0.233
7500–9999	0.79	0.40–1.55	0.493	0.77	0.33–1.81	0.554
More than 10,000	Ref

Abbreviations: OR, odds ratio; aOR, adjusted odds ratio; CI, confidence interval; Ref, reference group.

Table 4 COVID-19 Pandemic- and Vaccine-Related Factors Associated with COVID-19 Vaccine Hesitancy.

COVID-19 Pandemic and Vaccine Related Information	Acceptance (n=157)		Hesitancy (n=125)		χ^2	p-value
	n	%	n	%
How much do you know about COVID-19?
Nothing	5	3.2	7	5.6	1.45	0.694
Little	51	32.5	44	35.2
Quite a lot	89	56.7	66	52.8
A lot	12	7.6	8	6.4
What is your primary source of COVID-19 information?
Television, radio	85	54.1	71	56.8	4.16	0.527
Newspaper	2	1.3	1	0.8
Friend	12	7.6	9	7.2
News website	15	9.6	9	7.2
Social network	39	24.8	35	28.2
Others	4	2.5	0	0.0
How confident are you in government and public health agency information on COVID-19?
Not confident	14	8.9	14	11.2	14.37	0.002
Quite not confident	23	14.6	39	31.2
Quite confident	92	58.6	61	48.8
Confident	28	17.8	11	8.8
How confident are you in Thailand’s healthcare system’s ability to treat patients with COVID-19?
No confident	3	1.9	11	8.8	9.22	0.026
Quite not confident	15	9.6	16	12.8
Quite confident	83	52.9	65	52.0
Confident	56	35.7	33	26.4
How effective are the government’s measurements for controlling COIVD-19 infection?
Insufficient	50	31.8	46	36.8	3.01	0.39
Quite insufficient	45	28.7	42	33.6
Quite sufficient	51	32.5	30	24.0
Sufficient	11	7.0	7	5.6
What is your risk of getting COVID-19 infection?
Very low risk	29	18.5	13	10.4	8.77	0.033
Low risk	89	56.7	62	49.6
High risk	31	19.7	40	32.0
Very high risk	8	5.1	10	8.0
What is your chance of having severe COVID-19 infection or life-threatening condition if you get COVID-19 infection?
Very low chance	23	14.6	7	5.6	10.69	0.014
Low chance	82	52.2	61	48.8
High chance	43	27.4	40	32.0
Very high chance	9	5.7	17	13.6
How uneasy/anxious/agitated/sad/worried do you feel when you have to practice social distancing?
Never	112	71.3	76	60.8	3.91	0.271
Sometimes	36	22.9	39	31.2
Often	5	3.2	7	5.6
Always	4	2.5	3	2.4
Is there a patient with COVID-19 in your neighborhood?
No	86	54.8	58	46.4	1.95	0.162
Yes	71	45.2	67	53.6
Do you know anyone who has been infected with COVID-19?
No	97	61.8	63	50.4	3.67	0.055
Yes	60	38.2	62	49.6
Do you know anyone who has died as a result of COVID-19?
No	130	82.8	97	77.6	1.2	0.273
Yes	27	17.2	28	22.4
Do you know anyone who has had a serious reaction to the COVID-19 vaccine?
No	145	92.4	107	85.6	3.34	0.068
Yes	12	7.6	18	14.4
Will you refuse COVID-19 vaccination?
No	151	96.2	118	94.4	0.5	0.479
Yes	6	3.8	7	5.6
Do you think the manufacturers of the COVID-19 vaccine influenced your decision to get vaccinated?
No	118	75.2	41	32.8	50.78	<0.001
Yes	39	24.8	84	67.2
Do you want to get vaccinated if you are offered a vaccine from a manufacturer you did not expect?
No	12	7.6	30	24.0	33.9	<0.001
Yes	129	82.2	62	49.6
Unsure	16	10.2	33	26.4
Number of new COVID-19 patients per day (patients)
Less than 5000	13	8.3	32	25.6	17.47	0.001
5000–7499	49	31.2	39	31.2
7500–9999	46	29.3	23	18.4
More than 10,000	49	31.2	31	24.8

Figure 2 Most desirable vaccine manufacturer as perceived by participants.

Figure 3 Most important reason for COVID-19 vaccine hesitancy.

Figure 4 Most important reasons to get vaccinated against COVID-19.