COVID-19 vaccine uptake to remain low in HK due to misconceptions

Uptake of coronavirus disease 2019 (COVID-19) vaccines is likely to remain low in Hong Kong, with only 25 percent of unvaccinated individuals intending vaccination in the next 6 months, according to a recent survey conducted by the Chinese University of Hong Kong (CUHK).

Among 1,202 adult residents of Hong Kong surveyed between 23 April and 8 May 2021, 76.1 percent were yet to be vaccinated. “While 63.7 percent of the respondents agreed that vaccination is currently the most effective means to control the COVID-19 pandemic, only 25 percent of unvaccinated respondents intended to be vaccinated in the next 6 months,” reported Professor Martin Wong of the Jockey Club School of Public Health and Primary Care, CUHK.

“Belief of fatal or serious adverse effects [AEs] was the main reason [score, 8.2/10] for these respondents to remain unvaccinated, followed by lack of confidence in the government’s recommendations [score, 7.7/10] or in the place of vaccine production [score, 7.1/10], and the wish to wait for a better vaccine [score, 7.3/10],” Wong continued.

While efficacy and AEs (score, 8/10 each) and cases of death after vaccination (score, 7.5/10) were the respondents’ main considerations in vaccine selection, 27.2 percent of the respondents did not understand the differences between the mRNA vaccine and inactivated vaccine currently available in Hong Kong.

“Among those who did not intend to be vaccinated, 34.7 percent did not understand the differences between the two types of vaccines. This lack of understanding was more commonly reported by unvaccinated individuals ≥60 years of age [47.6 percent] than in those 40–59 years [31.5 percent] or 18–39 years of age [26.1 percent],” said Professor Eliza Wong of the Jockey Club School of Public Health and Primary Care, CUHK.

While a majority (82.6 percent) of respondents supported the availability of different vaccine types for selection, 78 percent said that lack of comprehensive information about the vaccines was a reason for hesitancy towards vaccination. Most respondents (79 percent) also indicated a preference for personalized recommendations on vaccine selection from healthcare professionals.

“This highlights doctors’ role in more extensively promoting vaccination and clarifying misconceptions about COVID-19 vaccines,” said Professor Paul Chan of the Department of Microbiology, CUHK.

The survey also showed that no single incentive was perceived by the respondents as a strong enough motivation for vaccination. “Seventy percent of the respondents disagreed with the use of cash by the government to boost vaccine uptake. Travel permits [score, 4.4/10], paid leave for vaccination [score, 3.8/10], and relaxation of quarantine and social distancing requirements [score, 3.5–3.7/10] were seen as relatively better incentives,” noted Chan. “These findings suggest that multiple incentives are needed to boost COVID-19 vaccine uptake.”

In terms of compulsory vaccination, 59.3 percent of the respondents agreed that personnel providing essential public services (eg, police officers, firefighters) should be targeted. About half of the respondents agreed that foreign domestic helpers (51.1 percent), healthcare workers and care institution staff (49.9 percent), and service industry workers in contact with large numbers of customers (49.6 percent) should be targeted. Respondents ≥60 years of age showed higher acceptance of targeting specific occupations for compulsory vaccination than other age groups.