Perceptions and Concerns Regarding COVID-19 Vaccination in a Military Base Population
Authors: Theis Samuel R , Li Peter C , Kelly Devin , Ocampo Thad , Berglund Andrew , Morgan Damien , Markert Ronald , Fisher Evan , Burtson Kathryn 
Published: June 2021

ABSTRACT

Introduction
Safe and effective vaccines against severe acute respiratory syndrome-associated coronavirus 2 are essential tools in the fight against the coronavirus disease 2019 (COVID-19) pandemic. However, hesitancy to vaccination is a major barrier to achieving herd immunity, particularly among a population working on a military base. To better understand the perceptions and concerns of these individuals, a voluntary survey was conducted.

Materials and Methods
An interactive, online survey was constructed and disseminated to individuals associated with Wright-Patterson Air Force Base (WPAFB) in Dayton, OH. Survey participation was voluntary with responses collected over the initial weeks in which WPAFB began to distribute COVID-19 vaccines in a series of phases. Although initially designed to collect demographic data and identify reasons for potential vaccine hesitancy among WPAFB 88th Medical Group personnel, the study population was expanded to include all WPAFB-affiliated personnel at the direction of base leadership. The chi-squared test was used to examine the relationships between categorical variables, while multivariable logistic regression was used to assess age and occupation as independent risk factors for vaccine hesitancy.

Results
A total of 816 individuals completed the survey, of whom 22.7% (n = 185) self-identified as vaccine hesitant (VH). The VH group had a lower mean age than the not vaccine hesitant (NVH) group (39.3 ± 14.2 vs. 45.9 ± 13.4, P &lt; .001). Respondents whose occupation was medical were more likely to be VH than their non-medical colleagues (49% vs. 18%, P &lt; .001). The VH group was more concerned about short-term side effects (43% vs. 26%, P &lt; .001), long-term side effects (82% vs. 50%, P &lt; 0.001), vaccine effectiveness (23% vs. 5%, P &lt; .001), vaccine making them feel sick (22% vs. 13%, P = .002), being infected with COVID-19 from the vaccine (10% vs. 5%, P = 0.008), and worry about misinformation/political agenda (43% vs. 31%, P = 0.003). Younger respondents and medical personnel were more likely to be concerned about long-term side effects and vaccine effectiveness, and the younger group was also more likely to be concerned about pregnancy/breastfeeding issues and worry about misinformation/political agenda. Age (younger vs. older, odds ratio 2.15) and occupation (medical vs. non-medical, odds ratio 3.74) were independent risk factors for vaccine hesitancy. The NVH group was more likely to recommend the COVID-19 vaccine to a friend or family member than the VH group (93% vs. 20%, P &lt; .001) as were the older age group (79% vs. 67%, P = .001) and non-medical personnel (81% vs. 52%, P &lt; .001).

Conclusions
Younger age and medical occupation were independent risk factors for vaccine hesitancy and these individuals were less likely to recommend vaccination to a friend or family member. We also identified several key concerns related to vaccination hesitancy, in particular those related to short- and long-term side effects, and the spread of misinformation. Among military personnel, these findings carry important implications that may negatively impact mission readiness, a matter that merits further investigation. Our COVID-19 vaccination hesitancy findings can be used to guide targeted interventions at future vaccination campaigns in a military population.