Gabin F. Morillon and Thomas G. Poder, PhD
School of public health, University of Montreal

We conducted this survey in fall 2020, before the first vaccines against the COVID-19 disease were approved. A lot of incertitude remained about the vaccine effectiveness, its risk of mild and severe side-effects or its availability. We wanted to know what the preferences of the Quebec adult population were with respect to the vaccination program that may be offered to them. We were among the first to conduct this type of study in the context of COVID-19, and we chose to articulate this question around the issue of vaccine hesitancy.

To answer this question, we used a choice-based exercise between different vaccination scenarios. Although hypothetical, these scenarios were all highly plausible. To allow individuals to make their choices, we described the scenarios according to seven characteristics, namely: the origin of the vaccine, its effectiveness, its risk of side effects, its protection duration, the priority population to be vaccinated, the waiting time to be vaccinated, and the institutions from which the recommendations to use the vaccine emanate. Each of these characteristics could be described by different modalities which varied according to the proposed scenarios. It was by having individuals make a series of choices, either choosing to be vaccinated or opting-out, that we were able to model their preferences.

Overall, we found vaccine effectiveness, risk of side-effects, and protection duration to be the most important characteristics, followed, to a lesser extent, by vaccine origin and the institution whose recommendations came from. On the other hand, the waiting time to be vaccinated and the priority population were not characteristics that emerged as being important in the choices of the general population. By breaking down responses into sets of participants with shared answers’ patterns, we found that the importance given to the seven characteristics differed according to several sociodemographic variables, COVID-19 experiences, and perception of vaccination. We were thus able to draw up profiles which, in terms of choice of vaccination, were on the continuum of vaccine hesitancy between “pro-vaccine” and “anti-vaccine” as defined by MacDonald and the SAGE Working Group on Vaccine Hesitancy in 2015.

Although our work was carried out at the end of 2020, our results are now part of a large body of similar studies carried out, particularly in China, the United States and Europe, in which some similar characteristics were studied and where quite similar results were found. It seems essential to us to understand and describe behaviors in terms of vaccination in times of pandemic, in particular hesitant behaviors and not to marginalize them in order not to reinforce them. One way to do so is to take into account their preferences and to better integrate them into the vaccination campaign. In this respect, this study was aimed at both the general population and policy makers. Details are available online.

This newsletter editorial represents the views of the author and does not necessarily reflect the views of ISOQOL. 

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