Professor of Pediatrics LSU Health Science Center - Shreveport Shreveport, Louisiana, United States
Background: Vaccine hesitancy has been identified by the World Health Organization as a significant threat to human health, and vaccine refusal has been an increasing concern for pediatricians and public health agencies over the past several decades. The pandemic of COVID-19 and the public health response to this novel pathogen further incited anti-vaccine sentiment in many parts of the United States. Objective: The objective of this study is to compare attitudes regarding vaccines among Louisiana voters by analysis of statewide survey data from July 2019 and October 2022. Design/Methods: The Louisiana Chapter of the American Academy of Pediatrics commissioned surveys in 2019 and 2022 to assess vaccine attitudes among Louisiana voters. We used a 5-point Likert scale to assess individuals' agreement with statements (strongly agree, agree, don't know, disagree, strongly disagree) regarding vaccine safety, efficacy and requirements. Categorical variables were compared using Chi-square test. The reliability of the questions was measured using Cronbach’s α test. P-value < 0.05 indicated statistical significance. Results: A representative sample of Louisiana citizens by age, gender, race, political affiliation and location of residence (n=700) were surveyed by landline or cellular phone during each survey period. The 2019 survey revealed strong support for vaccines, with >90% of respondents indicating support for vaccines in seven of the fourteen questions, while support was between 70-89% for four additional questions. Uncertainty was low overall, with respondents choosing “undecided” < 10% of the time for ten of the fourteen questions and only two questions had "undecided" >15%. Comparison of nine questions in common between the 2019 and 2022 surveys revealed that the vaccine confidence (agree or strongly agree with pro-vaccine position) waned by a mean of 25.8% (range 17% to 36%) and that uncertainty was >15% for eight of the nine questions. Shifts in vaccine confidence were most pronounced when compared by political affiliation (Republican > Democrat) and race (White > Black). In 2022, the most trusted sources of vaccine information were: nurses (77%), doctors (75%), family and friends (63%), Louisiana Department of Health (55%), and CDC (51%).
Conclusion(s): Comparison of vaccine attitudes in July of 2019 and October of 2022 demonstrates the significant loss of trust and increase in uncertainty among Louisiana voters temporally associated with the COVID-19 pandemic. These findings may be useful to guide education and public messaging regarding the importance of vaccines for the health of infants, children and adults.
