Abstract

When vaccination depends on injection, it is plausible that the blood-injection-injury cluster of fears may contribute to hesitancy.

Our primary aim was to estimate in the UK adult population the proportion of COVID-19 vaccine hesitancy explained by blood-injection-injury fears.

Methods

In total, 15 014 UK adults, quota sampled to match the population for age, gender, ethnicity, income and region, took part (19 January–5 February 2021) in a non-probability online survey.

The Oxford COVID-19 Vaccine Hesitancy Scale assessed intent to be vaccinated.

Two scales (Specific Phobia Scale-blood-injection-injury phobia and Medical Fear Survey–injections and blood subscale) assessed blood-injection-injury fears.

Four items from these scales were used to create a factor score specifically for injection fears.

Results

In total, 3927 (26.2%) screened positive for blood-injection-injury phobia.

Individuals screening positive (22.0%) were more likely to report COVID-19 vaccine hesitancy compared to individuals screening negative (11.5%), odds ratio = 2.18, 95% confidence interval (CI) 1.97–2.40, p < 0.001.

The population attributable fraction (PAF) indicated that if blood-injection-injury phobia were absent then this may prevent 11.5% of all instances of vaccine hesitancy, AF = 0.11; 95% CI 0.09–0.14, p < 0.001.

COVID-19 vaccine hesitancy was associated with higher scores on the Specific Phobia Scale, r = 0.22, p < 0.001, Medical Fear Survey, r = 0.23, p = <0.001 and injection fears, r = 0.25, p < 0.001.

Injection fears were higher in youth and in Black and Asian ethnic groups, and explained a small degree of why vaccine hesitancy is higher in these groups.

Conclusions

Across the adult population, blood-injection-injury fears may explain approximately 10% of cases of COVID-19 vaccine hesitancy.

Addressing such fears will likely improve the effectiveness of vaccination programmes.

Citations

Daniel Freeman Sinéad Lambe , Ly-Mee Yu , Jason Freeman , Andrew Chadwick , Cristian Vaccari , Felicity Waite , Laina Rosebrock , Ariane Petit , Samantha Vanderslott , Stephan Lewandowsky , Michael Larkin , Stefania Innocenti , Helen McShane , Andrew J. Pollard and Bao Sheng Loe. Injection fears and COVID-19 vaccine hesitancy. 2021. Psychological Medicine, 1-11.

Sponsorship: Supported by the NIHR

DOI: https://doi:10.1017/S0033291721002609

URI: https://www.oxfordhealth.nhs.uk/orka/title/injection-fears-and-covid-19-vaccine-hesitancy/