Predicting COVID-19 vaccine hesitancy in Hong Kong: Vaccine knowledge, risks from coronavirus, and risks and benefits of vaccination

Introduction
Hongkongers have had access to COVID-19 vaccines for about four months, but vaccination rate remains low (34.4% as of 4 July 2021). Given that vaccine uptake is vital, this study aimed to determine how vaccine-hesitant and vaccinated individuals differ. The study also examined why people choose to delay vaccination (within 1 month, within 2 months, within 3 months, 3 months or more).

Material and Methods
A population-based online survey (N = 1,654) was conducted between 22 and 30 June 2021, a month after the Hong Kong government announced “Say no to vaccine hesitancy” on its website. All adults aged 18 years and older were eligible to take part. The survey included sociodemographic details, perceived susceptibility to infection, and perceived vaccine efficacy and risks. A series of analyses of covariance was performed to inspect differences among the groups and multiple regression analyses were done to examine factors associated with COVID-19 vaccine hesitancy.

Results
With a vaccine hesitancy rate of 30.3%, analyses revealed that sociodemographic factors, party identification and self-reported health status had no effects on the degrees of vaccine hesitancy. While vaccine knowledge, perceived susceptibility to infection, and vaccine efficacy and safety were positive correlates of vaccine uptake, risks from vaccination and vaccine efficacy were positive correlates of vaccine hesitancy.

Conclusions
Hesitancy in Hong Kong is more about vaccine efficacy and safety, and less about infection risks. Specifically, respondents expressed concerns about the particular vaccines supplied, especially BioNTech’s efficacy and risks from Sinovac. While higher risk motivates longer preparation for vaccine uptake, higher levels of benefits from BioNTech could reduce hesitancy.