Barriers to COVID-19 Vaccination in a Troop of Fleet Antiterrorism Security Team Marines: Observational Study.

JMIR Form Res

Behavioral Reinforcement Learning Lab (BReLL), Lirio, Knoxville, TN, United States.

Published: March 2024

AI Article Synopsis

  • The World Health Organization identified vaccine reluctance as a top health threat in 2019, which became a concern for military readiness when COVID-19 vaccines were introduced in early 2021.
  • An observational study explored why Marines decided to decline the COVID-19 vaccine by analyzing essays they wrote detailing their reasons.
  • The most common reasons for vaccine reluctance included difficulty understanding health information (45%), low perception of risk (14%), and fear of discomfort (12%), leading to suggested interventions to improve vaccination rates.

Article Abstract

Background: In 2019, the World Health Organization declared the reluctance to vaccinate despite the availability of vaccination services as one of the top 10 threats to global health. In early 2021, self-reported reluctance to vaccinate among military personnel might have been considered a significant threat to national security. Having a choice architecture that made COVID-19 vaccination optional rather than required for military personnel could have inadvertently undermined military readiness if vaccination uptake did not reach an acceptable threshold.

Objective: The purpose of this observational study was to examine Marines' self-reported reasons for planning to decline the COVID-19 vaccine to understand their barriers to vaccination.

Methods: As the vaccination became available to 1 company of Fleet Antiterrorism Security Team (FAST) Marines in early 2021, company command required those planning to decline vaccination to write an essay with up to 5 reasons for their choice. These essays provided the data for this study. Qualitative descriptive analysis with elements from grounded theory was used to thematically categorize FAST Marines' written reasons for planning to decline the COVID-19 vaccine into a codebook describing 8 key behavioral determinants. Interrater agreement among 2 qualitatively trained researchers was very good (κ=0.81).

Results: A troop of 47 Marines provided 235 reasons why they planned to decline the COVID-19 vaccine. The most frequent reasons were difficulty understanding health information (105/235, 45%), low estimates of risk (33/235, 14%), and fear of physical discomfort (29/235, 12%). Resulting interventions directly targeted Marines' self-reported reasons by reducing barriers (eg, normalized getting the vaccine), increasing vaccine benefits (eg, improved access to base gyms and recreational facilities), and increasing nonvaccine friction (eg, required in writing 5 reasons for declining the vaccine).

Conclusions: Understanding the barriers military personnel experience toward COVID-19 vaccination remains critical as vaccine acquisition and availability continue to protect military personnel. Insights from subpopulations like FAST Marines can enhance our ability to identify barriers and appropriate intervention techniques to influence COVID-19 vaccination behaviors.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988372PMC
http://dx.doi.org/10.2196/50181DOI Listing

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