Abstract

Background and Objective. Although the COVID-19 pandemic has ended and COVID-19 vaccines have lost their relevance, vaccine hesitancy can still be considered a serious public health problem. Estonia’s vaccination rate was among the lowest in the European Union countries at the end of the pandemic and Estonian parents are increasingly refusing to vaccinate their children. The objective of this study was to provide an overview of COVID-19 vaccination attitudes and factors associated with vaccine hesitancy.
Methodology. The study is based on the cross-sectional data from the COVID-19 rapid survey conducted by the National Institute for Health Development in the spring of 2021. A total of 3,590 individuals aged 19–80 years were included in the analysis and divided into three groups: COVID-19 vaccine supporters, skeptics, and refusers. Weighted prevalences of the groups were calculated with the 95% confidence interval (95% CI), and assessments of vaccine-related statements were obtained. Logistic regression analysis was used to determine both unadjusted and adjusted odds ratios (aOR) and 95% CI.
Results. Among the respondents, 81.3% (95% CI 79.8–82.7) had a positive attitude towards COVID-19 vaccination, while 7.4% (95% CI 6.5–8.5) were skeptics and 11.3% (95% CI 10.2–12.5) were refusers. The majority considered vaccination to be effective (91%) and important (89%), and trusted the recommendations of healthcare workers (90%). Among the respondents, 62% perceived vaccination as safe, and 63% found vaccine information to be reliable (17% of the refusers agreed with both statements). Vaccine hesitancy was more common among women (aOR = 1.85, 95% CI 1.44–2.36), those under 70 years of age, non-native speakers (aOR = 1.86, 95% CI 1.40–2.47), respondents with primary and secondary education (aOR = 2.57, 95% CI 1.77–3.74 and 1.70, 95% CI 1.32–2.20, respectively), and those with poor living conditions (aOR = 1.95, 95% CI 1.34–2.84). Hesitancy was also higher among those who did not consider the coronavirus to be dangerous (aOR = 10.32, 95% CI 8.04–13.25), perceived the likelihood of infection to be low (aOR = 1.39, 95% CI 1.10–1.76), and experienced no stress (aOR 0.62. 95% CI 0.48–0.80).
Conclusions. During the survey, the level of trust in COVID-19 vaccines was high. As trust is a core factor in vaccine hesitancy, it is important to find solutions to build trust among groups with the highest levels of vaccine hesitancy. One possible solution would be to incorporate the experiences gained during the pandemic in shaping the national vaccination strategy