Vaccine Decision-Making Influences - Insights from Severe COVID-19 Survivors: A Qualitative Study

Abstract

Vaccination have been critical for reducing death rates, severe illness, and severe long-term health risks; however, vaccine hesitancy has emerged as a key challenge. Understanding survivors’ perspectives on vaccination, given their direct virus experience and elevated risks, is critical. This study explores COVID-19 vaccination decision-making among Romanian adult survivors to gain a deeper understanding of the factors influencing vaccine acceptance and hesitancy within this societal context. Semi-structured interviews were conducted from November 2022-April 2023 with 30 participants (ages 35-76) previously hospitalized for severe COVID-19. Before contacting COVID-19, 26.6% of participants accepted vaccine, and an additional 50% chose to accept following their discharge. Thematic analysis identified four main themes: Severe Illness as a Catalyst for Vaccine Acceptancce, Vaccine Adverse Reactions Fueling Hesitancy, Accepting influence from trustworthy relationship and, General disbelief and Conspiracy Theories. This study’s findings indicate that many participants were deeply affected by their own severe experiences with COVID-19. For these participants, their traumatic experience was ultimately the main factor that motivated them to proactively seek out reliable information, ignore conspiracy theories, and engage diligently in recommended safety behaviours. Nevertheless, many survivors still opted against vaccination after hospital discharge. This qualitative study advances understanding of the intricacies underlying COVID-19 vaccination decision-making amongst survivors.