Vaccine hesitancy relates to vaccine hesitancy? Discovering nonlinear relations between differing operationalizations of vaccine hesitancy.

Abstract

Objectives: Vaccine hesitancy is often conceptualized as negative perceptions regarding vaccines, but recent authors have increasingly argued that the construct should instead be conceptualized as indecision in the vaccination decision-making process. This has caused authors to reevaluate the placement of vaccine hesitancy in associated models and frameworks, and it has caused uncertainty regarding how these two conceptualizations relate to each other. In the current article, we argue that the relation between these two conceptualizations of vaccine hesitancy is best understood via nonlinear effects. Specifically, we argue that this relation takes an inverted U-shape.

Study design: We utilized a cross-sectional survey design.

Methods: We recruited 273 participants from Prolific who completed two measures of vaccine hesitancy: an eight-dimension measure reflecting negative perceptions of vaccines and a unidimensional measure reflecting indecision in the vaccine decision-making process.

Results: We performed eight quadratic regression analyses (one for each dimension) to assess our proposed nonlinear relation. The quadratic term was significant in all eight regression analyses (all p < .01), supporting our proposed inverted U-shape relation.

Conclusions: Our results provide reasoning for future authors to test whether vaccine hesitancy as negative perceptions impacts vaccination via vaccine hesitancy as indecision, and researchers must now recognize their nonlinear relation in any developed models and frameworks.