Associations between Public Fear of COVID-19 and Number of COVID-19 Vaccinations: A County-Level Longitudinal Analysis

Background and Purpose: A large number of COVID-19 infections and deaths and the ensuing socioeconomic problems created widespread public fear around COVID-19. Fear around COVID-19 greatly influences people’s attitudes towards receiving the COVID-19 vaccines. The purpose of this study is examining (a) the impact of the public fear of COVID-19 (PFC) on the number of COVID-19 vaccinations at the county level; (b) the interaction effect between the PFC and per capita income, unemployment rates, and COVID-19 vaccines incentive policies, on the number of COVID-19 vaccinations at the county level. Method: This is a longitudinal analysis across states in the U.S. by using county-level data of 2856 counties from 1 February to 1 July. Random-effects models were adopted to analyze the associations between the PFC and the number of COVID-19 vaccinations. Result: the PFC was positively associated with the number of COVID-19 vaccinations at county-level, as PFC increases from 0 to 300, the predicted vaccination number increases from 10,000 to 230,000. However, the associations were divergent when the PFC interacts with county-level per capita income, unemployment rates, and incentive policies. Conclusion: public fear is an important indicator for the county-level vaccination numbers of COVID-19. However, it is critical to consider public fear and socioeconomic factors when making policies that aim to increase COVID-19 vaccination rates.