COVID-19 Vaccine Hesitancy in Middle-Aged and Older Adults in India: A Mixed-Methods Study

Introduction: Vaccine hesitancy is a significant threat to public health efforts to stop the negative impacts of the COVID-19 pandemic. In India, it is critical to attain high vaccination rates to prevent overload in the healthcare system. Older adults play a central role in families’ decision-making, but there is a lack of research on middle-aged and older adults' vaccine perceptions in India in general, and about their concerns about COVID-19 vaccinations. Research question: This study aimed to explore which factors affect COVID-19 vaccine hesitancy in middle-aged and older adults in India and what factors can reduce their vaccine hesitancy and increase its uptake. Materials and methods: A mixed-method sequential design was employed to conduct the study. Convenience sampling was used to recruit participants by sending an online invitation. For phase one of the study, a quantitative survey with 34 questions was distributed through WhatsApp. For phase two of the study, qualitative one-on-one interviews were conducted with those participants who completed the survey and agreed to participate in this next phase. Results: In total, 65 individuals responded to the online survey and 10 participated in semi-structured interviews. The participants were residing in India and their age range was from 40 to 89 years. Analysis of the data identified that although the majority of participants supported the vaccine, the main reasons for vaccine hesitancy included uncertainty about the effectiveness of the vaccine, fear of side effects, unclear and insufficient information about the vaccines and altered risk perception. This study also showed that those who felt that the consequences of COVID-19 were mild were also more likely to be vaccine-hesitant. Conclusion: While the results of the study showed that most of the participants supported the COVID-19 vaccines, they expressed uncertainty regarding their effectiveness. The safety and effectiveness of the vaccines were found to be prime contributing factors to vaccine hesitancy in this sample. The findings from this pilot study can be used to develop a larger, more comprehensive study on vaccine hesitancy among middle-aged and older adults in India, which would provide more insights into strategies that can be employed to promote vaccinations.