key: cord-0764369-e1goh2aw authors: Andrade, Gabriel title: Predictive demographic factors of Covid-19 vaccine hesitancy in Venezuela: a cross-sectional study date: 2021-09-07 journal: Vacunas DOI: 10.1016/j.vacun.2021.07.009 sha: d22c2b688ee3443b2a2d88827d393919ea8b71b1 doc_id: 764369 cord_uid: e1goh2aw Objective: To assess if seven demographic variables (age, gender, religion, ethnicity, income, educational level, and political views) are predictive of Covid-19 vaccine hesitancy Material and methods: 327 participants completed a survey asking questions regarding each of the variables. Results: Age, gender and political views have no statistically significant correlation with vaccine hesitancy. Ethnicity and religion are predictive of vaccine hesitancy. Income has a weak negative correlation with Covid-19 vaccine hesitancy, and educational level has a moderate negative correlation with Covid-19 vaccine hesitancy. Conclusion: In order to curb Covid-19 vaccine hesitancy, public health authorities in Venezuela need to focus efforts on marginalized ethnic groups, Protestants, and those with lower levels of education. As a result of what some authors have called a "humanitarian crisis" (1), Venezuela's healthcare system has been on the border of collapse for the past five years. In this context, the nation was ill-prepared to manage the Covid-19 pandemic. Due to economic sanctions (imposed by the United States and the European Union), Venezuela has encountered additional difficulties in receiving vaccines. A vaccination program has begun, but it is still slow in achieving its goals (2) . As in many other countries, one difficulty in the vaccination campaign has been vaccine hesitancy. Public health officials need to have a good understanding of what sectors of the population are at greater risk in vaccine hesitancy, so as to focus informative campaign efforts on the most hesitant. Consequently, the present study assesses whether seven demographic variables (age, gender, religion, ethnicity, income, education and political views) are predictive of Covid-19 vaccine hesitancy in Venezuela. Due to restraints due to Covid-19 lockdowns, this study had to work with non-probabilistic sampling. 327 participants were recruited on the basis of availability and willingness to answer a J o u r n a l P r e -p r o o f survey. Recruitment took place in two malls and two public parks in Maracaibo, during the period between February and May 2021. The survey asked participants their age, gender, religion, ethnicity, household income per capita, years of schooling, whether or not they support the government, and whether or not they have received or intend to receive the Covid-19 vaccine when available. Chi-square coefficients were calculated to determine if vaccine hesitancy has a statistical correlation with the following nominal variables: gender, religion, ethnicity, and opposition/support for the government. Given that in this study vaccine hesitancy is a dichotomous variable (i.e., only two values are possible), conventional correlation coefficients were not calculated. Instead, point biserial coefficients (used for at least one dichotomous variable) were calculated to determine if there is a correlation between vaccine hesitancy and the following quantitative variables: age, household income per capita, years of schooling. Statistical significance was placed at p<0.05. Descriptive statistics are presented in Table 1 . In the present sample, 28.75% are vaccine hesitant. Chi square analyses are presented in Table 2 . Table 3 presents point biserial correlations. (4), including the Covid-19 vaccine (5) . In the present study, that pattern is repeated. One possible cofounding variable is acceptance of conspiracy theories. Given their greater mistrust of the societal system at large because of discrimination, ethnic minorities are more likely to accept conspiracy theories (6) , and consequently, have greater levels of vaccine hesitancy. Religion also comes out as a predictor of vaccine hesitancy, with Protestants having the greatest level of vaccine hesitancy (39.76%), followed by other (26.66%) and Catholic (24.89%). Prior research in other contexts has shown that very conservative religious groups are more prone Results come out showing that age has no correlation with vaccine hesitancy. Household per capita income only has a weak negative correlation with vaccine hesitancy. However, years of schooling does have a moderate negative correlation with vaccine hesitancy. This finding coheres with extensive research that so far has proven that one big factor in vaccine hesitancy is low educational level (10) . Naturally, as subjects have greater exposure to education, they are more apt in understanding how vaccines work, and the high risks of not getting vaccines (11) . Results from this study suggest that authorities in Venezuela have reason to be concerned about Covid-19 vaccine hesitancy. Those with lesser education, and traditionally marginalized ethnic groups, are at greater risk for vaccine hesitancy. Protestants are also less likely to be receptive of vaccination. Vaccination campaigns in Venezuela need to focus efforts in persuading members of these groups to receive the Covid-19 vaccine. In the longer term, authorities also need to work towards greater inclusion of traditionally marginalized ethnic groups, and expand educational efforts towards the population at large, as the results from the present study suggest that this may reduce vaccine hesitancy. Likewise, public health authorities need to engage Protestant communities in order to promote greater acceptance of scientific thinking, as results from this study also suggest that these policies may also curb vaccine hesitancy. Declaration of Interest statement: The author declares no conflict of interest Gabriel Andrade Venezuela's humanitarian crisis, resurgence of vector-borne diseases, and implications for spillover in the region. The Lancet Infectious Diseases Venezuela is collapsing without COVID-19 vaccines The influence of political ideology and trust on willingness to vaccinate Covid-19 vaccine hesitancy among ethnic minority groups Racial and ethnic differences in COVID-19 vaccine hesitancy and uptake. medRxiv Social devaluation of African Americans and racerelated conspiracy theories I Took the Trouble to Make Inquiries, So I Refuse to Accept Your Instructions": Religious Authority and Vaccine Hesitancy Among Ultra-Orthodox Jewish Mothers in Israel A test of three theories of anti-science attitudes. Sociological Focus Vaccine Hesitancy: Public Trust, Expertise, and the War on Science How health care providers should address vaccine hesitancy in the clinical setting: Evidence for presumptive language in making a strong recommendation. Human vaccines & immunotherapeutics Vaccine hesitancy and health literacy