Role of Individual, Social and Health Factors as Determinants of COVID-19 Vaccine Hesitancy: Results from the Second Phase of the Italian EPICOVID19 Web-Based Survey

Fulvio Adorni, Chiara Cavigli, Nithiya Jesuthasan, Liliana Cori, Aleksandra Sojic, Fabrizio Bianchi, Olivia Curzio () and Federica Prinelli
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Fulvio Adorni: Institute of Biomedical Technologies of the National Research Council, ITB-CNR, Segrate, 20090 Milano, Italy
Chiara Cavigli: Institute of Clinical Physiology of the National Research Council, IFC-CNR, 56124 Pisa, Italy
Nithiya Jesuthasan: Institute of Biomedical Technologies of the National Research Council, ITB-CNR, Segrate, 20090 Milano, Italy
Liliana Cori: Institute of Clinical Physiology of the National Research Council, IFC-CNR, 56124 Pisa, Italy
Aleksandra Sojic: Institute of Biomedical Technologies of the National Research Council, ITB-CNR, Segrate, 20090 Milano, Italy
Fabrizio Bianchi: Institute of Clinical Physiology of the National Research Council, IFC-CNR, 56124 Pisa, Italy
Olivia Curzio: Institute of Clinical Physiology of the National Research Council, IFC-CNR, 56124 Pisa, Italy
Federica Prinelli: Institute of Biomedical Technologies of the National Research Council, ITB-CNR, Segrate, 20090 Milano, Italy

IJERPH, 2025, vol. 22, issue 2, 1-21

Abstract: Background: Despite scientific breakthroughs in vaccine development, some people remain reluctant to accept the anti-SARS-CoV-2 vaccine. This study evaluates attitudes and behaviours towards the vaccine and factors associated with refusal/hesitancy at the start of Italy’s vaccination campaign. Methods: EPICOVID19 is a two-phase observational web-based study where adult volunteers completed questionnaires in April–June 2020 and January–February 2021. Refusal/hesitancy towards the vaccine was assessed among those not yet vaccinated. We analysed factors associated with refusal/hesitancy by applying multivariate multinomial logistic regression models. Results: Among 36,820 survey participants (mean age of 51 years, 59.7% women, 63.6% highly educated), 2449 (6.7%) were against or hesitant, 4468 (12.1%) were inclined but unsure, and 29,903 (81.2%) were willing to be vaccinated. Factors positively associated with refusal/hesitancy included female sex, middle age, at-risk occupations, medium and low education, deprived status, being underweight, previous SARS-CoV-2 positivity, poor perceived health, no fear of contracting SARS-CoV-2, the fear of contaminated food and natural disasters, and low trust in science, media, government, or institutions. Low hesitancy was associated with student and retired status, overweight and obesity, moderate and high alcohol consumption, no concern about economic and working conditions, and sensitivity to climate change/environmental pollution and epidemics. Conclusions: This survey showed that, during the first month of Italy’s vaccination campaign, some individuals were reluctant to receive the anti-SARS-CoV-2 vaccine. This study highlights potential target groups for tailored communication and prevention campaigns.

Keywords: COVID-19; vaccine acceptance; SARS-CoV-2; anti-SARS-CoV-2 vaccination; vaccine hesitancy; vaccine refusal; determinants; web-based survey; observational study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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