Spatial analysis of determinants of COVID-19 vaccine hesitancy in Portugal

• Autor(a) principal: Carvalho, Constança Pinto de
• Data de Publicação: 2023
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10362/164714
• topic: COVID-19; SARS-CoV-2; Vaccine hesitancy; Social Deprivation; Migrant Health; hesitação vacinal; privação social; saúde do migrante; Domínio/Área Científica::Ciências Sociais::Outras Ciências Sociais

ABSTRACT - Background: Vaccine hesitancy tends to exhibit geographical patterns and is often associated with social deprivation and migrant status. Objectives: We aim to estimate the COVID-19 vaccination hesitancy in a high vaccination acceptance country, Portugal, and its association with sociodemographic risk factors. Methods: We used the Registry of National Health System Users to determine the eligible population for vaccination and the Vaccination Registry to determine the individuals without COVID-19 vaccine doses. Individuals older than five with no COVID 19 vaccine dose administered on March 31, 2022 were considered hesitant. We calculated hesitancy rates by the municipality, sex and age group for all municipalities in mainland Portugal. We modeled vaccine hesitancy rates with the spatial statistical scan method to identify the spatial clusters and the Besag, York, and Mollié (BYM) model to estimate the effect of age, sex, social deprivation, and migrant proportion across all the municipalities of mainland Portugal. Results: The eligible population was 9,852,283, with 1,212,565 (12%) COVID-19 vaccine-hesitant individuals. We found high hesitancy spatial clusters in the Lisbon metropolitan area and the country's southwest. Our model showed that municipalities with higher proportions of migrants are associated with an increased relative risk (RR) of vaccine hesitancy (RR = 8.0; CI 95% 4.6; 14.0). Social deprivation and gender were not associated with vaccine hesitancy rates. Conclusion: We found clusters of COVID-19 vaccine hesitancy in Portugal and a strong association with the proportion of migrants per municipality.