Factors Associated with Vaccine Hesitancy in the State of Alaska

Background: Vaccine hesitancy (VH) is a major public health problem which includes not only concerns about vaccine, but often includes beliefs not aligned with evidence. The etiology of VH is complicate, including genuine concerns about vaccine safety to beliefs in disproven or unsubstantiated theories. Understanding VH includes determining the factors associated with people most likely to be susceptible. Objectives: To identify characteristics of persons more likely to have VH based on perceived vaccine safety. Design: We conducted a cross sectional, targeted online survey of 1,024 respondents. Methods: The survey collected data on demographics and vaccine beliefs. A seven-question VH scale was created based on an extensive literature review. When measured, this scale had high internal validity based on Cronbach's Alpha (a = 0.80, 95% CI, 0.79, 0.82) and provided a continuous measurement to understand the VH degree. Results: Persons reporting a conservative political ideology had the highest VH score ((-) x = 15.0), followed by other ((-) x =12.7), moderate ((-) x =9.29), and liberal ((-) x =6.72). Education level was another strong indicator of VH, decreasing from the highest score of high school graduates ( (-) x = 13.2) to graduate degree holders ((-) x = 9.22). Conclusion: The more conservative a person's political ideology, the higher the VHS. We asked for ideology, rather than political party, although they are related, they are not the same. Ideology influences more domains than voting patterns. Higher educational attainment shows a protective effect against VH. These findings have direct implication for public health interventions, new interventions should be designed to be more accessible for persons with less formal education and more amenable to persons who hold a more conservative ideology.