An exploration of SARS-CoV-2 vaccine attitudes in U.S. adults: a case for spatially variable factors

Over the previous years of the SARS-CoV-2 pandemic (commonly called the COVID-19 pandemic), studies of SARS-CoV-2 vaccines over space within the U.S. and general studies of attitudes about these vaccines have been areas of intense research. However, the combination of these two research areas is the topic of much less research in the available scientific literature. To fill this gap, this study looked at vaccine attitude data for the SARS-CoV-2 vaccines across the U.S. Vaccine attitude and ZIP code of residence data for many U.S. adults were obtained from a collection of surveys created and delivered by the Healthcare and Public Perceptions of Immunizations (HaPPI) Survey Collaborative between April 2021–April 2022. A linear regression analysis, which is a method of analyzing data to find potential relationships between factors and vaccine attitudes, in this case, found that for this sample, factors related to vaccine attitude largely matched the results of prior studies. This was compared with results of geographically weighted regression, a method of looking at how important relationships vary over space. This was performed at the level of congressional districts and indicated that relationships between multiple factors and SARS-CoV-2 vaccine attitudes depended on location in space within the U.S. Age, median household income, educational attainment, and religious adherence were found to be related to more positive vaccine attitudes at regional and/or subregional scales. The same was found for female gender, but related to more negative vaccine attitudes in this case. These findings suggest that spatial analyses can provide fuller understanding of vaccine attitudes among U.S. adults compared with findings of non-spatial methods of analysis. Particularly, this allows for better understanding of exactly where some of these factors should be targeted in order to improve vaccine attitudes, and potentially increase SARS-CoV-2 vaccination rates in turn.