From ec138c9b284a8ee3d1a3a2bf4cf96f66a6874586 Mon Sep 17 00:00:00 2001 From: Alex Reinhart Date: Thu, 22 Apr 2021 13:39:15 -0400 Subject: [PATCH 1/6] Typo fix --- content/blog/2021-03-10_c2b.Rmd | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/content/blog/2021-03-10_c2b.Rmd b/content/blog/2021-03-10_c2b.Rmd index 898514e0..a31ae7b0 100644 --- a/content/blog/2021-03-10_c2b.Rmd +++ b/content/blog/2021-03-10_c2b.Rmd @@ -16,7 +16,7 @@ heroImageThumb: /blog/images/blog-thumb-c2b-1.jpg # size: 300x200 jpg and webp f # related: summary: | In our partnership with the Allegheny County Health Department, - we explored avariety of solutions to different pressing challenges + we explored a variety of solutions to different pressing challenges during the pandemic. Cases2Beds was one such tool that came as a result of rising COVID cases in Allegheny County. From 36c6f4cabdb446ea2b5120c7345616a7ab455345 Mon Sep 17 00:00:00 2001 From: Alex Reinhart Date: Thu, 22 Apr 2021 13:52:27 -0400 Subject: [PATCH 2/6] New vaccine hesitancy blog post --- content/blog/_2021-04-20-jj-vaccine.Rmd | 526 ++++++++ content/blog/_2021-04-20-jj-vaccine.html | 1092 +++++++++++++++++ .../figure-html/side-effect-hesitancy-1.svg | 132 ++ .../side-effect-hesitancy-map-1.svg | 175 +++ .../figure-html/uptake-acceptance-1.svg | 121 ++ 5 files changed, 2046 insertions(+) create mode 100644 content/blog/_2021-04-20-jj-vaccine.Rmd create mode 100644 content/blog/_2021-04-20-jj-vaccine.html create mode 100644 static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-1.svg create mode 100644 static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg create mode 100644 static/blog/_2021-04-20-jj-vaccine_files/figure-html/uptake-acceptance-1.svg diff --git a/content/blog/_2021-04-20-jj-vaccine.Rmd b/content/blog/_2021-04-20-jj-vaccine.Rmd new file mode 100644 index 00000000..49c090ae --- /dev/null +++ b/content/blog/_2021-04-20-jj-vaccine.Rmd @@ -0,0 +1,526 @@ +--- +title: "Vaccine Hesitancy and the J&J Vaccine Suspension" +author: Alex Reinhart +date: 2021-04-22 +tags: + - COVIDcast + - symptom surveys + - vaccine +authors: + - alex +heroImage: /blog/images/blog-lg-vaccine-survey.jpg +heroImageThumb: /blog/images/blog-thumb-vaccine-survey.jpg +related: 2021-01-28-survey-vaccines +summary: | + Did the suspension of the Johnson & Johnson COVID vaccine increase vaccine + hesitancy in the United States? +acknowledgements: | + Esther Kim, Curtiss Cobb, Sarah LaRocca, and Katherine Morris at Facebook + contributed ideas for the analysis in this post. At Delphi, Wichada La + Motte-Kerr implemented many of the survey questions used in this analysis, + while Nat DeFries maintained the data processing systems needed to make the + data available. +output: + html_document: + code_folding: hide + blogdown::html_page: + toc: true +--- + +```{r, echo=FALSE, message=FALSE, warning=FALSE} +## This post's filename starts with _ so it is not run by blogdown during the +## post build process, since it depends on private microdata. Instead, we commit +## the HTML. + +library(data.table) +library(dplyr) +library(purrr) +library(covidcast) +library(ggplot2) +library(scales) +library(gt) + +knitr::opts_chunk$set(echo = FALSE) + +dfs <- lapply(list.files("jj-data/", "*.csv.gz$", include.dirs = TRUE), + function(f) { fread(paste0("jj-data/", f)) }) +d <- rbindlist(dfs) + +# some cleaning +d <- d %>% + filter(!is.na(fips)) %>% + mutate(fips = sprintf("%05d", fips), + state = fips_to_abbr(fips), + vaccinated = case_when( + V1 == 1 ~ 1, + V1 == 2 ~ 0, + V1 == 3 ~ 0, + TRUE ~ NA_real_ + ), + accepting = V3 == 1 | V3 == 2, + vaccinated_or_accept = case_when( + V1 == 1 ~ 1, + V3 == 1 ~ 1, + V3 == 2 ~ 1, + V3 == 3 ~ 0, + V3 == 4 ~ 0, + TRUE ~ NA_real_ + ), + hesitancy_level = case_when( + V1 == 1 ~ "Vaccinated", + V3 == 1 ~ "Definitely would", + V3 == 2 ~ "Probably would", + V3 == 3 ~ "Probably not", + V3 == 4 ~ "Definitely not", + TRUE ~ NA_character_ + ), + gender = case_when( + D1 == 1 ~ "Male", + D1 == 2 ~ "Female", + D1 == 3 ~ "Non-binary", + D1 == 4 ~ "Self-describe", + TRUE ~ NA_character_ + ), + date = as.Date(StartDatetime) + ) + +# Set interpretable ordering +d$hesitancy_level <- factor(d$hesitancy_level, + levels = rev(c("Vaccinated", "Definitely would", + "Probably would", "Probably not", + "Definitely not"))) +# Now let's code hesitancy reasons +split_options <- function(column) { + return(strsplit(column, ",", fixed = TRUE)) +} + +d$hesitancy_reasons_logic <- ifelse( + !is.na(d$V5b), + split_options(d$V5b), + split_options(d$V5c)) + +is_selected <- function(vec, selection) { + selections <- unlist(lapply( + vec, + function(resp) { + if (length(resp) == 0 || all(is.na(resp))) { + # Qualtrics files code no selection as "" (empty string), which is + # parsed by `read_csv` as `NA` (missing) by default. Since all our + # selection items include "None of the above" or similar, treat both no + # selection ("") or missing (NA) as missing, for generality. + NA + } else { + selection %in% resp + } + })) + + return(selections) +} +``` + +```{r} +## Time series plot tools +ga_date <- as.Date("2021-04-09") +national_date <- as.Date("2021-04-13") + +axes_me_up <- function(g, date_breaks = "4 days", accuracy = 1.0) { + g + + geom_line() + + scale_x_date(date_breaks = date_breaks, + date_minor_breaks = "1 day", + date_labels = "%b %d") + + scale_y_continuous(labels = label_percent(accuracy = accuracy)) + + geom_vline(xintercept = national_date, color = "red", linetype = "dashed") + + geom_vline(xintercept = ga_date, color = "red", linetype = "dashed") + + labs(x = "", caption = "Data from Delphi COVIDcast, delphi.cmu.edu") + + theme_bw() +} + +## Tools for pre/post tables of common hesitancy reasons +raisins <- c("Concerned about side effects", + "Concerned about allergic reaction", + "Don't know if vaccine works", + "Don't need a COVID vaccine", + "Don't like vaccines", + "Not recommended by doctor", + "Plan to wait and see if it's safe", + "Other people need it more", + "Concerned about cost", + "Don't trust COVID-19 vaccines", + "Don't trust the government", + "Concerned about safety for health condition", + "Other", + "Concerned about safety during pregnancy/breastfeeding", + "Against religious beliefs") + +reason_frequency <- function(data) { + map_dfr(seq_along(raisins), + function(r) { + data.frame(reason = raisins[r], + frequency = weighted.mean( + is_selected(data$hesitancy_reasons_logic, as.character(r)), + data$weight, na.rm = TRUE), + n = sum(!is.na(data$V5b)) + sum(!is.na(data$V5c))) + }) +} + +# logic: +# if they're vaccinated, V3 and is_selected are both NA, so they get NA +# if they're unvaccinated and accepted, the reason is not present, so 0 +# otherwise, count the reason occurrence +reason_frequency_unvaccinated <- function(data) { + map_dfr(seq_along(raisins), + function(r) { + data.frame( + reason = raisins[r], + frequency = weighted.mean( + ifelse(data$V3 == 1 | data$V3 == 2, 0, + is_selected(data$hesitancy_reasons_logic, as.character(r))), + data$weight, na.rm = TRUE), + n = sum(!is.na(data$V3))) + }) +} + +# Given a data set (national or subset as desired), make a pre/post comparison +# table. +pre_post_table <- function(data, title, subtitle, n = 6, include_unvaccinated = FALSE) { + reason_fn <- if (include_unvaccinated) { + reason_frequency_unvaccinated + } else { + reason_frequency + } + + pre_announcement <- data %>% + filter(date >= "2021-04-02", date <= "2021-04-08") %>% + reason_fn() + post_announcement <- data %>% + filter(date >= "2021-04-13") %>% + reason_fn() + + n_pre <- pre_announcement$n[1] + n_post <- post_announcement$n[1] + + # margins of error + p_pre <- max(pre_announcement$frequency) + p_post <- max(post_announcement$frequency) + moe_pre <- prettyNum(sqrt(p_pre * (1 - p_pre) / n_pre) * 200, + digits = 1) + moe_post <- prettyNum(sqrt(p_post * (1 - p_post) / n_post) * 200, + digits = 1) + + pre_announcement %>% + inner_join(post_announcement, by = "reason", suffix = c(".pre", ".post")) %>% + select(reason, frequency.pre, frequency.post) %>% + arrange(desc(frequency.pre)) %>% + head(n = n) %>% + gt() %>% + tab_header(title, subtitle) %>% + tab_footnote(paste0("April 2 – April 8, n = ", prettyNum(n_pre, big.mark = ","), + ", margin ±", moe_pre, " points"), + cells_column_labels("frequency.pre")) %>% + tab_footnote(paste0("April 13 – April 20, n = ", prettyNum(n_post, big.mark = ","), + ", margin ±", moe_post, " points"), + cells_column_labels("frequency.post")) %>% + cols_label(reason = "Reason", + frequency.pre = "Before", + frequency.post = "After") %>% + fmt_percent(columns = c("frequency.pre", "frequency.post"), + decimals = 0) +} +``` + +As the United States races to vaccinate its residents, allowing COVID +restrictions to loosen and much of normal life to resume, it's crucial that +everyone is confident in the COVID vaccines and willing to receive them. That's +why it was concerning when, on April 13th, the Centers for Disease Control and +Prevention (CDC) and the Food and Drug Administration +[announced](https://www.fda.gov/news-events/press-announcements/joint-cdc-and-fda-statement-johnson-johnson-covid-19-vaccine) +their recommendation to pause use of the Johnson & Johnson vaccine until they +can investigate severe blood clots developed by several women after they +received the vaccine. This followed news reports of adverse effects reported +several days earlier. Though all signs suggest the Pfizer and Moderna vaccines +-- which make up the bulk of the US's doses -- are safe, and the blood clots are +being carefully investigated, it would be unfortunate if this incident lowers +public confidence in vaccine. + +Some polls already suggest [the public is now less confident in the Johnson & +Johnson +vaccine](https://today.yougov.com/topics/politics/articles-reports/2021/04/15/johnson-johnson-vaccine-confidence), +but it's difficult to track changes over time with most polls, and to put the +changes into context. That's why the Delphi Group has been tracking COVID +vaccination using its [COVID Symptom +Survey](https://delphi.cmu.edu/covidcast/surveys/), a massive survey distributed +daily across the United States through our partnership with Facebook. We've +successfully used this survey to track +`r blogdown::shortcode_html("reflink", "2021-01-22-holiday-surveys", "social distancing")` and +`r blogdown::shortcode_html("reflink", "2020-12-10-masks-public", "mask use")`, and +it's part of Delphi's COVID forecasting system. + +Since the beginning of January 2021, we have asked all respondents about whether +they have been vaccinated, whether they'd be willing to be vaccinated, and any +reasons they may choose not to be vaccinated -- and because the survey is taken +by nearly 40,000 respondents per day, we can detect sudden changes and make +geographic comparisons across the United States. + +The good news is that, while there may be a temporary setback, we don't see +major changes in vaccine hesitancy yet. But our data also suggests this is the +time for action -- that public health officials must work to earn public trust +and boost confidence in COVID vaccines, and must do so quickly. + +## National changes in vaccine acceptance + +Let's start with vaccine acceptance. We ask respondents whether they are already +vaccinated; if not, we ask whether they would accept a vaccine if one was +offered to them today. If we count everyone who either is already vaccinated or +is willing to be, then among `r prettyNum(sum(!is.na(d$vaccinated_or_accept)), +big.mark=",")` survey responses, we see a consistent increasing trend that stops +as the news broke, followed by a delay of a few days and a recovery: + +```{r uptake-acceptance, fig.height=4} +d %>% + group_by(date) %>% + summarize(vaccinated_or_accept = weighted.mean(vaccinated_or_accept, weight, + na.rm = TRUE)) %>% + ggplot(aes(x = date, y = vaccinated_or_accept)) %>% + axes_me_up() + + labs(y = "Vaccinated or accepting", + title = "Vaccine uptake and acceptance in the US") +``` + +The red lines mark April 9th, when some of the first reports of adverse effects +made it onto the news, and April 13th, when the CDC and FDA issued their +recommendation to suspend the vaccine. The resulting dip in acceptance lasted a +few days before rates returned to their previous levels. But note the *Y* axis +scale: we're looking at a change of **less than 1 percentage point**, which is +only noticeable because of the size of our survey. + +It's more useful to look at the reasons. When respondents say they probably or +definitely would not choose to get vaccinated, we also ask them to select from a +list of possible reasons. We might expect an increase in the number of +respondents indicating concern about side effects as a reason, and we might also +expect a larger increase among women -- since the early blood clots all affected +women. But among all respondents (counting those already vaccinated as not +having side effect-related hesitancy), the percentage who are unwilling to get +vaccinated and indicate side effects as a cause shows only a small bump: + +```{r side-effect-hesitancy, fig.height=4, message=FALSE} +d %>% + filter(gender == "Female" | gender == "Male") %>% + group_by(date, gender) %>% + summarize( + side_effects = weighted.mean( + ifelse(V1 == 1 | V3 == 1 | V3 == 2, 0, + is_selected(hesitancy_reasons_logic, "1")), + weight, na.rm = TRUE)) %>% + ggplot(aes(x = date, y = side_effects, color = gender)) %>% + axes_me_up(accuracy = 0.1) + + labs(y = "Hesitant and concerned about side effects", + title = "Hesitancy related to concern about vaccine side effects", + subtitle = "Among all respondents, nationally", + color = "Gender") +``` + +The bump is larger among men than women, although the difference is quite small +(around half a percentage point) and could easily reflect measurement error +rather than a true difference. + +Now let's look just at unvaccinated respondents. Concerns about side effects +have consistently been one of the most common reasons unvaccinated respondents +give for hesitancy, even before the announcement: + +```{r} +pre_post_table(d, "Frequency of hesitancy reasons among unvaccinated respondents", + "Before and after J&J vaccine pause, nationally", + include_unvaccinated = TRUE) +``` + +As you can see, each reason has been increasing over time. (Respondents can +select multiple reasons from a list of about 15, so the numbers do not add to +100%.) But that is **exactly what we would expect to happen** in normal +circumstances: As more people get vaccinated, the people who remain unvaccinated +are those who either don't want to be vaccinated or haven't yet been able to. + +Given the other reasons commonly selected -- a lack of trust in the vaccines and +the government, a preference to wait and see if the vaccines are safe -- the +concerns about side effects are likely part of the common concern that the COVID +vaccines are unsafe because they were developed very quickly. Those concerns +predate the Johnson & Johnson vaccine announcement. + +Hesitancy and concerns about side effects are also not distributed evenly across +the United States, instead being concentrated in southern and southwestern +states like Louisiana, South Carolina, and New Mexico, as well as north-central +states like Wyoming, North Dakota, and Montana: + +```{r side-effect-hesitancy-map} +d %>% + filter(date >= "2021-04-14") %>% + group_by(state) %>% + summarize( + side_effects = 100 * weighted.mean( + ifelse(V3 == 1 | V3 == 2, 0, + is_selected(hesitancy_reasons_logic, "1")), + weight, na.rm = TRUE)) %>% + mutate(state = tolower(state), + time_value = "2021-04-13") %>% + rename(geo_value = state, value = side_effects) %>% + as.covidcast_signal(signal = "side-effects", geo_type = "state") %>% + plot(plot_type = "choro", range = c(10, 45)) + + labs(title = "Hesitancy related to concerns about side effects", + subtitle = "Among unvaccinated respondents, April 14–20", + caption = "Data from Delphi COVIDcast, delphi.cmu.edu") +``` + +This disparity across the country suggests that concerns about side effects are +not just driven by the news. They're partly driven by longstanding demographic +and historical differences, and as [other researchers have +noted](https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-what-weve-learned-april-2021/), +"no group is monolithic in their vaccine attitudes, and in every demographic +segment there are large shares of people who are ready to get the vaccine, +others who are in “wait and see” mode, and some who are more resistant." There +is hence no magic solution, only thoughtful and considerate approaches that work +to earn the trust of each potential vaccine recipient. + +## Who would respondents trust? + +This, of course, raises a question: What would convince hesitant people to get +vaccinated? What messages work best, delivered by whom? But while our survey +helps us understand their reasoning, it doesn't say how best to convince them -- +after all, it's hard to ask a survey respondent "Tell us the best way to change +your mind." There are some steps that are clearly necessary, such as a thorough +and public investigation of any adverse effects so they can be understood and +prevented. But our survey doesn't directly say what information should be +provided to the public. + +Other researchers have been studying the reasons people are hesitant in more +depth, to better understand the messaging that would convince them. For example, +Surgo Ventures has developed [a grouping of hesitancy +reasons](https://surgoventures.org/newsroom-all/analysis-surgo-projects-us-covid-19-vaccination-rates-will-plateau-in-late-april), +so messaging can be targeted separately to "the watchful" -- those who want to +wait and see if the vaccines are safe -- and to other groups like those anxious +about medical costs or those who distrust the system. We're currently working to +expand our survey to facilitate this analysis at a national scale. + +We also ask *who* respondents would trust to recommend COVID vaccines to them. +We ask all unvaccinated respondents "Would you be more or less likely to get a +COVID-19 vaccination if it were recommended to you by each of the following?" +Looking just at respondents who are concerned about side effects, here's what we +see: + +```{r} +sef <- d %>% + filter(is_selected(hesitancy_reasons_logic, "1")) + +count_responses <- function(data, var) { + var <- enquo(var) + + data %>% + filter(!is.na(!!var)) %>% + group_by(!!var) %>% + summarize(sum_weights = sum(weight)) %>% + mutate(sum_weights = sum_weights / sum(sum_weights)) %>% + arrange(!!var) %>% + pull(sum_weights) +} + +responses <- as.data.frame(rbind( + count_responses(sef, V4_1), + count_responses(sef, V4_2), + count_responses(sef, V4_3), + count_responses(sef, V4_4), + count_responses(sef, V4_5) +)) + +names(responses) <- c("more", "same", "less") + +responses$group <- c("Friends and family", + "Doctors and other health professionals you go to for medical care", + "World Health Organization", + "Government health officials", + "Politicians") + +responses %>% + arrange(desc(more)) %>% + gt() %>% + tab_header("How recommedations by different sources would change vaccine intent", + "Among respondents hesitant because of concerns about side effects") %>% + cols_move_to_start("group") %>% + cols_label(group = "Source", + more = "More likely", + same = "About the same", + less = "Less likely") %>% + fmt_percent(columns = c("more", "same", "less"), + decimals = 0) +``` + +It seems most respondents don't anticipate anyone changing their minds -- but +if anyone did, it would be the healthcare providers they already trust, or their +own friends and family members. This suggests strategies that involve enlisting +the support of primary care doctors, nurses, and other healthcare providers +across the country who see patients regularly, know their histories, and +understand their concerns about vaccines. And these results certainly suggest +that announcements by politicians would achieve little among people already +skeptical of vaccines and the government. + +## Limitations + +As with any scientific study, there are limitations to the results seen above. +Here are a few important things to keep in mind: + +* **We're surveying Facebook users.** While we [weight survey + responses](https://arxiv.org/abs/2009.14675) to ensure their age and gender + distribution matches the United States population, our respondents do tend to + be more educated than the national average, and the weights cannot correct for + everything. +* **The survey is voluntary.** Facebook draws a random sample of active users + every day and invites them to take the survey via a blurb in their News Feed. + But many people don't respond to the invitation, and so our respondents won't + be representative of the Facebook user base. Our survey weights also attempt + to account for this using Facebook's models for predicting the probability + each user will respond -- but it's hard to account for every possible + difference between responding and non-responding users, so there may be biases + remaining. +* **Survey responses are simplifications.** Our respondents can select reasons + for hesitancy from a list, but ticking boxes can't fully represent the + complexity of their beliefs and the reasons for their lack of trust in COVID + vaccines. Also, their responses may not always match their behavior: a + respondent who says they "probably wouldn't" get vaccinated may decide to get + vaccinated when a dose is offered to them, and a respondent who "definitely + would" get vaccinated might change their mind. + +One result of these biases is that our estimate of the percent of Americans who +have already received a COVID vaccine is too high when compared against official +CDC data. So while our survey can detect changes over time, it's possible +there's a consistent upwards bias to some of our vaccine uptake and acceptance +estimates. Fortunately our results, and particularly the prominent role of +concerns about side effects from vaccines, match well with [results from other +surveys conducted with nationally representative +samples](https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-rural-america/). + +## Conclusions + +Based on survey responses from hundreds of thousands of Facebook users, we do +not see evidence that the Johnson & Johnson vaccine pause has caused major +changes in public willingness to get vaccinated. While there have been some +shifts, they're relatively small and are consistent with long-term trends. To +expand acceptance of COVID vaccines, public health officials will need a +combination of approaches and a good understanding of the reasons people are +hesitant. Surveys like ours can help target this work and track progress, but it +will take much more than just surveys to reach out to all Americans and ensure +they both have access to vaccines and the willingness to receive them. + +Nonetheless, this demonstrates the value of Delphi's [COVID Symptom +Surveys](https://delphi.cmu.edu/covidcast/surveys/) for studying public +attitudes and behavior during the pandemic. In partnership with Facebook, who +help us distribute the surveys, and the University of Maryland, who run [an +international version](https://covidmap.umd.edu/) in 56 languages worldwide, we +have been able to track the pandemic and its effects on society for over a year +now. And much of our data is easily accessible to researchers, through +aggregates in the [Delphi COVIDcast Epidata +API](https://cmu-delphi.github.io/delphi-epidata/api/covidcast-signals/fb-survey.html) +and [tables available for +download](https://cmu-delphi.github.io/delphi-epidata/symptom-survey/contingency-tables.html), +and as de-identified individual responses for [researchers who sign Data Use +Agreements](https://cmu-delphi.github.io/delphi-epidata/symptom-survey/data-access.html). +With so many responses daily, we can react quickly and spot local changes. If +you're conducting COVID-related research, we encourage you to explore the data +and see how it can help you. diff --git a/content/blog/_2021-04-20-jj-vaccine.html b/content/blog/_2021-04-20-jj-vaccine.html new file mode 100644 index 00000000..d81ba781 --- /dev/null +++ b/content/blog/_2021-04-20-jj-vaccine.html @@ -0,0 +1,1092 @@ +--- +title: "Vaccine Hesitancy and the J&J Vaccine Suspension" +author: Alex Reinhart +date: 2021-04-22 +tags: + - COVIDcast + - symptom surveys + - vaccine +authors: + - alex +heroImage: /blog/images/blog-lg-vaccine-survey.jpg +heroImageThumb: /blog/images/blog-thumb-vaccine-survey.jpg +related: 2021-01-28-survey-vaccines +summary: | + Did the suspension of the Johnson & Johnson COVID vaccine increase vaccine + hesitancy in the United States? +acknowledgements: | + Esther Kim, Curtiss Cobb, Sarah LaRocca, and Katherine Morris at Facebook + contributed ideas for the analysis in this post. At Delphi, Wichada La + Motte-Kerr implemented many of the survey questions used in this analysis, + while Nat DeFries maintained the data processing systems needed to make the + data available. +output: + html_document: + code_folding: hide + blogdown::html_page: + toc: true +--- + + + + + + +

As the United States races to vaccinate its residents, allowing COVID +restrictions to loosen and much of normal life to resume, it’s crucial that +everyone is confident in the COVID vaccines and willing to receive them. That’s +why it was concerning when, on April 13th, the Centers for Disease Control and +Prevention (CDC) and the Food and Drug Administration +announced +their recommendation to pause use of the Johnson & Johnson vaccine until they +can investigate severe blood clots developed by several women after they +received the vaccine. This followed news reports of adverse effects reported +several days earlier. Though all signs suggest the Pfizer and Moderna vaccines +– which make up the bulk of the US’s doses – are safe, and the blood clots are +being carefully investigated, it would be unfortunate if this incident lowers +public confidence in vaccine.

+

Some polls already suggest the public is now less confident in the Johnson & +Johnson +vaccine, +but it’s difficult to track changes over time with most polls, and to put the +changes into context. That’s why the Delphi Group has been tracking COVID +vaccination using its COVID Symptom +Survey, a massive survey distributed +daily across the United States through our partnership with Facebook. We’ve +successfully used this survey to track +{{< reflink "2021-01-22-holiday-surveys" "social distancing" >}} and +{{< reflink "2020-12-10-masks-public" "mask use" >}}, and +it’s part of Delphi’s COVID forecasting system.

+

Since the beginning of January 2021, we have asked all respondents about whether +they have been vaccinated, whether they’d be willing to be vaccinated, and any +reasons they may choose not to be vaccinated – and because the survey is taken +by nearly 40,000 respondents per day, we can detect sudden changes and make +geographic comparisons across the United States.

+

The good news is that, while there may be a temporary setback, we don’t see +major changes in vaccine hesitancy yet. But our data also suggests this is the +time for action – that public health officials must work to earn public trust +and boost confidence in COVID vaccines, and must do so quickly.

+
+

National changes in vaccine acceptance

+

Let’s start with vaccine acceptance. We ask respondents whether they are already +vaccinated; if not, we ask whether they would accept a vaccine if one was +offered to them today. If we count everyone who either is already vaccinated or +is willing to be, then among 1,514,042 survey responses, we see a consistent increasing trend that stops +as the news broke, followed by a delay of a few days and a recovery:

+

+

The red lines mark April 9th, when some of the first reports of adverse effects +made it onto the news, and April 13th, when the CDC and FDA issued their +recommendation to suspend the vaccine. The resulting dip in acceptance lasted a +few days before rates returned to their previous levels. But note the Y axis +scale: we’re looking at a change of less than 1 percentage point, which is +only noticeable because of the size of our survey.

+

It’s more useful to look at the reasons. When respondents say they probably or +definitely would not choose to get vaccinated, we also ask them to select from a +list of possible reasons. We might expect an increase in the number of +respondents indicating concern about side effects as a reason, and we might also +expect a larger increase among women – since the early blood clots all affected +women. But among all respondents (counting those already vaccinated as not +having side effect-related hesitancy), the percentage who are unwilling to get +vaccinated and indicate side effects as a cause shows only a small bump:

+

+

The bump is larger among men than women, although the difference is quite small +(around half a percentage point) and could easily reflect measurement error +rather than a true difference.

+

Now let’s look just at unvaccinated respondents. Concerns about side effects +have consistently been one of the most common reasons unvaccinated respondents +give for hesitancy, even before the announcement:

+ +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
Frequency of hesitancy reasons among unvaccinated respondents
Before and after J&J vaccine pause, nationally
ReasonBefore1After2
Concerned about side effects22%29%
Don't trust COVID-19 vaccines21%28%
Don't trust the government18%23%
Plan to wait and see if it's safe17%22%
Don't need a COVID vaccine16%20%
Concerned about allergic reaction11%15%
+

+ + 1 + + + April 2 – April 8, n = 77,314, margin ±0.3 points +
+

+

+ + 2 + + + April 13 – April 20, n = 67,441, margin ±0.4 points +
+

+
+

As you can see, each reason has been increasing over time. (Respondents can +select multiple reasons from a list of about 15, so the numbers do not add to +100%.) But that is exactly what we would expect to happen in normal +circumstances: As more people get vaccinated, the people who remain unvaccinated +are those who either don’t want to be vaccinated or haven’t yet been able to.

+

Given the other reasons commonly selected – a lack of trust in the vaccines and +the government, a preference to wait and see if the vaccines are safe – the +concerns about side effects are likely part of the common concern that the COVID +vaccines are unsafe because they were developed very quickly. Those concerns +predate the Johnson & Johnson vaccine announcement.

+

Hesitancy and concerns about side effects are also not distributed evenly across +the United States, instead being concentrated in southern and southwestern +states like Louisiana, South Carolina, and New Mexico, as well as north-central +states like Wyoming, North Dakota, and Montana:

+
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+

This disparity across the country suggests that concerns about side effects are +not just driven by the news. They’re partly driven by longstanding demographic +and historical differences, and as other researchers have +noted, +“no group is monolithic in their vaccine attitudes, and in every demographic +segment there are large shares of people who are ready to get the vaccine, +others who are in “wait and see” mode, and some who are more resistant." There +is hence no magic solution, only thoughtful and considerate approaches that work +to earn the trust of each potential vaccine recipient.

+
+
+

Who would respondents trust?

+

This, of course, raises a question: What would convince hesitant people to get +vaccinated? What messages work best, delivered by whom? But while our survey +helps us understand their reasoning, it doesn’t say how best to convince them – +after all, it’s hard to ask a survey respondent “Tell us the best way to change +your mind.” There are some steps that are clearly necessary, such as a thorough +and public investigation of any adverse effects so they can be understood and +prevented. But our survey doesn’t directly say what information should be +provided to the public.

+

Other researchers have been studying the reasons people are hesitant in more +depth, to better understand the messaging that would convince them. For example, +Surgo Ventures has developed a grouping of hesitancy +reasons, +so messaging can be targeted separately to “the watchful” – those who want to +wait and see if the vaccines are safe – and to other groups like those anxious +about medical costs or those who distrust the system. We’re currently working to +expand our survey to facilitate this analysis at a national scale.

+

We also ask who respondents would trust to recommend COVID vaccines to them. +We ask all unvaccinated respondents “Would you be more or less likely to get a +COVID-19 vaccination if it were recommended to you by each of the following?” +Looking just at respondents who are concerned about side effects, here’s what we +see:

+ +
+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
How recommedations by different sources would change vaccine intent
Among respondents hesitant because of concerns about side effects
SourceMore likelyAbout the sameLess likely
Doctors and other health professionals you go to for medical care16%51%33%
Friends and family10%54%36%
World Health Organization4%34%62%
Government health officials2%28%70%
Politicians1%16%83%
+

It seems most respondents don’t anticipate anyone changing their minds – but +if anyone did, it would be the healthcare providers they already trust, or their +own friends and family members. This suggests strategies that involve enlisting +the support of primary care doctors, nurses, and other healthcare providers +across the country who see patients regularly, know their histories, and +understand their concerns about vaccines. And these results certainly suggest +that announcements by politicians would achieve little among people already +skeptical of vaccines and the government.

+
+
+

Limitations

+

As with any scientific study, there are limitations to the results seen above. +Here are a few important things to keep in mind:

+
    +
  • We’re surveying Facebook users. While we weight survey +responses to ensure their age and gender +distribution matches the United States population, our respondents do tend to +be more educated than the national average, and the weights cannot correct for +everything.
    • +
  • The survey is voluntary. Facebook draws a random sample of active users +every day and invites them to take the survey via a blurb in their News Feed. +But many people don’t respond to the invitation, and so our respondents won’t +be representative of the Facebook user base. Our survey weights also attempt +to account for this using Facebook’s models for predicting the probability +each user will respond – but it’s hard to account for every possible +difference between responding and non-responding users, so there may be biases +remaining.
    • +
  • Survey responses are simplifications. Our respondents can select reasons +for hesitancy from a list, but ticking boxes can’t fully represent the +complexity of their beliefs and the reasons for their lack of trust in COVID +vaccines. Also, their responses may not always match their behavior: a +respondent who says they “probably wouldn’t” get vaccinated may decide to get +vaccinated when a dose is offered to them, and a respondent who “definitely +would” get vaccinated might change their mind.
    • +
+

One result of these biases is that our estimate of the percent of Americans who +have already received a COVID vaccine is too high when compared against official +CDC data. So while our survey can detect changes over time, it’s possible +there’s a consistent upwards bias to some of our vaccine uptake and acceptance +estimates. Fortunately our results, and particularly the prominent role of +concerns about side effects from vaccines, match well with results from other +surveys conducted with nationally representative +samples.

+
+
+

Conclusions

+

Based on survey responses from hundreds of thousands of Facebook users, we do +not see evidence that the Johnson & Johnson vaccine pause has caused major +changes in public willingness to get vaccinated. While there have been some +shifts, they’re relatively small and are consistent with long-term trends. To +expand acceptance of COVID vaccines, public health officials will need a +combination of approaches and a good understanding of the reasons people are +hesitant. Surveys like ours can help target this work and track progress, but it +will take much more than just surveys to reach out to all Americans and ensure +they both have access to vaccines and the willingness to receive them.

+

Nonetheless, this demonstrates the value of Delphi’s COVID Symptom +Surveys for studying public +attitudes and behavior during the pandemic. In partnership with Facebook, who +help us distribute the surveys, and the University of Maryland, who run an +international version in 56 languages worldwide, we +have been able to track the pandemic and its effects on society for over a year +now. And much of our data is easily accessible to researchers, through +aggregates in the Delphi COVIDcast Epidata +API +and tables available for +download, +and as de-identified individual responses for researchers who sign Data Use +Agreements. +With so many responses daily, we can react quickly and spot local changes. If +you’re conducting COVID-related research, we encourage you to explore the data +and see how it can help you.

+
diff --git a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-1.svg b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-1.svg new file mode 100644 index 00000000..28f7afb5 --- /dev/null +++ b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-1.svg @@ -0,0 +1,132 @@ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +7.0% +7.5% +8.0% +8.5% +9.0% + + + + + + + + + + + + + + + + +Mar 10 +Mar 14 +Mar 18 +Mar 22 +Mar 26 +Mar 30 +Apr 03 +Apr 07 +Apr 11 +Apr 15 +Apr 19 +Hesitant and concerned about side effects + +Gender + + + + +Female +Male +Among all respondents, nationally +Hesitancy related to concern about vaccine side effects +Data from Delphi COVIDcast, delphi.cmu.edu + diff --git a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg new file mode 100644 index 00000000..3a9eee42 --- /dev/null +++ b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg @@ -0,0 +1,175 @@ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +10 +15 +20 +25 +30 +35 +40 +45 + + + + + + + + + + + + + + + + +Among unvaccinated respondents, April 14–20 +Hesitancy related to concerns about side effects +Data from Delphi COVIDcast, delphi.cmu.edu + diff --git a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/uptake-acceptance-1.svg b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/uptake-acceptance-1.svg new file mode 100644 index 00000000..9a7fb00a --- /dev/null +++ b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/uptake-acceptance-1.svg @@ -0,0 +1,121 @@ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +79% +80% +81% +82% +83% + + + + + + + + + + + + + + + + +Mar 10 +Mar 14 +Mar 18 +Mar 22 +Mar 26 +Mar 30 +Apr 03 +Apr 07 +Apr 11 +Apr 15 +Apr 19 +Vaccinated or accepting +Vaccine uptake and acceptance in the US +Data from Delphi COVIDcast, delphi.cmu.edu + From af4f6e0f2b44856930380281a49ecf9512c347b2 Mon Sep 17 00:00:00 2001 From: Alex Reinhart Date: Thu, 22 Apr 2021 13:56:34 -0400 Subject: [PATCH 3/6] Fix YAML list --- content/blog/_2021-04-20-jj-vaccine.Rmd | 3 ++- content/blog/_2021-04-20-jj-vaccine.html | 3 ++- 2 files changed, 4 insertions(+), 2 deletions(-) diff --git a/content/blog/_2021-04-20-jj-vaccine.Rmd b/content/blog/_2021-04-20-jj-vaccine.Rmd index 49c090ae..03fd81d7 100644 --- a/content/blog/_2021-04-20-jj-vaccine.Rmd +++ b/content/blog/_2021-04-20-jj-vaccine.Rmd @@ -10,7 +10,8 @@ authors: - alex heroImage: /blog/images/blog-lg-vaccine-survey.jpg heroImageThumb: /blog/images/blog-thumb-vaccine-survey.jpg -related: 2021-01-28-survey-vaccines +related: + - 2021-01-28-survey-vaccines summary: | Did the suspension of the Johnson & Johnson COVID vaccine increase vaccine hesitancy in the United States? diff --git a/content/blog/_2021-04-20-jj-vaccine.html b/content/blog/_2021-04-20-jj-vaccine.html index d81ba781..4c797099 100644 --- a/content/blog/_2021-04-20-jj-vaccine.html +++ b/content/blog/_2021-04-20-jj-vaccine.html @@ -10,7 +10,8 @@ - alex heroImage: /blog/images/blog-lg-vaccine-survey.jpg heroImageThumb: /blog/images/blog-thumb-vaccine-survey.jpg -related: 2021-01-28-survey-vaccines +related: + - 2021-01-28-survey-vaccines summary: | Did the suspension of the Johnson & Johnson COVID vaccine increase vaccine hesitancy in the United States? From ab9fd648ae1fc743644481d5a274903840584165 Mon Sep 17 00:00:00 2001 From: Alex Reinhart Date: Thu, 22 Apr 2021 13:59:47 -0400 Subject: [PATCH 4/6] Fix warnings --- content/blog/_2021-04-20-jj-vaccine.Rmd | 2 +- content/blog/_2021-04-20-jj-vaccine.html | 216 ++++++------------ .../side-effect-hesitancy-map-1.svg | 2 +- 3 files changed, 74 insertions(+), 146 deletions(-) diff --git a/content/blog/_2021-04-20-jj-vaccine.Rmd b/content/blog/_2021-04-20-jj-vaccine.Rmd index 03fd81d7..9eed470c 100644 --- a/content/blog/_2021-04-20-jj-vaccine.Rmd +++ b/content/blog/_2021-04-20-jj-vaccine.Rmd @@ -367,7 +367,7 @@ d %>% as.covidcast_signal(signal = "side-effects", geo_type = "state") %>% plot(plot_type = "choro", range = c(10, 45)) + labs(title = "Hesitancy related to concerns about side effects", - subtitle = "Among unvaccinated respondents, April 14–20", + subtitle = "Among unvaccinated respondents, April 14-20", caption = "Data from Delphi COVIDcast, delphi.cmu.edu") ``` diff --git a/content/blog/_2021-04-20-jj-vaccine.html b/content/blog/_2021-04-20-jj-vaccine.html index 4c797099..c03e3278 100644 --- a/content/blog/_2021-04-20-jj-vaccine.html +++ b/content/blog/_2021-04-20-jj-vaccine.html @@ -107,7 +107,7 @@

National changes in vaccine acceptance

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National changes in vaccine acceptance

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National changes in vaccine acceptance

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National changes in vaccine acceptance

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National changes in vaccine acceptance

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National changes in vaccine acceptance

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National changes in vaccine acceptance

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National changes in vaccine acceptance

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National changes in vaccine acceptance

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National changes in vaccine acceptance

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National changes in vaccine acceptance

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+
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National changes in vaccine acceptance

the United States, instead being concentrated in southern and southwestern states like Louisiana, South Carolina, and New Mexico, as well as north-central states like Wyoming, North Dakota, and Montana:

-
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This disparity across the country suggests that concerns about side effects are not just driven by the news. They’re partly driven by longstanding demographic @@ -635,7 +563,7 @@

Who would respondents trust?

font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Helvetica Neue', 'Fira Sans', 'Droid Sans', Arial, sans-serif; } -#buvmbwmskx .gt_table { +#ofbmvshksr .gt_table { display: table; border-collapse: collapse; margin-left: auto; @@ -660,7 +588,7 @@

Who would respondents trust?

border-left-color: #D3D3D3; } -#buvmbwmskx .gt_heading { +#ofbmvshksr .gt_heading { background-color: #FFFFFF; text-align: center; border-bottom-color: #FFFFFF; @@ -672,7 +600,7 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#buvmbwmskx .gt_title { +#ofbmvshksr .gt_title { color: #333333; font-size: 125%; font-weight: initial; @@ -682,7 +610,7 @@

Who would respondents trust?

border-bottom-width: 0; } -#buvmbwmskx .gt_subtitle { +#ofbmvshksr .gt_subtitle { color: #333333; font-size: 85%; font-weight: initial; @@ -692,13 +620,13 @@

Who would respondents trust?

border-top-width: 0; } -#buvmbwmskx .gt_bottom_border { +#ofbmvshksr .gt_bottom_border { border-bottom-style: solid; border-bottom-width: 2px; border-bottom-color: #D3D3D3; } -#buvmbwmskx .gt_col_headings { +#ofbmvshksr .gt_col_headings { border-top-style: solid; border-top-width: 2px; border-top-color: #D3D3D3; @@ -713,7 +641,7 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#buvmbwmskx .gt_col_heading { +#ofbmvshksr .gt_col_heading { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -733,7 +661,7 @@

Who would respondents trust?

overflow-x: hidden; } -#buvmbwmskx .gt_column_spanner_outer { +#ofbmvshksr .gt_column_spanner_outer { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -745,15 +673,15 @@

Who would respondents trust?

padding-right: 4px; } -#buvmbwmskx .gt_column_spanner_outer:first-child { +#ofbmvshksr .gt_column_spanner_outer:first-child { padding-left: 0; } -#buvmbwmskx .gt_column_spanner_outer:last-child { +#ofbmvshksr .gt_column_spanner_outer:last-child { padding-right: 0; } -#buvmbwmskx .gt_column_spanner { +#ofbmvshksr .gt_column_spanner { border-bottom-style: solid; border-bottom-width: 2px; border-bottom-color: #D3D3D3; @@ -765,7 +693,7 @@

Who would respondents trust?

width: 100%; } -#buvmbwmskx .gt_group_heading { +#ofbmvshksr .gt_group_heading { padding: 8px; color: #333333; background-color: #FFFFFF; @@ -787,7 +715,7 @@

Who would respondents trust?

vertical-align: middle; } -#buvmbwmskx .gt_empty_group_heading { +#ofbmvshksr .gt_empty_group_heading { padding: 0.5px; color: #333333; background-color: #FFFFFF; @@ -802,15 +730,15 @@

Who would respondents trust?

vertical-align: middle; } -#buvmbwmskx .gt_from_md > :first-child { +#ofbmvshksr .gt_from_md > :first-child { margin-top: 0; } -#buvmbwmskx .gt_from_md > :last-child { +#ofbmvshksr .gt_from_md > :last-child { margin-bottom: 0; } -#buvmbwmskx .gt_row { +#ofbmvshksr .gt_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -829,7 +757,7 @@

Who would respondents trust?

overflow-x: hidden; } -#buvmbwmskx .gt_stub { +#ofbmvshksr .gt_stub { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -841,7 +769,7 @@

Who would respondents trust?

padding-left: 12px; } -#buvmbwmskx .gt_summary_row { +#ofbmvshksr .gt_summary_row { color: #333333; background-color: #FFFFFF; text-transform: inherit; @@ -851,7 +779,7 @@

Who would respondents trust?

padding-right: 5px; } -#buvmbwmskx .gt_first_summary_row { +#ofbmvshksr .gt_first_summary_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -861,7 +789,7 @@

Who would respondents trust?

border-top-color: #D3D3D3; } -#buvmbwmskx .gt_grand_summary_row { +#ofbmvshksr .gt_grand_summary_row { color: #333333; background-color: #FFFFFF; text-transform: inherit; @@ -871,7 +799,7 @@

Who would respondents trust?

padding-right: 5px; } -#buvmbwmskx .gt_first_grand_summary_row { +#ofbmvshksr .gt_first_grand_summary_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -881,11 +809,11 @@

Who would respondents trust?

border-top-color: #D3D3D3; } -#buvmbwmskx .gt_striped { +#ofbmvshksr .gt_striped { background-color: rgba(128, 128, 128, 0.05); } -#buvmbwmskx .gt_table_body { +#ofbmvshksr .gt_table_body { border-top-style: solid; border-top-width: 2px; border-top-color: #D3D3D3; @@ -894,7 +822,7 @@

Who would respondents trust?

border-bottom-color: #D3D3D3; } -#buvmbwmskx .gt_footnotes { +#ofbmvshksr .gt_footnotes { color: #333333; background-color: #FFFFFF; border-bottom-style: none; @@ -908,13 +836,13 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#buvmbwmskx .gt_footnote { +#ofbmvshksr .gt_footnote { margin: 0px; font-size: 90%; padding: 4px; } -#buvmbwmskx .gt_sourcenotes { +#ofbmvshksr .gt_sourcenotes { color: #333333; background-color: #FFFFFF; border-bottom-style: none; @@ -928,46 +856,46 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#buvmbwmskx .gt_sourcenote { +#ofbmvshksr .gt_sourcenote { font-size: 90%; padding: 4px; } -#buvmbwmskx .gt_left { +#ofbmvshksr .gt_left { text-align: left; } -#buvmbwmskx .gt_center { +#ofbmvshksr .gt_center { text-align: center; } -#buvmbwmskx .gt_right { +#ofbmvshksr .gt_right { text-align: right; font-variant-numeric: tabular-nums; } -#buvmbwmskx .gt_font_normal { +#ofbmvshksr .gt_font_normal { font-weight: normal; } -#buvmbwmskx .gt_font_bold { +#ofbmvshksr .gt_font_bold { font-weight: bold; } -#buvmbwmskx .gt_font_italic { +#ofbmvshksr .gt_font_italic { font-style: italic; } -#buvmbwmskx .gt_super { +#ofbmvshksr .gt_super { font-size: 65%; } -#buvmbwmskx .gt_footnote_marks { +#ofbmvshksr .gt_footnote_marks { font-style: italic; font-size: 65%; } -
Frequency of hesitancy reasons among unvaccinated respondents
+
diff --git a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg index 3a9eee42..ad335145 100644 --- a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg +++ b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg @@ -169,7 +169,7 @@ -Among unvaccinated respondents, April 14–20 +Among unvaccinated respondents, April 14-20 Hesitancy related to concerns about side effects Data from Delphi COVIDcast, delphi.cmu.edu From 4a801337ff95c2ab2cccaa47c7c5acba99cd8398 Mon Sep 17 00:00:00 2001 From: Alex Reinhart Date: Thu, 22 Apr 2021 14:52:28 -0400 Subject: [PATCH 5/6] Soften some language --- content/blog/_2021-04-20-jj-vaccine.Rmd | 24 ++-- content/blog/_2021-04-20-jj-vaccine.html | 168 ++++++++++++----------- 2 files changed, 100 insertions(+), 92 deletions(-) diff --git a/content/blog/_2021-04-20-jj-vaccine.Rmd b/content/blog/_2021-04-20-jj-vaccine.Rmd index 9eed470c..ad13c664 100644 --- a/content/blog/_2021-04-20-jj-vaccine.Rmd +++ b/content/blog/_2021-04-20-jj-vaccine.Rmd @@ -337,15 +337,18 @@ pre_post_table(d, "Frequency of hesitancy reasons among unvaccinated respondents As you can see, each reason has been increasing over time. (Respondents can select multiple reasons from a list of about 15, so the numbers do not add to -100%.) But that is **exactly what we would expect to happen** in normal -circumstances: As more people get vaccinated, the people who remain unvaccinated -are those who either don't want to be vaccinated or haven't yet been able to. +100%.) But that is **what we would expect to happen** in normal circumstances: +As more people get vaccinated, the people who remain unvaccinated are those who +either don't want to be vaccinated or haven't yet been able to. Given the other reasons commonly selected -- a lack of trust in the vaccines and the government, a preference to wait and see if the vaccines are safe -- the concerns about side effects are likely part of the common concern that the COVID vaccines are unsafe because they were developed very quickly. Those concerns -predate the Johnson & Johnson vaccine announcement. +predate the Johnson & Johnson vaccine announcement. The largest increases are +among choices about side effects and trust in the vaccines, suggesting the +announcement may have exacerbated existing concerns among people skeptical of +the vaccines. Hesitancy and concerns about side effects are also not distributed evenly across the United States, instead being concentrated in southern and southwestern @@ -502,12 +505,13 @@ samples](https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vacc Based on survey responses from hundreds of thousands of Facebook users, we do not see evidence that the Johnson & Johnson vaccine pause has caused major changes in public willingness to get vaccinated. While there have been some -shifts, they're relatively small and are consistent with long-term trends. To -expand acceptance of COVID vaccines, public health officials will need a -combination of approaches and a good understanding of the reasons people are -hesitant. Surveys like ours can help target this work and track progress, but it -will take much more than just surveys to reach out to all Americans and ensure -they both have access to vaccines and the willingness to receive them. +shifts, they're relatively small and connect to existing skepticism about the +safety of the COVID vaccines. To expand acceptance of COVID vaccines, public +health officials will need a combination of approaches and a good understanding +of the reasons people are hesitant. Surveys like ours can help target this work +and track progress, but it will take much more than just surveys to reach out to +all Americans and ensure they both have access to vaccines and the willingness +to receive them. Nonetheless, this demonstrates the value of Delphi's [COVID Symptom Surveys](https://delphi.cmu.edu/covidcast/surveys/) for studying public diff --git a/content/blog/_2021-04-20-jj-vaccine.html b/content/blog/_2021-04-20-jj-vaccine.html index c03e3278..94b1ec7e 100644 --- a/content/blog/_2021-04-20-jj-vaccine.html +++ b/content/blog/_2021-04-20-jj-vaccine.html @@ -107,7 +107,7 @@

National changes in vaccine acceptance

font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Helvetica Neue', 'Fira Sans', 'Droid Sans', Arial, sans-serif; } -#nawtbmynnn .gt_table { +#cjezyportx .gt_table { display: table; border-collapse: collapse; margin-left: auto; @@ -132,7 +132,7 @@

National changes in vaccine acceptance

border-left-color: #D3D3D3; } -#nawtbmynnn .gt_heading { +#cjezyportx .gt_heading { background-color: #FFFFFF; text-align: center; border-bottom-color: #FFFFFF; @@ -144,7 +144,7 @@

National changes in vaccine acceptance

border-right-color: #D3D3D3; } -#nawtbmynnn .gt_title { +#cjezyportx .gt_title { color: #333333; font-size: 125%; font-weight: initial; @@ -154,7 +154,7 @@

National changes in vaccine acceptance

border-bottom-width: 0; } -#nawtbmynnn .gt_subtitle { +#cjezyportx .gt_subtitle { color: #333333; font-size: 85%; font-weight: initial; @@ -164,13 +164,13 @@

National changes in vaccine acceptance

border-top-width: 0; } -#nawtbmynnn .gt_bottom_border { +#cjezyportx .gt_bottom_border { border-bottom-style: solid; border-bottom-width: 2px; border-bottom-color: #D3D3D3; } -#nawtbmynnn .gt_col_headings { +#cjezyportx .gt_col_headings { border-top-style: solid; border-top-width: 2px; border-top-color: #D3D3D3; @@ -185,7 +185,7 @@

National changes in vaccine acceptance

border-right-color: #D3D3D3; } -#nawtbmynnn .gt_col_heading { +#cjezyportx .gt_col_heading { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -205,7 +205,7 @@

National changes in vaccine acceptance

overflow-x: hidden; } -#nawtbmynnn .gt_column_spanner_outer { +#cjezyportx .gt_column_spanner_outer { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -217,15 +217,15 @@

National changes in vaccine acceptance

padding-right: 4px; } -#nawtbmynnn .gt_column_spanner_outer:first-child { +#cjezyportx .gt_column_spanner_outer:first-child { padding-left: 0; } -#nawtbmynnn .gt_column_spanner_outer:last-child { +#cjezyportx .gt_column_spanner_outer:last-child { padding-right: 0; } -#nawtbmynnn .gt_column_spanner { +#cjezyportx .gt_column_spanner { border-bottom-style: solid; border-bottom-width: 2px; border-bottom-color: #D3D3D3; @@ -237,7 +237,7 @@

National changes in vaccine acceptance

width: 100%; } -#nawtbmynnn .gt_group_heading { +#cjezyportx .gt_group_heading { padding: 8px; color: #333333; background-color: #FFFFFF; @@ -259,7 +259,7 @@

National changes in vaccine acceptance

vertical-align: middle; } -#nawtbmynnn .gt_empty_group_heading { +#cjezyportx .gt_empty_group_heading { padding: 0.5px; color: #333333; background-color: #FFFFFF; @@ -274,15 +274,15 @@

National changes in vaccine acceptance

vertical-align: middle; } -#nawtbmynnn .gt_from_md > :first-child { +#cjezyportx .gt_from_md > :first-child { margin-top: 0; } -#nawtbmynnn .gt_from_md > :last-child { +#cjezyportx .gt_from_md > :last-child { margin-bottom: 0; } -#nawtbmynnn .gt_row { +#cjezyportx .gt_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -301,7 +301,7 @@

National changes in vaccine acceptance

overflow-x: hidden; } -#nawtbmynnn .gt_stub { +#cjezyportx .gt_stub { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -313,7 +313,7 @@

National changes in vaccine acceptance

padding-left: 12px; } -#nawtbmynnn .gt_summary_row { +#cjezyportx .gt_summary_row { color: #333333; background-color: #FFFFFF; text-transform: inherit; @@ -323,7 +323,7 @@

National changes in vaccine acceptance

padding-right: 5px; } -#nawtbmynnn .gt_first_summary_row { +#cjezyportx .gt_first_summary_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -333,7 +333,7 @@

National changes in vaccine acceptance

border-top-color: #D3D3D3; } -#nawtbmynnn .gt_grand_summary_row { +#cjezyportx .gt_grand_summary_row { color: #333333; background-color: #FFFFFF; text-transform: inherit; @@ -343,7 +343,7 @@

National changes in vaccine acceptance

padding-right: 5px; } -#nawtbmynnn .gt_first_grand_summary_row { +#cjezyportx .gt_first_grand_summary_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -353,11 +353,11 @@

National changes in vaccine acceptance

border-top-color: #D3D3D3; } -#nawtbmynnn .gt_striped { +#cjezyportx .gt_striped { background-color: rgba(128, 128, 128, 0.05); } -#nawtbmynnn .gt_table_body { +#cjezyportx .gt_table_body { border-top-style: solid; border-top-width: 2px; border-top-color: #D3D3D3; @@ -366,7 +366,7 @@

National changes in vaccine acceptance

border-bottom-color: #D3D3D3; } -#nawtbmynnn .gt_footnotes { +#cjezyportx .gt_footnotes { color: #333333; background-color: #FFFFFF; border-bottom-style: none; @@ -380,13 +380,13 @@

National changes in vaccine acceptance

border-right-color: #D3D3D3; } -#nawtbmynnn .gt_footnote { +#cjezyportx .gt_footnote { margin: 0px; font-size: 90%; padding: 4px; } -#nawtbmynnn .gt_sourcenotes { +#cjezyportx .gt_sourcenotes { color: #333333; background-color: #FFFFFF; border-bottom-style: none; @@ -400,46 +400,46 @@

National changes in vaccine acceptance

border-right-color: #D3D3D3; } -#nawtbmynnn .gt_sourcenote { +#cjezyportx .gt_sourcenote { font-size: 90%; padding: 4px; } -#nawtbmynnn .gt_left { +#cjezyportx .gt_left { text-align: left; } -#nawtbmynnn .gt_center { +#cjezyportx .gt_center { text-align: center; } -#nawtbmynnn .gt_right { +#cjezyportx .gt_right { text-align: right; font-variant-numeric: tabular-nums; } -#nawtbmynnn .gt_font_normal { +#cjezyportx .gt_font_normal { font-weight: normal; } -#nawtbmynnn .gt_font_bold { +#cjezyportx .gt_font_bold { font-weight: bold; } -#nawtbmynnn .gt_font_italic { +#cjezyportx .gt_font_italic { font-style: italic; } -#nawtbmynnn .gt_super { +#cjezyportx .gt_super { font-size: 65%; } -#nawtbmynnn .gt_footnote_marks { +#cjezyportx .gt_footnote_marks { font-style: italic; font-size: 65%; } -
How recommedations by different sources would change vaccine intent
+
@@ -513,14 +513,17 @@

National changes in vaccine acceptance

Frequency of hesitancy reasons among unvaccinated respondents

As you can see, each reason has been increasing over time. (Respondents can select multiple reasons from a list of about 15, so the numbers do not add to -100%.) But that is exactly what we would expect to happen in normal -circumstances: As more people get vaccinated, the people who remain unvaccinated -are those who either don’t want to be vaccinated or haven’t yet been able to.

+100%.) But that is what we would expect to happen in normal circumstances: +As more people get vaccinated, the people who remain unvaccinated are those who +either don’t want to be vaccinated or haven’t yet been able to.

Given the other reasons commonly selected – a lack of trust in the vaccines and the government, a preference to wait and see if the vaccines are safe – the concerns about side effects are likely part of the common concern that the COVID vaccines are unsafe because they were developed very quickly. Those concerns -predate the Johnson & Johnson vaccine announcement.

+predate the Johnson & Johnson vaccine announcement. The largest increases are +among choices about side effects and trust in the vaccines, suggesting the +announcement may have exacerbated existing concerns among people skeptical of +the vaccines.

Hesitancy and concerns about side effects are also not distributed evenly across the United States, instead being concentrated in southern and southwestern states like Louisiana, South Carolina, and New Mexico, as well as north-central @@ -563,7 +566,7 @@

Who would respondents trust?

font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Helvetica Neue', 'Fira Sans', 'Droid Sans', Arial, sans-serif; } -#ofbmvshksr .gt_table { +#nocjscfjoy .gt_table { display: table; border-collapse: collapse; margin-left: auto; @@ -588,7 +591,7 @@

Who would respondents trust?

border-left-color: #D3D3D3; } -#ofbmvshksr .gt_heading { +#nocjscfjoy .gt_heading { background-color: #FFFFFF; text-align: center; border-bottom-color: #FFFFFF; @@ -600,7 +603,7 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#ofbmvshksr .gt_title { +#nocjscfjoy .gt_title { color: #333333; font-size: 125%; font-weight: initial; @@ -610,7 +613,7 @@

Who would respondents trust?

border-bottom-width: 0; } -#ofbmvshksr .gt_subtitle { +#nocjscfjoy .gt_subtitle { color: #333333; font-size: 85%; font-weight: initial; @@ -620,13 +623,13 @@

Who would respondents trust?

border-top-width: 0; } -#ofbmvshksr .gt_bottom_border { +#nocjscfjoy .gt_bottom_border { border-bottom-style: solid; border-bottom-width: 2px; border-bottom-color: #D3D3D3; } -#ofbmvshksr .gt_col_headings { +#nocjscfjoy .gt_col_headings { border-top-style: solid; border-top-width: 2px; border-top-color: #D3D3D3; @@ -641,7 +644,7 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#ofbmvshksr .gt_col_heading { +#nocjscfjoy .gt_col_heading { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -661,7 +664,7 @@

Who would respondents trust?

overflow-x: hidden; } -#ofbmvshksr .gt_column_spanner_outer { +#nocjscfjoy .gt_column_spanner_outer { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -673,15 +676,15 @@

Who would respondents trust?

padding-right: 4px; } -#ofbmvshksr .gt_column_spanner_outer:first-child { +#nocjscfjoy .gt_column_spanner_outer:first-child { padding-left: 0; } -#ofbmvshksr .gt_column_spanner_outer:last-child { +#nocjscfjoy .gt_column_spanner_outer:last-child { padding-right: 0; } -#ofbmvshksr .gt_column_spanner { +#nocjscfjoy .gt_column_spanner { border-bottom-style: solid; border-bottom-width: 2px; border-bottom-color: #D3D3D3; @@ -693,7 +696,7 @@

Who would respondents trust?

width: 100%; } -#ofbmvshksr .gt_group_heading { +#nocjscfjoy .gt_group_heading { padding: 8px; color: #333333; background-color: #FFFFFF; @@ -715,7 +718,7 @@

Who would respondents trust?

vertical-align: middle; } -#ofbmvshksr .gt_empty_group_heading { +#nocjscfjoy .gt_empty_group_heading { padding: 0.5px; color: #333333; background-color: #FFFFFF; @@ -730,15 +733,15 @@

Who would respondents trust?

vertical-align: middle; } -#ofbmvshksr .gt_from_md > :first-child { +#nocjscfjoy .gt_from_md > :first-child { margin-top: 0; } -#ofbmvshksr .gt_from_md > :last-child { +#nocjscfjoy .gt_from_md > :last-child { margin-bottom: 0; } -#ofbmvshksr .gt_row { +#nocjscfjoy .gt_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -757,7 +760,7 @@

Who would respondents trust?

overflow-x: hidden; } -#ofbmvshksr .gt_stub { +#nocjscfjoy .gt_stub { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -769,7 +772,7 @@

Who would respondents trust?

padding-left: 12px; } -#ofbmvshksr .gt_summary_row { +#nocjscfjoy .gt_summary_row { color: #333333; background-color: #FFFFFF; text-transform: inherit; @@ -779,7 +782,7 @@

Who would respondents trust?

padding-right: 5px; } -#ofbmvshksr .gt_first_summary_row { +#nocjscfjoy .gt_first_summary_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -789,7 +792,7 @@

Who would respondents trust?

border-top-color: #D3D3D3; } -#ofbmvshksr .gt_grand_summary_row { +#nocjscfjoy .gt_grand_summary_row { color: #333333; background-color: #FFFFFF; text-transform: inherit; @@ -799,7 +802,7 @@

Who would respondents trust?

padding-right: 5px; } -#ofbmvshksr .gt_first_grand_summary_row { +#nocjscfjoy .gt_first_grand_summary_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -809,11 +812,11 @@

Who would respondents trust?

border-top-color: #D3D3D3; } -#ofbmvshksr .gt_striped { +#nocjscfjoy .gt_striped { background-color: rgba(128, 128, 128, 0.05); } -#ofbmvshksr .gt_table_body { +#nocjscfjoy .gt_table_body { border-top-style: solid; border-top-width: 2px; border-top-color: #D3D3D3; @@ -822,7 +825,7 @@

Who would respondents trust?

border-bottom-color: #D3D3D3; } -#ofbmvshksr .gt_footnotes { +#nocjscfjoy .gt_footnotes { color: #333333; background-color: #FFFFFF; border-bottom-style: none; @@ -836,13 +839,13 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#ofbmvshksr .gt_footnote { +#nocjscfjoy .gt_footnote { margin: 0px; font-size: 90%; padding: 4px; } -#ofbmvshksr .gt_sourcenotes { +#nocjscfjoy .gt_sourcenotes { color: #333333; background-color: #FFFFFF; border-bottom-style: none; @@ -856,46 +859,46 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#ofbmvshksr .gt_sourcenote { +#nocjscfjoy .gt_sourcenote { font-size: 90%; padding: 4px; } -#ofbmvshksr .gt_left { +#nocjscfjoy .gt_left { text-align: left; } -#ofbmvshksr .gt_center { +#nocjscfjoy .gt_center { text-align: center; } -#ofbmvshksr .gt_right { +#nocjscfjoy .gt_right { text-align: right; font-variant-numeric: tabular-nums; } -#ofbmvshksr .gt_font_normal { +#nocjscfjoy .gt_font_normal { font-weight: normal; } -#ofbmvshksr .gt_font_bold { +#nocjscfjoy .gt_font_bold { font-weight: bold; } -#ofbmvshksr .gt_font_italic { +#nocjscfjoy .gt_font_italic { font-style: italic; } -#ofbmvshksr .gt_super { +#nocjscfjoy .gt_super { font-size: 65%; } -#ofbmvshksr .gt_footnote_marks { +#nocjscfjoy .gt_footnote_marks { font-style: italic; font-size: 65%; } -
+
@@ -996,12 +999,13 @@

Conclusions

Based on survey responses from hundreds of thousands of Facebook users, we do not see evidence that the Johnson & Johnson vaccine pause has caused major changes in public willingness to get vaccinated. While there have been some -shifts, they’re relatively small and are consistent with long-term trends. To -expand acceptance of COVID vaccines, public health officials will need a -combination of approaches and a good understanding of the reasons people are -hesitant. Surveys like ours can help target this work and track progress, but it -will take much more than just surveys to reach out to all Americans and ensure -they both have access to vaccines and the willingness to receive them.

+shifts, they’re relatively small and connect to existing skepticism about the +safety of the COVID vaccines. To expand acceptance of COVID vaccines, public +health officials will need a combination of approaches and a good understanding +of the reasons people are hesitant. Surveys like ours can help target this work +and track progress, but it will take much more than just surveys to reach out to +all Americans and ensure they both have access to vaccines and the willingness +to receive them.

Nonetheless, this demonstrates the value of Delphi’s COVID Symptom Surveys for studying public attitudes and behavior during the pandemic. In partnership with Facebook, who From 8b419095ce4f16f32a6ca85d0d474c94d6f7a8e5 Mon Sep 17 00:00:00 2001 From: Alex Reinhart Date: Fri, 23 Apr 2021 10:08:41 -0400 Subject: [PATCH 6/6] Update to latest data, make requested edits --- content/blog/_2021-04-20-jj-vaccine.Rmd | 47 ++--- content/blog/_2021-04-20-jj-vaccine.html | 189 +++++++++--------- .../figure-html/side-effect-hesitancy-1.svg | 179 +++++++++-------- .../side-effect-hesitancy-map-1.svg | 110 +++++----- .../figure-html/uptake-acceptance-1.svg | 137 ++++++------- 5 files changed, 335 insertions(+), 327 deletions(-) diff --git a/content/blog/_2021-04-20-jj-vaccine.Rmd b/content/blog/_2021-04-20-jj-vaccine.Rmd index ad13c664..06582cf2 100644 --- a/content/blog/_2021-04-20-jj-vaccine.Rmd +++ b/content/blog/_2021-04-20-jj-vaccine.Rmd @@ -1,7 +1,7 @@ --- title: "Vaccine Hesitancy and the J&J Vaccine Suspension" author: Alex Reinhart -date: 2021-04-22 +date: 2021-04-23 tags: - COVIDcast - symptom surveys @@ -219,7 +219,7 @@ pre_post_table <- function(data, title, subtitle, n = 6, include_unvaccinated = tab_footnote(paste0("April 2 – April 8, n = ", prettyNum(n_pre, big.mark = ","), ", margin ±", moe_pre, " points"), cells_column_labels("frequency.pre")) %>% - tab_footnote(paste0("April 13 – April 20, n = ", prettyNum(n_post, big.mark = ","), + tab_footnote(paste0("April 13 – April 21, n = ", prettyNum(n_post, big.mark = ","), ", margin ±", moe_post, " points"), cells_column_labels("frequency.post")) %>% cols_label(reason = "Reason", @@ -292,17 +292,20 @@ The red lines mark April 9th, when some of the first reports of adverse effects made it onto the news, and April 13th, when the CDC and FDA issued their recommendation to suspend the vaccine. The resulting dip in acceptance lasted a few days before rates returned to their previous levels. But note the *Y* axis -scale: we're looking at a change of **less than 1 percentage point**, which is -only noticeable because of the size of our survey. - -It's more useful to look at the reasons. When respondents say they probably or -definitely would not choose to get vaccinated, we also ask them to select from a -list of possible reasons. We might expect an increase in the number of -respondents indicating concern about side effects as a reason, and we might also -expect a larger increase among women -- since the early blood clots all affected -women. But among all respondents (counting those already vaccinated as not -having side effect-related hesitancy), the percentage who are unwilling to get -vaccinated and indicate side effects as a cause shows only a small bump: +scale: we're looking at a change of **around 1 percentage point**, which is only +noticeable because of the size of our survey. While it is not yet clear if +acceptance will resume its upward trend or if we've reached a ceiling, it is +reassuring that it has not dramatically fallen. + +But these numbers don't tell the whole story. It's more useful to look at the +reasons for hesitancy. When respondents say they probably or definitely would +not choose to get vaccinated, we also ask them to select from a list of possible +reasons. We might expect an increase in the number of respondents indicating +concern about side effects as a reason, and we might also expect a larger +increase among women -- since the early blood clots all affected women. But +among all respondents (counting those already vaccinated as not having side +effect-related hesitancy), the percentage who are unwilling to get vaccinated +and indicate side effects as a cause shows only a small bump: ```{r side-effect-hesitancy, fig.height=4, message=FALSE} d %>% @@ -370,7 +373,7 @@ d %>% as.covidcast_signal(signal = "side-effects", geo_type = "state") %>% plot(plot_type = "choro", range = c(10, 45)) + labs(title = "Hesitancy related to concerns about side effects", - subtitle = "Among unvaccinated respondents, April 14-20", + subtitle = "Among unvaccinated respondents, April 14-21", caption = "Data from Delphi COVIDcast, delphi.cmu.edu") ``` @@ -473,16 +476,14 @@ Here are a few important things to keep in mind: * **We're surveying Facebook users.** While we [weight survey responses](https://arxiv.org/abs/2009.14675) to ensure their age and gender distribution matches the United States population, our respondents do tend to - be more educated than the national average, and the weights cannot correct for - everything. + be more educated than the national average, which the weights do not correct + for. * **The survey is voluntary.** Facebook draws a random sample of active users - every day and invites them to take the survey via a blurb in their News Feed. - But many people don't respond to the invitation, and so our respondents won't - be representative of the Facebook user base. Our survey weights also attempt - to account for this using Facebook's models for predicting the probability - each user will respond -- but it's hard to account for every possible - difference between responding and non-responding users, so there may be biases - remaining. + every day and invites them to take the survey via a promotion in their News + Feed. Many people don't respond to the invitation, and while the + Facebook-provided survey weights attempt to account for this by using models + to predict the probability each user will respond, there may still be + unobserved biases remaining. * **Survey responses are simplifications.** Our respondents can select reasons for hesitancy from a list, but ticking boxes can't fully represent the complexity of their beliefs and the reasons for their lack of trust in COVID diff --git a/content/blog/_2021-04-20-jj-vaccine.html b/content/blog/_2021-04-20-jj-vaccine.html index 94b1ec7e..8464d4e5 100644 --- a/content/blog/_2021-04-20-jj-vaccine.html +++ b/content/blog/_2021-04-20-jj-vaccine.html @@ -1,7 +1,7 @@ --- title: "Vaccine Hesitancy and the J&J Vaccine Suspension" author: Alex Reinhart -date: 2021-04-22 +date: 2021-04-23 tags: - COVIDcast - symptom surveys @@ -79,23 +79,26 @@

National changes in vaccine acceptance

Let’s start with vaccine acceptance. We ask respondents whether they are already vaccinated; if not, we ask whether they would accept a vaccine if one was offered to them today. If we count everyone who either is already vaccinated or -is willing to be, then among 1,514,042 survey responses, we see a consistent increasing trend that stops +is willing to be, then among 1,545,599 survey responses, we see a consistent increasing trend that stops as the news broke, followed by a delay of a few days and a recovery:

The red lines mark April 9th, when some of the first reports of adverse effects made it onto the news, and April 13th, when the CDC and FDA issued their recommendation to suspend the vaccine. The resulting dip in acceptance lasted a few days before rates returned to their previous levels. But note the Y axis -scale: we’re looking at a change of less than 1 percentage point, which is -only noticeable because of the size of our survey.

-

It’s more useful to look at the reasons. When respondents say they probably or -definitely would not choose to get vaccinated, we also ask them to select from a -list of possible reasons. We might expect an increase in the number of -respondents indicating concern about side effects as a reason, and we might also -expect a larger increase among women – since the early blood clots all affected -women. But among all respondents (counting those already vaccinated as not -having side effect-related hesitancy), the percentage who are unwilling to get -vaccinated and indicate side effects as a cause shows only a small bump:

+scale: we’re looking at a change of around 1 percentage point, which is only +noticeable because of the size of our survey. While it is not yet clear if +acceptance will resume its upward trend or if we’ve reached a ceiling, it is +reassuring that it has not dramatically fallen.

+

But these numbers don’t tell the whole story. It’s more useful to look at the +reasons for hesitancy. When respondents say they probably or definitely would +not choose to get vaccinated, we also ask them to select from a list of possible +reasons. We might expect an increase in the number of respondents indicating +concern about side effects as a reason, and we might also expect a larger +increase among women – since the early blood clots all affected women. But +among all respondents (counting those already vaccinated as not having side +effect-related hesitancy), the percentage who are unwilling to get vaccinated +and indicate side effects as a cause shows only a small bump:

The bump is larger among men than women, although the difference is quite small (around half a percentage point) and could easily reflect measurement error @@ -107,7 +110,7 @@

National changes in vaccine acceptance

font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Helvetica Neue', 'Fira Sans', 'Droid Sans', Arial, sans-serif; } -#cjezyportx .gt_table { +#oylffzbjjc .gt_table { display: table; border-collapse: collapse; margin-left: auto; @@ -132,7 +135,7 @@

National changes in vaccine acceptance

border-left-color: #D3D3D3; } -#cjezyportx .gt_heading { +#oylffzbjjc .gt_heading { background-color: #FFFFFF; text-align: center; border-bottom-color: #FFFFFF; @@ -144,7 +147,7 @@

National changes in vaccine acceptance

border-right-color: #D3D3D3; } -#cjezyportx .gt_title { +#oylffzbjjc .gt_title { color: #333333; font-size: 125%; font-weight: initial; @@ -154,7 +157,7 @@

National changes in vaccine acceptance

border-bottom-width: 0; } -#cjezyportx .gt_subtitle { +#oylffzbjjc .gt_subtitle { color: #333333; font-size: 85%; font-weight: initial; @@ -164,13 +167,13 @@

National changes in vaccine acceptance

border-top-width: 0; } -#cjezyportx .gt_bottom_border { +#oylffzbjjc .gt_bottom_border { border-bottom-style: solid; border-bottom-width: 2px; border-bottom-color: #D3D3D3; } -#cjezyportx .gt_col_headings { +#oylffzbjjc .gt_col_headings { border-top-style: solid; border-top-width: 2px; border-top-color: #D3D3D3; @@ -185,7 +188,7 @@

National changes in vaccine acceptance

border-right-color: #D3D3D3; } -#cjezyportx .gt_col_heading { +#oylffzbjjc .gt_col_heading { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -205,7 +208,7 @@

National changes in vaccine acceptance

overflow-x: hidden; } -#cjezyportx .gt_column_spanner_outer { +#oylffzbjjc .gt_column_spanner_outer { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -217,15 +220,15 @@

National changes in vaccine acceptance

padding-right: 4px; } -#cjezyportx .gt_column_spanner_outer:first-child { +#oylffzbjjc .gt_column_spanner_outer:first-child { padding-left: 0; } -#cjezyportx .gt_column_spanner_outer:last-child { +#oylffzbjjc .gt_column_spanner_outer:last-child { padding-right: 0; } -#cjezyportx .gt_column_spanner { +#oylffzbjjc .gt_column_spanner { border-bottom-style: solid; border-bottom-width: 2px; border-bottom-color: #D3D3D3; @@ -237,7 +240,7 @@

National changes in vaccine acceptance

width: 100%; } -#cjezyportx .gt_group_heading { +#oylffzbjjc .gt_group_heading { padding: 8px; color: #333333; background-color: #FFFFFF; @@ -259,7 +262,7 @@

National changes in vaccine acceptance

vertical-align: middle; } -#cjezyportx .gt_empty_group_heading { +#oylffzbjjc .gt_empty_group_heading { padding: 0.5px; color: #333333; background-color: #FFFFFF; @@ -274,15 +277,15 @@

National changes in vaccine acceptance

vertical-align: middle; } -#cjezyportx .gt_from_md > :first-child { +#oylffzbjjc .gt_from_md > :first-child { margin-top: 0; } -#cjezyportx .gt_from_md > :last-child { +#oylffzbjjc .gt_from_md > :last-child { margin-bottom: 0; } -#cjezyportx .gt_row { +#oylffzbjjc .gt_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -301,7 +304,7 @@

National changes in vaccine acceptance

overflow-x: hidden; } -#cjezyportx .gt_stub { +#oylffzbjjc .gt_stub { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -313,7 +316,7 @@

National changes in vaccine acceptance

padding-left: 12px; } -#cjezyportx .gt_summary_row { +#oylffzbjjc .gt_summary_row { color: #333333; background-color: #FFFFFF; text-transform: inherit; @@ -323,7 +326,7 @@

National changes in vaccine acceptance

padding-right: 5px; } -#cjezyportx .gt_first_summary_row { +#oylffzbjjc .gt_first_summary_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -333,7 +336,7 @@

National changes in vaccine acceptance

border-top-color: #D3D3D3; } -#cjezyportx .gt_grand_summary_row { +#oylffzbjjc .gt_grand_summary_row { color: #333333; background-color: #FFFFFF; text-transform: inherit; @@ -343,7 +346,7 @@

National changes in vaccine acceptance

padding-right: 5px; } -#cjezyportx .gt_first_grand_summary_row { +#oylffzbjjc .gt_first_grand_summary_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -353,11 +356,11 @@

National changes in vaccine acceptance

border-top-color: #D3D3D3; } -#cjezyportx .gt_striped { +#oylffzbjjc .gt_striped { background-color: rgba(128, 128, 128, 0.05); } -#cjezyportx .gt_table_body { +#oylffzbjjc .gt_table_body { border-top-style: solid; border-top-width: 2px; border-top-color: #D3D3D3; @@ -366,7 +369,7 @@

National changes in vaccine acceptance

border-bottom-color: #D3D3D3; } -#cjezyportx .gt_footnotes { +#oylffzbjjc .gt_footnotes { color: #333333; background-color: #FFFFFF; border-bottom-style: none; @@ -380,13 +383,13 @@

National changes in vaccine acceptance

border-right-color: #D3D3D3; } -#cjezyportx .gt_footnote { +#oylffzbjjc .gt_footnote { margin: 0px; font-size: 90%; padding: 4px; } -#cjezyportx .gt_sourcenotes { +#oylffzbjjc .gt_sourcenotes { color: #333333; background-color: #FFFFFF; border-bottom-style: none; @@ -400,46 +403,46 @@

National changes in vaccine acceptance

border-right-color: #D3D3D3; } -#cjezyportx .gt_sourcenote { +#oylffzbjjc .gt_sourcenote { font-size: 90%; padding: 4px; } -#cjezyportx .gt_left { +#oylffzbjjc .gt_left { text-align: left; } -#cjezyportx .gt_center { +#oylffzbjjc .gt_center { text-align: center; } -#cjezyportx .gt_right { +#oylffzbjjc .gt_right { text-align: right; font-variant-numeric: tabular-nums; } -#cjezyportx .gt_font_normal { +#oylffzbjjc .gt_font_normal { font-weight: normal; } -#cjezyportx .gt_font_bold { +#oylffzbjjc .gt_font_bold { font-weight: bold; } -#cjezyportx .gt_font_italic { +#oylffzbjjc .gt_font_italic { font-style: italic; } -#cjezyportx .gt_super { +#oylffzbjjc .gt_super { font-size: 65%; } -#cjezyportx .gt_footnote_marks { +#oylffzbjjc .gt_footnote_marks { font-style: italic; font-size: 65%; } -
How recommedations by different sources would change vaccine intent
+
@@ -504,7 +507,7 @@

National changes in vaccine acceptance

2 - April 13 – April 20, n = 67,441, margin ±0.4 points + April 13 – April 21, n = 74,901, margin ±0.3 points

@@ -566,7 +569,7 @@

Who would respondents trust?

font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Helvetica Neue', 'Fira Sans', 'Droid Sans', Arial, sans-serif; } -#nocjscfjoy .gt_table { +#xzdvsxaaip .gt_table { display: table; border-collapse: collapse; margin-left: auto; @@ -591,7 +594,7 @@

Who would respondents trust?

border-left-color: #D3D3D3; } -#nocjscfjoy .gt_heading { +#xzdvsxaaip .gt_heading { background-color: #FFFFFF; text-align: center; border-bottom-color: #FFFFFF; @@ -603,7 +606,7 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#nocjscfjoy .gt_title { +#xzdvsxaaip .gt_title { color: #333333; font-size: 125%; font-weight: initial; @@ -613,7 +616,7 @@

Who would respondents trust?

border-bottom-width: 0; } -#nocjscfjoy .gt_subtitle { +#xzdvsxaaip .gt_subtitle { color: #333333; font-size: 85%; font-weight: initial; @@ -623,13 +626,13 @@

Who would respondents trust?

border-top-width: 0; } -#nocjscfjoy .gt_bottom_border { +#xzdvsxaaip .gt_bottom_border { border-bottom-style: solid; border-bottom-width: 2px; border-bottom-color: #D3D3D3; } -#nocjscfjoy .gt_col_headings { +#xzdvsxaaip .gt_col_headings { border-top-style: solid; border-top-width: 2px; border-top-color: #D3D3D3; @@ -644,7 +647,7 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#nocjscfjoy .gt_col_heading { +#xzdvsxaaip .gt_col_heading { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -664,7 +667,7 @@

Who would respondents trust?

overflow-x: hidden; } -#nocjscfjoy .gt_column_spanner_outer { +#xzdvsxaaip .gt_column_spanner_outer { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -676,15 +679,15 @@

Who would respondents trust?

padding-right: 4px; } -#nocjscfjoy .gt_column_spanner_outer:first-child { +#xzdvsxaaip .gt_column_spanner_outer:first-child { padding-left: 0; } -#nocjscfjoy .gt_column_spanner_outer:last-child { +#xzdvsxaaip .gt_column_spanner_outer:last-child { padding-right: 0; } -#nocjscfjoy .gt_column_spanner { +#xzdvsxaaip .gt_column_spanner { border-bottom-style: solid; border-bottom-width: 2px; border-bottom-color: #D3D3D3; @@ -696,7 +699,7 @@

Who would respondents trust?

width: 100%; } -#nocjscfjoy .gt_group_heading { +#xzdvsxaaip .gt_group_heading { padding: 8px; color: #333333; background-color: #FFFFFF; @@ -718,7 +721,7 @@

Who would respondents trust?

vertical-align: middle; } -#nocjscfjoy .gt_empty_group_heading { +#xzdvsxaaip .gt_empty_group_heading { padding: 0.5px; color: #333333; background-color: #FFFFFF; @@ -733,15 +736,15 @@

Who would respondents trust?

vertical-align: middle; } -#nocjscfjoy .gt_from_md > :first-child { +#xzdvsxaaip .gt_from_md > :first-child { margin-top: 0; } -#nocjscfjoy .gt_from_md > :last-child { +#xzdvsxaaip .gt_from_md > :last-child { margin-bottom: 0; } -#nocjscfjoy .gt_row { +#xzdvsxaaip .gt_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -760,7 +763,7 @@

Who would respondents trust?

overflow-x: hidden; } -#nocjscfjoy .gt_stub { +#xzdvsxaaip .gt_stub { color: #333333; background-color: #FFFFFF; font-size: 100%; @@ -772,7 +775,7 @@

Who would respondents trust?

padding-left: 12px; } -#nocjscfjoy .gt_summary_row { +#xzdvsxaaip .gt_summary_row { color: #333333; background-color: #FFFFFF; text-transform: inherit; @@ -782,7 +785,7 @@

Who would respondents trust?

padding-right: 5px; } -#nocjscfjoy .gt_first_summary_row { +#xzdvsxaaip .gt_first_summary_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -792,7 +795,7 @@

Who would respondents trust?

border-top-color: #D3D3D3; } -#nocjscfjoy .gt_grand_summary_row { +#xzdvsxaaip .gt_grand_summary_row { color: #333333; background-color: #FFFFFF; text-transform: inherit; @@ -802,7 +805,7 @@

Who would respondents trust?

padding-right: 5px; } -#nocjscfjoy .gt_first_grand_summary_row { +#xzdvsxaaip .gt_first_grand_summary_row { padding-top: 8px; padding-bottom: 8px; padding-left: 5px; @@ -812,11 +815,11 @@

Who would respondents trust?

border-top-color: #D3D3D3; } -#nocjscfjoy .gt_striped { +#xzdvsxaaip .gt_striped { background-color: rgba(128, 128, 128, 0.05); } -#nocjscfjoy .gt_table_body { +#xzdvsxaaip .gt_table_body { border-top-style: solid; border-top-width: 2px; border-top-color: #D3D3D3; @@ -825,7 +828,7 @@

Who would respondents trust?

border-bottom-color: #D3D3D3; } -#nocjscfjoy .gt_footnotes { +#xzdvsxaaip .gt_footnotes { color: #333333; background-color: #FFFFFF; border-bottom-style: none; @@ -839,13 +842,13 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#nocjscfjoy .gt_footnote { +#xzdvsxaaip .gt_footnote { margin: 0px; font-size: 90%; padding: 4px; } -#nocjscfjoy .gt_sourcenotes { +#xzdvsxaaip .gt_sourcenotes { color: #333333; background-color: #FFFFFF; border-bottom-style: none; @@ -859,46 +862,46 @@

Who would respondents trust?

border-right-color: #D3D3D3; } -#nocjscfjoy .gt_sourcenote { +#xzdvsxaaip .gt_sourcenote { font-size: 90%; padding: 4px; } -#nocjscfjoy .gt_left { +#xzdvsxaaip .gt_left { text-align: left; } -#nocjscfjoy .gt_center { +#xzdvsxaaip .gt_center { text-align: center; } -#nocjscfjoy .gt_right { +#xzdvsxaaip .gt_right { text-align: right; font-variant-numeric: tabular-nums; } -#nocjscfjoy .gt_font_normal { +#xzdvsxaaip .gt_font_normal { font-weight: normal; } -#nocjscfjoy .gt_font_bold { +#xzdvsxaaip .gt_font_bold { font-weight: bold; } -#nocjscfjoy .gt_font_italic { +#xzdvsxaaip .gt_font_italic { font-style: italic; } -#nocjscfjoy .gt_super { +#xzdvsxaaip .gt_super { font-size: 65%; } -#nocjscfjoy .gt_footnote_marks { +#xzdvsxaaip .gt_footnote_marks { font-style: italic; font-size: 65%; } -
Frequency of hesitancy reasons among unvaccinated respondents
+
@@ -967,16 +970,14 @@

Limitations

  • We’re surveying Facebook users. While we weight survey responses to ensure their age and gender distribution matches the United States population, our respondents do tend to -be more educated than the national average, and the weights cannot correct for -everything.
    • +be more educated than the national average, which the weights do not correct +for.
  • The survey is voluntary. Facebook draws a random sample of active users -every day and invites them to take the survey via a blurb in their News Feed. -But many people don’t respond to the invitation, and so our respondents won’t -be representative of the Facebook user base. Our survey weights also attempt -to account for this using Facebook’s models for predicting the probability -each user will respond – but it’s hard to account for every possible -difference between responding and non-responding users, so there may be biases -remaining.
    • +every day and invites them to take the survey via a promotion in their News +Feed. Many people don’t respond to the invitation, and while the +Facebook-provided survey weights attempt to account for this by using models +to predict the probability each user will respond, there may still be +unobserved biases remaining.
  • Survey responses are simplifications. Our respondents can select reasons for hesitancy from a list, but ticking boxes can’t fully represent the complexity of their beliefs and the reasons for their lack of trust in COVID diff --git a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-1.svg b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-1.svg index 28f7afb5..f7f18fc7 100644 --- a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-1.svg +++ b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-1.svg @@ -19,104 +19,107 @@ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + - - - - - - - + + + + + + - - - - - - - - - - - - - - + + + + + + + + + + + + + + + -7.0% -7.5% -8.0% -8.5% -9.0% - - - - - +7.0% +7.5% +8.0% +8.5% +9.0% + + + + + - - - - - - - - - - + + + + + + + + + + + Mar 10 -Mar 14 -Mar 18 -Mar 22 -Mar 26 -Mar 30 -Apr 03 -Apr 07 -Apr 11 -Apr 15 -Apr 19 +Mar 14 +Mar 18 +Mar 22 +Mar 26 +Mar 30 +Apr 03 +Apr 07 +Apr 11 +Apr 15 +Apr 19 +Apr 23 Hesitant and concerned about side effects Gender diff --git a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg index ad335145..709fe9e5 100644 --- a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg +++ b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/side-effect-hesitancy-map-1.svg @@ -74,63 +74,63 @@ - - - - - - - - - - - - + + + + + + + + + + + + - - - - - + + + + + - - - - - - - - - - - - - - - - - - - - - - - - - - - - + + + + + + + + + + + + + + + + + + + + + + + + + + + + - - - - - - - - - + + + + + + + + + @@ -169,7 +169,7 @@ -Among unvaccinated respondents, April 14-20 +Among unvaccinated respondents, April 14-21 Hesitancy related to concerns about side effects Data from Delphi COVIDcast, delphi.cmu.edu diff --git a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/uptake-acceptance-1.svg b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/uptake-acceptance-1.svg index 9a7fb00a..fd07cb3c 100644 --- a/static/blog/_2021-04-20-jj-vaccine_files/figure-html/uptake-acceptance-1.svg +++ b/static/blog/_2021-04-20-jj-vaccine_files/figure-html/uptake-acceptance-1.svg @@ -23,60 +23,61 @@ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + - - + - - - - - - - - - - - - - + + + + + + + + + + + + + + @@ -94,27 +95,29 @@ - - - - - - - - - - + + + + + + + + + + + Mar 10 -Mar 14 -Mar 18 -Mar 22 -Mar 26 -Mar 30 -Apr 03 -Apr 07 -Apr 11 -Apr 15 -Apr 19 +Mar 14 +Mar 18 +Mar 22 +Mar 26 +Mar 30 +Apr 03 +Apr 07 +Apr 11 +Apr 15 +Apr 19 +Apr 23 Vaccinated or accepting Vaccine uptake and acceptance in the US Data from Delphi COVIDcast, delphi.cmu.edu
    • How recommedations by different sources would change vaccine intent