Towards intervention development to increase the uptake of COVID-19 vaccination among those at high risk: outlining evidence-based and theoretically informed future intervention content

Objectives: Development of a vaccine against COVID-19 will be key to controlling the pandemic. We need to understand the barriers and facilitators to receiving a future COVID-19 vaccine so that we can provide recommendations for the design of interventions aimed at maximising vaccine uptake by the public. Design: Cross-sectional survey with high-risk individuals (older adults aged 65+ and patients with chronic respiratory disease). Methods: During the UK9s early April 2020 lockdown period, participants (N=527; mean age = 59.5 years) completed an online questionnaire assessing willingness to receive a COVID-19 vaccine, perceptions of COVID-19, and intention to receive other vaccinations. The questionnaire included a free text response (n=502) to examine barriers and facilitators to uptake. The Behaviour Change Wheel informed the analysis of these responses, which were coded to the Theoretical Domains Framework (TDF). Behaviour change techniques (BCTs) were identified. Results: Eighty-six percent of respondents want to receive a COVID-19 vaccine. This was positively correlated with the perception that COVID-19 will continue for a long time, and negatively associated with the perception that the media has over-exaggerated the risk. The majority of barriers and facilitators could be mapped onto the beliefs about consequences TDF domain, with themes relating to personal health, health consequences to others, concerns of vaccine safety, and severity of COVID-19. Conclusions: Willingness to receive a COVID-19 vaccination is currently high among high-risk individuals. Mass media interventions aimed at maximising vaccine uptake should utilise the BCTs of information about health, emotional, social and environmental consequences, and salience of consequences.