Unique Predictors of Intended Uptake of a COVID-19 Vaccine in Adults Living in a Rural College Town in the United States

Purpose: To explore public confidence in a COVID-19 vaccine. Design: Cross-sectional survey. Setting: A rural college town in central Pennsylvania. Subjects: Adult residents without minor children. Measures: The primary outcome was COVID-19 vaccination intention. Secondary measures included vaccination attitudes, norms, efficacy, past behavior, trust in the vaccination process, and sociodemographic variables of education, financial standing, political viewpoint, and religiosity. Analysis: Descriptive statistics were used to describe quantitative data. Multivariate ordinal regression was used to model predictors of vaccine intention. Results: Of 950 respondents, 55% were "very likely" and 20% "somewhat likely" to take a coronavirus vaccine, even though 70% had taken the flu vaccine since September 2019. The strongest predictors of vaccine acceptance were trust in the system evaluating vaccines and perceptions of local COVID-19 vaccination norms. The strongest predictors of negative vaccine intentions were worries about unknown side-effects and positive attitudes toward natural infection. Sociodemographic factors, political views, and religiosity did not predict vaccine intentions. Conclusion: Fewer adults intend to take a coronavirus vaccine than currently take the flu vaccine. Traditional sociodemographic factors may not be effective predictors of COVID-19 vaccine uptake. Although based on a small sample, the study adds to our limited understanding of COVID-19-specific vaccine confidence among some rural Americans and suggests that traditional public health vaccination campaigns based on sociodemographic characteristics may not be effective.