Abstract：
BACKGROUND: Primary and booster vaccinations are critical for mitigating COVID-19 transmission, morbidity, and mortality. Future booster vaccine campaigns rely on an increased understanding of vaccine hesitancy.
OBJECTIVE: To evaluate self-reported allergic and skin vaccine reactions as factors potentially associated with vaccine hesitancy in a nationwide vaccine allergy registry.
METHODS: Responses to survey questions concerning COVID-19 vaccine perceptions, coded from free text by 2 independent reviewers. Multivariable logistic regression models were used to determine the association between changed negative perception and respondent demographics, vaccination history, and reaction characteristics.
RESULTS: A total of 993 individuals (median of 46 years [IQR, 36-59], 88% female, 82% White) self-reported reactions to COVID-19 vaccination. Reactions included the following: delayed large local skin reaction (40%), hives/urticaria (32%), immediate large local skin reaction (3%), swelling (3%), anaphylaxis (2%), and other or unspecified (20%). Most respondents were initially unconcerned about the safety of COVID-19 vaccines (56%). After reactions, 401 of 993 (40%) report negative change in perception of vaccination, with more than half of these respondents (n = 211, 53%) citing their reasoning as a negative experience with adverse effects. Of 102 individuals asked about future vaccination, 79 (77%) indicated that they were unlikely or very unlikely to receive future COVID-19 vaccinations. Increased negative perception after reaction was associated with younger age, later COVID-19 vaccination dose number, and reaction type.
CONCLUSIONS: Our findings reveal that an individual\'s experience with allergic or cutaneous adverse effects after COVID-19 vaccination affects attitudes and decision-making regarding future vaccination, even in initially non-hesitant individuals. Further investigation of secondary vaccine hesitancy is necessary for adapting public health messaging to this important population.
OBJECTIVE: To evaluate self-reported allergic and skin vaccine reactions as factors potentially associated with vaccine hesitancy in a nationwide vaccine allergy registry.
METHODS: Responses to survey questions concerning COVID-19 vaccine perceptions, coded from free text by 2 independent reviewers. Multivariable logistic regression models were used to determine the association between changed negative perception and respondent demographics, vaccination history, and reaction characteristics.
RESULTS: A total of 993 individuals (median of 46 years [IQR, 36-59], 88% female, 82% White) self-reported reactions to COVID-19 vaccination. Reactions included the following: delayed large local skin reaction (40%), hives/urticaria (32%), immediate large local skin reaction (3%), swelling (3%), anaphylaxis (2%), and other or unspecified (20%). Most respondents were initially unconcerned about the safety of COVID-19 vaccines (56%). After reactions, 401 of 993 (40%) report negative change in perception of vaccination, with more than half of these respondents (n = 211, 53%) citing their reasoning as a negative experience with adverse effects. Of 102 individuals asked about future vaccination, 79 (77%) indicated that they were unlikely or very unlikely to receive future COVID-19 vaccinations. Increased negative perception after reaction was associated with younger age, later COVID-19 vaccination dose number, and reaction type.
CONCLUSIONS: Our findings reveal that an individual\'s experience with allergic or cutaneous adverse effects after COVID-19 vaccination affects attitudes and decision-making regarding future vaccination, even in initially non-hesitant individuals. Further investigation of secondary vaccine hesitancy is necessary for adapting public health messaging to this important population.
摘要：
背景：初级和加强疫苗接种对于减轻COVID-19传播至关重要，发病率，和死亡率。未来的加强疫苗运动依赖于对疫苗犹豫的更多理解。
目的：在全国疫苗过敏登记中，检查自我报告的过敏和皮肤疫苗反应作为潜在与疫苗犹豫相关的因素。
方法：对有关COVID-19疫苗认知的调查问题的回应，由两个独立的审阅者从自由文本编码。使用多变量逻辑回归模型来确定改变的负面感知与受访者的人口统计之间的关联。疫苗接种史,和反应特性。
结果：993人（中位数为46岁[IQR36,59]，88%女性，82%的白人）自我报告对COVID-19疫苗接种的反应。反应包括：延迟大的局部皮肤反应（40％），荨麻疹/荨麻疹（32%），立即出现较大的局部皮肤反应（3％），肿胀（3%），过敏反应（2%），和其他或未指定(20%)。大多数受访者最初不关心COVID-19疫苗的安全性（56%）。反应后,401/993（40%）报告接种疫苗的观念发生了负面变化，超过一半的受访者(n=211，53%)认为他们的推理是有副作用的负面经历。在被问及未来疫苗接种的102人中，79人（77%）表示他们不太可能或极不可能接受未来的COVID-19疫苗接种。反应后负面感知的增加与年龄较小有关，后来的COVID-19疫苗接种剂量数，和反应类型。
结论：我们的研究结果表明，个人在COVID-19疫苗接种后的过敏或皮肤副作用的经历会影响对未来疫苗接种的态度和决策，即使在最初不犹豫的个体中。为了使公共卫生信息适应这一重要人群，有必要进一步调查二级疫苗的犹豫。
目的：在全国疫苗过敏登记中，检查自我报告的过敏和皮肤疫苗反应作为潜在与疫苗犹豫相关的因素。
方法：对有关COVID-19疫苗认知的调查问题的回应，由两个独立的审阅者从自由文本编码。使用多变量逻辑回归模型来确定改变的负面感知与受访者的人口统计之间的关联。疫苗接种史,和反应特性。
结果：993人（中位数为46岁[IQR36,59]，88%女性，82%的白人）自我报告对COVID-19疫苗接种的反应。反应包括：延迟大的局部皮肤反应（40％），荨麻疹/荨麻疹（32%），立即出现较大的局部皮肤反应（3％），肿胀（3%），过敏反应（2%），和其他或未指定(20%)。大多数受访者最初不关心COVID-19疫苗的安全性（56%）。反应后,401/993（40%）报告接种疫苗的观念发生了负面变化，超过一半的受访者(n=211，53%)认为他们的推理是有副作用的负面经历。在被问及未来疫苗接种的102人中，79人（77%）表示他们不太可能或极不可能接受未来的COVID-19疫苗接种。反应后负面感知的增加与年龄较小有关，后来的COVID-19疫苗接种剂量数，和反应类型。
结论：我们的研究结果表明，个人在COVID-19疫苗接种后的过敏或皮肤副作用的经历会影响对未来疫苗接种的态度和决策，即使在最初不犹豫的个体中。为了使公共卫生信息适应这一重要人群，有必要进一步调查二级疫苗的犹豫。
