# Psychological reactance, misinformation, and distrust: A mixed methods analysis of COVID-19 vaccine uptake

## TL;DR

This study explores how factors like distrust and misinformation influenced decisions about getting the COVID-19 vaccine in diverse communities.

## Contribution

The study introduces a mixed methods approach to analyze vaccine hesitancy through psychological reactance and community discourse.

## Key findings

- Non-Hispanic Whites, Indigenous people, males, and those with moderate SES were least likely to be vaccinated.
- Focus groups revealed that mandates and misinformation led to distrust and resistance to vaccination.
- Participants who felt pressured to vaccinate showed weaker intentions to do so.

## Abstract

Assessing perceptions of the COVID-19 vaccines is essential for understanding vaccine hesitancy and for improving uptake during public health emergencies. In the complicated landscape of COVID-19 vaccine mandates and rampant misinformation, many individuals faced challenges during vaccination decision-making. The purpose of our mixed methods study is to elucidate factors affecting vaccine decision-making and to highlight the discourse surrounding the COVID-19 vaccines in diverse and underserved communities.

This mixed methods study was conducted in Arizona, Florida, Minnesota, and Wisconsin between March and November 2021, combining a cross-sectional survey (n = 3593) and focus groups (n = 47).

The groups least likely to report receiving a vaccination were non-Hispanic Whites, Indigenous people, males, and those with moderate socioeconomic status (SES). Those indicating high and low SES reported similar vaccination uptake. Focus group data highlighted resistance to mandates, distrust, misinformation, and concerns about the rapid development surrounding the COVID-19 vaccines. Psychological reactance theory posits that strongly persuasive messaging and social pressure can be perceived as a threat to freedom, encouraging an individual to take action to restore that freedom.

Our findings indicate that a subsection of participants felt pressured to get the vaccine, which led to weaker intentions to vaccinate. These results suggest that vaccine rollout strategies should be reevaluated to improve and facilitate informed decision-making.