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CompletedNCT04706403Updated May 24, 2022Results posted

Views on COVID-19 and Vaccination

An interventional study of Communication from a physician about the COVID-19 Vaccine in Covid19, sponsored by University of Massachusetts, Worcester. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-05-24.

Sponsored by University of Massachusetts, Worcester · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
756
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this study is to develop evidence-based messages that effectively mitigate concerns of people at risk for not being vaccinated against COVID-19, with the ultimate goal of maximizing vaccine uptake in vulnerable populations. The investigators will collect data on COVID-19 disease and vaccine knowledge, beliefs, and intent to be vaccinated from an existing online panel. Results from this data collection will be used to develop effective messages and communication strategies. The investigators will test alternate versions of messages intended to reduce vaccine hesitancy and promote vaccine uptake among vaccine-hesitant individuals. This project will ultimately result in a set of tested, evidence-derived messages about vaccination for COVID-19.

Read the detailed description

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly instigated a global pandemic. As of this writing, there are approximately 65 million documented cases of infection worldwide, and over 1.5 million deaths. In the United States (US), coronavirus disease 2019 (COVID-19) has disrupted the economy, overwhelmed healthcare system, led to widespread school cancellations, and caused more than 274,000 deaths since March 2020. A vaccine against COVID-19 is widely viewed as the key to controlling the pandemic and enabling a return to "normal" life. Vaccine development is proceeding at an unprecedented pace with 10 vaccines currently in phase 3 trials. Experts have projected that a safe and effective vaccine may be available by mid-2021. At the same time, a growing body of evidence indicates that a significant proportion of adults in the U.S. may not accept vaccination against COVID-19. Even more alarming, COVID-19 vaccine hesitancy (refusal or reluctance to accept a vaccine) appears to be increasing as the vaccine approval process becomes increasingly politicized. Just as efforts to develop vaccine production and delivery capacity have been undertaken in advance of having a proven effective vaccine, parallel efforts are needed to identify effective messages and communication strategies to overcome COVID-19 vaccine hesitancy.

The study team recently surveyed a nationally representative sample of approximately 1,000 adults in the United States and found that only 57% intended to be vaccinated when a coronavirus vaccine becomes available. This percentage was even lower among people who identified as Black or Hispanic (39% and 43% respectively), those with a high school education or less (46%), and those in the lowest income groups (49% of those reporting a household income of $30,000 or less, compared to 72% of those reporting a household income of $100,000 or more). The investigators asked those who indicated they would not or might not get vaccinated for their reasons and found that some individuals may be willing to be vaccinated if provided specific information about the vaccine such as side effects and effectiveness. Others expressed generalized skepticism, fear, and distrust of vaccines, with some even referring to anti-vaccine conspiracy theories. These findings are consistent with an extensive body of research documenting that people often do not behave rationally and highlight the urgent need to proactively develop and test interventions to maximize vaccination rates when a coronavirus vaccine becomes available. To address this need, in the present study, the investigators aim to create and test targeted messages to address the concerns of subgroups of people at risk for not being vaccinated, with the ultimate goal of maximizing vaccine uptake when a vaccine for COVID-19 becomes available. The investigators will accomplish this by working with an existing online panel of volunteers, which will allow efficient, focused data gathering. Results of the survey will provide a nuanced, current description of how vulnerable adults perceive the coronavirus and available vaccines, which will be used as the basis for developing messages and communication strategies. Participants will be randomized to receive one of five different versions of a message from a healthcare provider regarding vaccination. Specific wording and content of these messages will vary systematically in order to address concerns of those at risk for not being vaccinated. This project will ultimately result in a set of tested, evidence-derived messages about vaccination for COVID-19. The investigators will make these messages available, together with evidence of how these influence members of vulnerable populations' understanding of vaccination, and disease risk, as well as intent to be vaccinated. The messages will be freely available for use by organizations and providers seeking to improve communication about a coronavirus vaccine.

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Conditions studied

  • Covid19

Browse trials for

Keywords

  • Covid-19
  • Vaccination
03

In context

COVID-19

7,640 studies on the registry are indexed under COVID-19; 488 are open to participants now.

This study's enrollment of 756 is above the median of 100 across 4,099 interventional studies indexed under COVID-19.

Browse COVID-19 studies →

Lead sponsor

University of Massachusetts, Worcester is the lead sponsor of 288 studies on the registry; 54 are open to participants now.

Of its 25 completed or terminated interventional studies of FDA-regulated products, 18 (72%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adult (age 18 and over) who are members of an online panel (Prolific). Members of this panel joined the panel specifically to receive invitations to participate in research surveys and similar activities.
  • Able to complete an online survey in English.

Exclusion criteria

Exclusion Criteria:

  • None
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Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
756 participants (actual)

Study arms

  • Experimental
    Message 1

    Participants were randomized to receive version #1 of 5 different versions of a message from a physician regarding the COVID-19 vaccination. All messages included a statement that the vaccine is very safe and very effective. In Message 1, this statement was followed by a participatory-style recommendation ("What do you think?")

    Behavioral: Communication from a physician about the COVID-19 Vaccine

  • Experimental
    Message 2

    Participants were randomized to receive version #2 of 5 different versions of a message from a physician regarding vaccination. All messages included a statement that the vaccine is very safe and very effective. In Message 2, this statement was followed by a comparison of the COVID-19 vaccine to the flu shot and an explicit recommendation ("I recommend that you get it").

    Behavioral: Communication from a physician about the COVID-19 Vaccine

  • Experimental
    Message 3

    Participants were randomized to receive version #3 of 5 different versions of a message from a physician regarding vaccination. All messages included a statement that the vaccine is very safe and very effective. In Message 3, this statement was followed by a statement that millions of people have already received the COVID-19 vaccine and an explicit recommendation ("I recommend that you get it").

    Behavioral: Communication from a physician about the COVID-19 Vaccine

  • Experimental
    Message 4

    Participants were randomized to receive version #4 of 5 different versions of a message from a physician regarding vaccination. All messages included a statement that the vaccine is very safe and very effective. In Message 4, this statement was followed by an acknowledgment of concerns and reassurance that the physician personally reviewed the safety data and an explicit recommendation ("I recommend that you get it").

    Behavioral: Communication from a physician about the COVID-19 Vaccine

  • Experimental
    Message 5

    Participants were randomized to receive version #5 of 5 different versions of a message from a physician regarding vaccination. All messages included a statement that the vaccine is very safe and very effective. In Message 5, this statement was followed by an emphasis on protecting others an explicit recommendation ("I recommend that you get it").

    Behavioral: Communication from a physician about the COVID-19 Vaccine

Interventions

  • BehavioralCommunication from a physician about the COVID-19 Vaccine

    Participants who expressed hesitation about getting vaccinated against COVID-19 were randomized to receive one of five different versions of messages from a physician. The messages that participants in each group received varied slightly and systematically. Specific content and wording of these messages were developed to address and mitigate concerns of those at risk for not being vaccinated.

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What researchers measure

Primary outcomes

  1. Number of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message

    All participants were asked about their intent to be vaccinated against COVID-19 prior to exposure to one of the five physician messages (Response options: Yes, No, Not sure). After participants were randomly assigned to receive one of the five physician messages, reduction in COVID-19 vaccine hesitancy was assessed with the question: "Would you get vaccinated at this visit". Response options included yes, no, not sure. For participants whose initial vaccination intent was "not sure", a response of "yes" on re-assessment was defined as less hesitant. Response of "not sure" or "yes" were defined as less hesitant for participants whose initial vaccination intent was "no".

    Time frame: Through survey completion, an average of 12 minutes

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Results

Posted Jan 5, 2022
Limitations and caveats
Limitations include: (1) Inability to assess whether the impact of physician messages in practice would parallel the impact in the hypothetical scenarios used in this study; (2) The use of an online research platform (prolific.co) may limit generalizability of results.

Participant flow

Participants were recruited on Prolific.co from 01/12/21-02/01/21. Eligible panel members were \>= 18, English speaking, and U.S residents. Panel members were restricted to include White, Black, or Hispanic; Blacks and Hispanics were oversampled. Participants who responded "no" or "not sure" to "If you could get vaccinated for COVID-19 today, would you?" were classified as vaccine hesitant and randomized to receive 1 of 5 physician messages, after which their intent was reassessed.

Participant flow — Overall Study
MilestoneMessage 1Message 2Message 3Message 4Message 5
Started172121165146152
Completed172121164145150
Not completed00112
Withdrew: Participants did not provide respond to the question re-assessing vaccination intent00112

Outcome measures

PrimaryNumber of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message

All participants were asked about their intent to be vaccinated against COVID-19 prior to exposure to one of the five physician messages (Response options: Yes, No, Not sure). After participants were randomly assigned to receive one of the five physician messages, reduction in COVID-19 vaccine hesitancy was assessed with the question: "Would you get vaccinated at this visit". Response options included yes, no, not sure. For participants whose initial vaccination intent was "not sure", a response of "yes" on re-assessment was defined as less hesitant. Response of "not sure" or "yes" were defined as less hesitant for participants whose initial vaccination intent was "no".

Time frame:
Through survey completion, an average of 12 minutes
Reported as:
Count of participants · Participants
Number of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message
ParticipantsMessage 1Message 2Message 3Message 4Message 5
Number of Participants Who Became Less Hesitant About the COVID-19 Vaccine After Receiving a Physician Message2326433540

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Message 1———
Message 2———
Message 3———
Message 4———
Message 5———

Baseline characteristics

Age, Customized
Age, Customized(Participants)Message 1Message 2Message 3Message 4Message 5Total
Age — Less than 24 years4331373841190
Age — 25 - 34 years4032422842184
Age — 35 - 44 years5027315033191
Age — 45 - 54 years2221271720107
Age — 55 - 64 years13420101158
Age — 65 years or older3532215
Age — Missing114017
Sex/Gender, Customized
Sex/Gender, Customized(Participants)Message 1Message 2Message 3Message 4Message 5Total
Gender — Male6241715265291
Gender — Female10878889382449
Gender — Other024006
Gender — Prefer not to say100001
Gender — Missing101035
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Message 1Message 2Message 3Message 4Message 5Total
Hispanic/Latino3531413337177
Black/African American7952666465326
White5837574848248
Missing010001
Region of Enrollment
Region of Enrollment(participants)Message 1Message 2Message 3Message 4Message 5Total
United States172121164145150752
Initial Vaccination Intent
Initial Vaccination Intent(Participants)Message 1Message 2Message 3Message 4Message 5Total
Initially "No"10366837881411
Initially "Not Sure"6955816769341
Education
Education(Participants)Message 1Message 2Message 3Message 4Message 5Total
High School or Less4440533849224
Some college8656857068365
4-year college or more4225253632160
Missing001113
Employment
Employment(Participants)Message 1Message 2Message 3Message 4Message 5Total
Employed8864838376394
Unemployed3020292030129
Student251515191892
Homemaker16129141364
Disabled63104528
Retired3374421
Other43101422
Missing011002
Household Income
Household Income(Participants)Message 1Message 2Message 3Message 4Message 5Total
Less than $30,0004743554057242
$30,000 - $60,0005341575153255
$60,000 - $100,0004427352627159
More than $100,0002171119967
Prefer not to answer6259325
Missing111014

4 further baseline measures are reported on the registry.

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Study locations

1 site
  • Meyers Health Care Institute
    Worcester, Massachusetts 01605, United States
09

References and documents

Publications

  • Fisher KA, Bloomstone SJ, Walder J, Crawford S, Fouayzi H, Mazor KM. Attitudes Toward a Potential SARS-CoV-2 Vaccine : A Survey of U.S. Adults. Ann Intern Med. 2020 Dec 15;173(12):964-973. doi: 10.7326/M20-3569. Epub 2020 Sep 4. PubMed 32886525 ↗
  • Brewer NT, Chapman GB, Rothman AJ, Leask J, Kempe A. Increasing Vaccination: Putting Psychological Science Into Action. Psychol Sci Public Interest. 2017 Dec;18(3):149-207. doi: 10.1177/1529100618760521. PubMed 29611455 ↗
  • Godinho CA, Yardley L, Marcu A, Mowbray F, Beard E, Michie S. Increasing the intent to receive a pandemic influenza vaccination: Testing the impact of theory-based messages. Prev Med. 2016 Aug;89:104-111. doi: 10.1016/j.ypmed.2016.05.025. Epub 2016 May 25. PubMed 27235605 ↗
  • Mowbray F, Marcu A, Godinho CA, Michie S, Yardley L. Communicating to increase public uptake of pandemic flu vaccination in the UK: Which messages work? Vaccine. 2016 Jun 14;34(28):3268-74. doi: 10.1016/j.vaccine.2016.05.006. Epub 2016 May 8. PubMed 27166824 ↗
  • Nowak GJ, Sheedy K, Bursey K, Smith TM, Basket M. Promoting influenza vaccination: insights from a qualitative meta-analysis of 14 years of influenza-related communications research by U.S. Centers for Disease Control and Prevention (CDC). Vaccine. 2015 Jun 4;33(24):2741-56. doi: 10.1016/j.vaccine.2015.04.064. Epub 2015 Apr 28. PubMed 25936726 ↗
  • Redelings MD, Piron J, Smith LV, Chan A, Heinzerling J, Sanchez KM, Bedair D, Ponce M, Kuo T. Knowledge, attitudes, and beliefs about seasonal influenza and H1N1 vaccinations in a low-income, public health clinic population. Vaccine. 2012 Jan 5;30(2):454-8. doi: 10.1016/j.vaccine.2011.10.050. Epub 2011 Oct 30. PubMed 22044740 ↗

Study documents

  • Protocol and statistical analysis plan · Jan 15, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 24, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04706403
Lead sponsor
University of Massachusetts, Worcester
Collaborators
National Library of Medicine (NLM)
Responsible party
Kimberly Fisher (Associate Professor, University of Massachusetts, Worcester) — Principal investigator
First posted
Jan 12, 2021
Start date
Jan 12, 2021
Primary completion
Feb 1, 2021
Completion
Feb 1, 2021
Results posted
Jan 5, 2022
Last update
May 24, 2022

Study contacts

Kimberly Fisher, MD
principal investigator · University of Massachusetts, Worcester

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in May 2022. You cannot join it, but the record below documents what was studied.

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