疫苗猶豫與風險溝通之必要：對照長者與慢性病族群經驗

Vaccine hesitancy and risk communication: experiences among older adults and patients with chronic diseases

目標：本研究探討長者與慢性病族群針對新冠疫苗出現之疫苗猶豫，及其對於風險溝通之需求。方法：資料來自於2021年6月1日至10月31日進行之「台灣新冠疫苗民眾決策態度之快速質性研究調查」，以訪談與焦點團體蒐集資料。結果：基於調查與分析，本研究發現由於年齡與特定病症的身體狀況，長者與慢病族群對於疫情威脅下緊急授權之疫苗持有疑慮，擔憂自身之脆弱性能否承受新冠疫苗之不確定性與副作用，這些疑慮是否被充分回應，成為決策關鍵。本研究對照具相似疑慮，但出現不同決策傾向的長者與慢病族群，當後者在尋得資訊後，多能處理原有疫苗猶豫、轉而接種，前者則因特殊情境下對資訊缺乏控制感，仍陷於困惑、抗拒接種。結論：風險溝通在建立脆弱族群疫苗信心上具有關鍵角色。

Objectives: This study explored COVID-19 vaccine hesitancy among older adults and patients with chronic diseases and the need for risk communication in these two communities. Methods: The data source was the Rapid Qualitative Investigation on Attitudes and Factors Influencing COVID-19 Vaccination Among People in Taiwan project. Interviews and focus groups were conducted from June 1 to October 31, 2021. Results: Older adults and patients with chronic diseases reported feeling hesitant about COVID-19 vaccination because of their specific health conditions associated with aging and chronic disease. They reported concerns that they were vulnerable to the side effects of COVID-19 vaccines developed under emergency use authorization and that they were unable to tolerate this uncertainty. Most participants with chronic diseases eventually accepted vaccination after acquiring information addressing their concerns. By contrast, because they lacked a sense of control and the ability to adequately assess information, older adult participants remained skeptical and resisted COVID-19 vaccination. Discussions: By comparing the experiences of older adults and participants with chronic diseases, this study demonstrates that, even when two communities report similar concerns about COVID-19 vaccination, targeted strategies must be adopted; these must be developed according to each population's capacity to assess complex information. Policy initiatives and information campaigns must address their specific concerns to effectively promote COVID-19 vaccination among these two communities. Conclusions: These findings highlight the importance of risk communication for initiatives to enhance COVID-19 vaccine confidence among vulnerable populations.