因應緊急公共衛生事件之快速質性研究：臺灣COVID–19疫苗猶豫調查

Rapid Qualitative Research in Public Health Emergencies: COVID–19 Vaccine Hesitancy in Taiwan

因應COVID–19疫情，疫苗接種為協助社會回歸正常運作之重要公共衛生策略，然而，基於緊急狀況下開發之疫苗，其疫苗猶豫亦可預見，國際間在第一時間針對COVID–19疫苗之風險溝通進行準備，本研究為臺灣首次針對民眾於COVID–19疫苗接種態度與決策之快速質性調查，提出四項主要發現(1)民眾對疫苗不確定性高度警覺，須完整且經轉譯的資訊(2)情感面因素是關鍵，應被重視(3)標籤化效應逐漸出現，不利溝通(4)政策細節之說明影響整體信任。
基於上述發現，本研究建議政府正視並回應民眾對於COVID–19疫苗接種之慮，提供充足資訊、及連貫與友善易懂之說明，避免標籤化未接種疫苗之民眾，透過有效之風險溝通，建立民眾對於疫苗政策之長期信心。在調查與研究方法上，本研究呈現公衛緊急事件時基於實務需求、並能及時回饋政策之質性調查方法，未來亦能廣泛應用於常態時期實務方案之發展與評估。

Regarding the COVID–19 pandemic, massive vaccination has become the primary public health approach for human society to return to its normal function. However, considering the emergency situation and the unprecedented speed of vaccine development, hesitancy toward COVID–19 vaccination is foreseeable. Global organizations have prepared for the necessary risk communication for COVID–19 vacci¬nation from the very beginning.
In Taiwan, the COVID–19 vaccines roll-out started at late March 2021. At the beginning, people appeared to be hesitant to receive COVID–19 vaccination. The overall vaccination rates remained low until significant increases of COVID–19 cases occurred in Taiwan. However, it is dangerous to rely on merely the rise of infection cases to motivate people for vaccination. Without clear and effective risk communication about the uncertainty surrounding both the pandemic and COVID–19 vaccines, people may not be able to build up long-term confidence toward the vaccines. Meanwhile, there appears relatively strong COVID–19 vaccine hesitancy among certain communities, including vulnerable groups such as the elderly. As such, a thorough investigation into people’s concerns about COVID–19 vaccines and potential factors influencing decision-making is needed.
This study is the first“rapid qualitative research”conducted locally in Taiwan to investigate people’s hesitancy toward COVID–19 vacci¬nation. This research approach has been developed and promoted by a group of applied anthropologists. It has been used in public health emergencies, and its ability to measure people’s concerns quickly so as to guide pandemic control interventions has been demonstrated. This study presents an approach particularly suitable for public health emergencies which is based on filling practical needs and providing timely feedback for policy formulation, although it can also be applied to development and evaluation of policy interventions in non-emer¬gency situations.
Considering the importance of this newly emerging method, this article presents a detailed description of the process of this rapid qualitative investigation method step by step, as well as visualization of the whole process. In so doing, the authors hope to introduce this very important method to a Taiwanese audience.
The findings are as follows: (1) People are highly aware of the uncertainty of COVID–19 vaccination, and they need comprehensive and well-translated information. Conventional information campaigns are insufficient to allay people’s concerns over safety in a situation involving emergency-use authorization. (2) There has been scant attention paid to the important emotional aspects in health-related decision-making, yet these were found to be crucial in people’s final decision on whether to be vaccinated against COVID–19, and should thus be given serious weight in future risk communication. (3) A labeling effect can emerge, possibly hindering communication. People feel unable to express their different concerns and ideas while con¬sidering whether or not to vaccinate themselves for COVID–19. Due to feelings of being misunderstood and pressured, people who remain hesitant may shut down their communication with the outside world. (4) Explanations of vaccine policy details affect the overall trust in vaccine policy. A lack of clear explanation of the time arrangement of vaccine roll-out and availability of boosters directly leads to people’s concerns about whether they should receive any vaccine in such an uncertain situation.
Based on the findings, this study suggests that the government should pay serious attention to people’s concerns on COVID–19 vac¬cination, provide comprehensive and lay-friendly information and avoid labeling unvaccinated people. Effective and well-designed communication can help people build long-term, solid confidence in COVID–19 vaccination.