?:abstract
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Introduction: There has been evidence of increases in vaccinating delays and refusals in the UK in recent years. As the United Kingdom begins a mass vaccination campaign with a novel COVID-19 vaccine, it is unclear whether refusal of the vaccine in some regions and among some socio-economic groups will pose challenges for achieving herd/community immunity against SARS-CoV-2. Methods: This study estimates uptake of a COVID-19 at unprecedented spatial resolution across the UK using a large-scale survey and state-of-the-art Bayesian statistical methods for estimating public opinion. Between 24 September and 14 October 2020, 17,684 individuals are surveyed in a cross-sectional online survey design. Regions and socio-economic groups who may be more resistant towards a new vaccine are identified using multilevel regression and poststratification. Gibbs sampling is used for Bayesian model inference, with 95% Bayesian highest posterior density intervals to capture uncertainty in parameter estimates. Findings: This study predicts that clusters of non-vaccinators will likely emerge in many regions across the UK, most notably in London (which has 13 of the 20 lowest ranking regions) and the North West (which has four, including Greater Manchester and Liverpool). Males are much more likely to state intent to accept the vaccine than females (OR 1.59, 1.47 to 1.73), while Muslims are less likely than atheists / agnostics (0.75, 0.57 to 0.96), Black / Black British are less likely than Whites (0.47, 0.38 to 0.60), and Polish speakers (0.45, 0.31 to 0.63) are less likely than those who primarily speak English or Welsh. Across the UK, less than half the UK say they would \'definitely\' accept a COVID-19 vaccine (47.5%, 46.5 to 48.5%) and 8.7% (8.2 to 9.2%) state that they would \'definitely not\' accept a vaccine, with the rest being unsure. Interpretation: The study findings are extremely important in the context of achieving herd/community immunity. Low predicted acceptance rates in parts of London and the North West are of particular concern as many of these regions have among the highest rates of COVID-19 infection across the UK: low vaccine uptake in these regions may result in disease \'hotspots\' that amplify the spread of the disease and require increases in vaccination levels in adjacent regions to provide nationwide herd/community immunity. It is therefore extremely important to identify such regions, and to engage with communities within them in advance of vaccination rollout to the population at large. Encouragingly, intent to accept a COVID-19 vaccine is higher among older age-groups, who are among the first to receive a COVID-19 vaccine.
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