COVID‐19 vaccine acceptance: A comparative longitudinal analysis of the association between risk perception, confidence, and the acceptance of a COVID‐19 vaccine

Following the outbreak of COVID-19, scientists rushed to develop vaccines to protectindividuals and ferry the world out of the pandemic. Unfortunately, vaccine hesitancyis a major threat to the success of vaccination campaigns. Research on previous pan-demics highlighted the centrality of perceived risk and confidence as core determinantsof vaccine acceptance. Research on COVID-19 is less conclusive, and frequently itrelies on one-country, cross-sectional data, thus making it hard to generalize resultsacross contexts and observe these relationships over time. To bridge these gaps, in thisarticle, we analyzed the association between perceived risk, confidence, and vaccineacceptance cross-sectionally at individual and country levels. Then, we longitudinallyexplored whether a within-country variation in perceived risk and confidence was cor-related with a variation in vaccine acceptance. We used data from a large-scale surveyof individuals in 23 countries and 19 time-points between June 2020 and March 2021and comparative longitudinal multilevel models to estimate the associations at differentlevels of analysis simultaneously. Results show the existence of cross-sectional rela-tionships at the individual and country levels but no significant associations withincountries over time. This article contributes to our understanding of the roles of riskperception and confidence in COVID-19 vaccines’ acceptance by underlining that theserelationships might differ at diverse levels of analysis. To foster vaccine uptake, it mightbe important to address individual concerns and persisting contextual characteristics,but increasing levels of perceived risk and confidence might not be a sufficient strategyto increase vaccine acceptance rates.