{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:09:45Z","timestamp":1790752185985,"version":"4.1.0"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T00:00:00Z","timestamp":1648598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>While mass vaccination campaigns against COVID-19 have inoculated almost 200 million Americans and billions more worldwide, significant pockets of vaccine hesitancy remain. Research has firmly established that vaccine efficacy is an important driver of public vaccine acceptance and choice. However, current vaccines offer widely varying levels of protection against different adverse health outcomes of COVID-19. This study employs an experiment embedded on a survey of 1,194 US adults in June 2021 to examine how communications about vaccine efficacy affect vaccine choice. The experiment manipulated how vaccine efficacy was defined across four treatments: (1) protection against symptomatic infection; (2) protection against severe illness; (3) protection against hospitalization\/death; (4) efficacy data on all three metrics. The control group received no efficacy information. Subjects were asked to choose between a pair of vaccines\u2014a one-dose viral vector vaccine or two-dose mRNA vaccine\u2014whose efficacy data varied across the four experimental treatment groups. Efficacy data for each vaccine on each dimension were adapted from clinical trial data on the Johnson &amp; Johnson\/Janssen and Pfizer\/BioNTech vaccines. Among all respondents, only modest preference gaps between the two vaccines emerged in the control group and when the two vaccines\u2019 roughly equivalent efficacy data against hospitalization and death were reported. Strong preferences for a two-dose mRNA vaccine emerged in treatments where its higher efficacy against symptomatic or severe illness was reported, as well as in the treatment where data on all three efficacy criteria were reported. Unvaccinated respondents preferred a one-dose viral vector vaccine when only efficacy data against hospitalization or death was presented. Black and Latino respondents were significantly more likely to choose the one-shot viral vector vaccine in the combined efficacy treatment than were whites. Results speak to the importance of understanding how communications about vaccine efficacy affect public preferences in an era of increasing uncertainty about efficacy against variants.<\/jats:p>","DOI":"10.1371\/journal.pone.0265011","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T17:25:34Z","timestamp":1648661134000},"page":"e0265011","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Communication about vaccine efficacy and COVID-19 vaccine choice: Evidence from a survey experiment in the United States"],"prefix":"10.1371","volume":"17","author":[{"given":"Sarah","family":"Kreps","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9353-2334","authenticated-orcid":true,"given":"Douglas L.","family":"Kriner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,3,30]]},"reference":[{"key":"pone.0265011.ref001","unstructured":"World Health Organization. WHO Coronavirus (COVID-19) Dashboard. 2021 [cited 4 Dec 2021]. Available: https:\/\/covid19.who.int\/"},{"key":"pone.0265011.ref002","unstructured":"Daily UK. Daily summary | Coronavirus in the UK. In: Coronavirus.data.gov.uk [Internet]. 2020 [cited 6 Jul 2021]. Available: https:\/\/coronavirus.data.gov.uk\/#category=nations&map=rate"},{"key":"pone.0265011.ref003","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/S0140-6736(20)32623-4","article-title":"Oxford\u2013AstraZeneca COVID-19 vaccine efficacy","author":"MD Knoll","year":"2021","journal-title":"The Lancet. 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A conjoint analysis of how vaccine characteristics influence vaccination intentions.","author":"M. Motta","year":"2021","journal-title":"Soc Sci Med."},{"key":"pone.0265011.ref010","doi-asserted-by":"crossref","first-page":"2021726118","DOI":"10.1073\/pnas.2021726118","article-title":"Influence of a COVID-19 vaccine\u2019s effectiveness and safety profile on vaccination acceptance","volume":"118","author":"RM Kaplan","year":"2021","journal-title":"Proc Natl Acad Sci U S A"},{"key":"pone.0265011.ref011","unstructured":"Forbes. Johnson & Johnson Vaccine\u2019s 66% Efficacy Figure Is Better Than It Looks. [cited 6 Jul 2021]. Available: https:\/\/www.forbes.com\/sites\/greatspeculations\/2021\/02\/01\/johnson\u2014johnson-vaccines-66-efficacy-figure-is-better-than-it-looks\/?sh=69d0ed144073"},{"key":"pone.0265011.ref012","article-title":"Johnson & Johnson\u2019s Covid-19 Vaccine Emerges as Preferred Shot for Homeless\u2014WSJ.","author":"J Wernau","year":"2021","journal-title":"Wall Street Journal"},{"key":"pone.0265011.ref013","unstructured":"Hoffman J. Many Unvaccinated Latinos in the U.S. Want the Shot, New Survey Finds\u2014The New York Times. New York Times. May. Available: https:\/\/www.nytimes.com\/2021\/05\/13\/health\/covid-vaccine-latino-hispanic.html. Accessed 24 Aug 2021."},{"key":"pone.0265011.ref014","article-title":"What to Know About Boosters if You Got the Johnson & Johnson Vaccine\u2014The New York Times","author":"E. Anthes","year":"2021","journal-title":"New York Times"},{"key":"pone.0265011.ref015","doi-asserted-by":"crossref","DOI":"10.1038\/s41541-021-00335-2","article-title":"Public Attitudes toward COVID-19 Vaccination: The Role of Vaccine Attributes, Incentives, and Misinformation.","volume":"6","author":"SE Kreps","year":"2021","journal-title":"npj Vaccines."},{"key":"pone.0265011.ref016","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1111\/hex.13140","article-title":"Public preference for COVID-19 vaccines in China: A discrete choice experiment.","volume":"23","author":"D Dong","year":"2020","journal-title":"Heal Expect"},{"key":"pone.0265011.ref017","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.vaccine.2020.12.032","article-title":"Preferences for a COVID-19 vaccine in Australia.","volume":"39","author":"A Borriello","year":"2021","journal-title":"Vaccine"},{"key":"pone.0265011.ref018","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1007\/s10654-020-00671-y","article-title":"Vaccine hesitancy: the next challenge in the fight against COVID-19","volume":"35","author":"AA Dror","year":"2020","journal-title":"Eur J Epidemiol"},{"key":"pone.0265011.ref019","first-page":"e1","article-title":"Communicating Effectively About Emergency Use Authorization and Vaccines in the COVID-19 Pandemic.","author":"SC Quinn","year":"2020","journal-title":"Am J Public Health."},{"key":"pone.0265011.ref020","article-title":"Timing of COVID-19 vaccine approval and endorsement by public figures","author":"SE Bokemper","year":"2021","journal-title":"Vaccine"},{"key":"pone.0265011.ref021","doi-asserted-by":"crossref","first-page":"109747","DOI":"10.1016\/j.econlet.2021.109747","article-title":"Efficacy or delivery? An online Discrete Choice Experiment to explore preferences for COVID-19 vaccines in the UK.","volume":"200","author":"R McPhedran","year":"2021","journal-title":"Econ Lett."},{"key":"pone.0265011.ref022","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1177\/1075547020960463","article-title":"A National Survey Assessing SARS-CoV-2 Vaccination Intentions: Implications for Future Public Health Communication Efforts.","volume":"42","author":"KJ Head","year":"2020","journal-title":"Sci Commun."},{"key":"pone.0265011.ref023","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.2105\/AJPH.2021.306293","article-title":"Why Debunking Misinformation Is Not Enough to Change People\u2019s Minds About Vaccines.","author":"HJ Larson","year":"2021","journal-title":"American journal of public health."},{"key":"pone.0265011.ref024","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1177\/10755470211009887","article-title":"Can We Stop the Spread of False Information on Vaccination? How Online Comments on Vaccination News Affect Readers\u2019 Credibility Assessments and Sharing Behaviors.","volume":"43","author":"J Petit","year":"2021","journal-title":"Sci Commun."},{"key":"pone.0265011.ref025","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1177\/1075547017731776","article-title":"Using Expert Sources to Correct Health Misinformation in Social Media.","volume":"39","author":"EK Vraga","year":"2017","journal-title":"Sci Commun."},{"key":"pone.0265011.ref026","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1038\/s41562-021-01056-1","article-title":"Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA","volume":"5","author":"S Loomba","year":"2021","journal-title":"Nat Hum Behav"},{"key":"pone.0265011.ref027","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/s10654-021-00758-0","article-title":"Vaccine hesitancy due to vaccine country of origin, vaccine technology, and certification","volume":"36","author":"AA Dror","year":"2021","journal-title":"Eur J Epidemiol"},{"key":"pone.0265011.ref028","doi-asserted-by":"crossref","first-page":"927","DOI":"10.3390\/vaccines9080927","article-title":"Factors Affecting Hesitancy to mRNA and Viral Vector COVID-19 Vaccines among College Students in Italy.","volume":"9","author":"L Salerno","year":"2021","journal-title":"Vaccines"},{"key":"pone.0265011.ref029","first-page":"1","article-title":"Validating the demographic, political, psychological, and experimental results obtained from a new source of online survey respondents.","volume":"6","author":"A Coppock","year":"2019","journal-title":"Res Polit."},{"key":"pone.0265011.ref030","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1001\/jama.2021.2927","article-title":"The Johnson & Johnson Vaccine for COVID-19.","author":"EH Livingston","year":"2021","journal-title":"JAMA\u2014Journal of the American Medical Association."},{"key":"pone.0265011.ref031","unstructured":"Pfizer. Pfizer and Biontech confirm high efficacy and no serious safety concerns through up to six months following second dose in updated topline analysis of landmark COVID-19 vaccine study. In: April 01, 2021 [Internet]. 2021 [cited 24 Aug 2021]. Available: https:\/\/www.pfizer.com\/news\/press-release\/press-release-detail\/pfizer-and-biontech-confirm-high-efficacy-and-no-serious"},{"key":"pone.0265011.ref032","unstructured":"Johnson & Johnson. Johnson & Johnson COVID-19 Vaccine Authorized by U.S. FDA For Emergency Use | Johnson & Johnson. In: Johnson & Johnson [Internet]. 2021 [cited 24 Aug 2021]. Available: https:\/\/www.jnj.com\/johnson-johnson-covid-19-vaccine-authorized-by-u-s-fda-for-emergency-usefirst-single-shot-vaccine-in-fight-against-global-pandemic"},{"key":"pone.0265011.ref033","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1080\/10810730.2020.1864521","article-title":"An Investigation of Low COVID-19 Vaccination Intentions among Black Americans: The Role of Behavioral Beliefs and Trust in COVID-19 Information Sources.","volume":"25","author":"C Woko","year":"2020","journal-title":"J Health Commun."},{"key":"pone.0265011.ref034","article-title":"Understanding Drivers of Coronavirus Disease 2019 Vaccine Hesitancy Among Blacks","author":"F Momplaisir","year":"2021","journal-title":"Clin Infect Dis"},{"key":"pone.0265011.ref035","doi-asserted-by":"crossref","first-page":"964","DOI":"10.7326\/M20-3569","article-title":"Attitudes Toward a Potential SARS-CoV-2 Vaccine: A Survey of U.S. Adults","volume":"173","author":"KA Fisher","year":"2020","journal-title":"Ann Intern Med"},{"key":"pone.0265011.ref036","doi-asserted-by":"crossref","first-page":"e2111629","DOI":"10.1001\/jamanetworkopen.2021.11629","article-title":"Factors Associated with Racial\/Ethnic Group-Based Medical Mistrust and Perspectives on COVID-19 Vaccine Trial Participation and Vaccine Uptake in the US","volume":"4","author":"HS Thompson","year":"2021","journal-title":"JAMA Netw Open"},{"key":"pone.0265011.ref037","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1001\/jama.2021.3465","article-title":"Approaches for Optimal Use of Different COVID-19 Vaccines: Issues of Viral Variants and Vaccine Efficacy.","author":"JP Moore","year":"2021","journal-title":"JAMA\u2014Journal of the American Medical Association."},{"key":"pone.0265011.ref038","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1126\/science.abg9461","article-title":"Vaccine efficacy probable against COVID-19 variants","author":"LL Luchsinger","year":"2021","journal-title":"Science."},{"key":"pone.0265011.ref039","article-title":"Covid-19 Breakthrough Infections in Vaccinated Health Care Workers","author":"M Bergwerk","year":"2021","journal-title":"N Engl J Med"},{"key":"pone.0265011.ref040","doi-asserted-by":"crossref","first-page":"n2943","DOI":"10.1136\/bmj.n2943","article-title":"Covid-19: Omicron may be more transmissible than other variants and partly resistant to existing vaccines, scientists fear","volume":"375","author":"I. Torjesen","year":"2021","journal-title":"BMJ"},{"key":"pone.0265011.ref041","doi-asserted-by":"crossref","first-page":"n1960","DOI":"10.1136\/bmj.n1960","article-title":"Covid-19: How effective are vaccines against the delta variant?","volume":"374","author":"C. Baraniuk","year":"2021","journal-title":"BMJ"},{"key":"pone.0265011.ref042","first-page":"1","article-title":"Impact of the Delta variant on vaccine efficacy and response strategies","author":"L Bian","year":"2021","journal-title":"Expert Rev Vaccines"},{"key":"pone.0265011.ref043","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1016\/S0140-6736(21)01358-1","article-title":"SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness","author":"A Sheikh","year":"2021","journal-title":"The Lancet."},{"key":"pone.0265011.ref044","doi-asserted-by":"crossref","first-page":"7859","DOI":"10.3390\/ijerph18157859","article-title":"Covid-19 vaccines safety tracking (Covast): Protocol of a multi-center prospective cohort study for active surveillance of covid-19 vaccines\u2019 side effects.","volume":"18","author":"A Riad","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0265011.ref045","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.3390\/ph14101049","article-title":"Side Effects of mRNA-Based COVID-19 Vaccines among Young Adults (18\u201330 Years Old): An Independent Post-Marketing Study.","volume":"14","author":"A Riad","year":"2021","journal-title":"Pharmaceuticals."},{"key":"pone.0265011.ref046","article-title":"Side effects of mrna-based and viral vector-based covid-19 vaccines among german healthcare workers","volume":"10","author":"M Klugar","year":"2021","journal-title":"Biology (Basel)."},{"key":"pone.0265011.ref047","first-page":"1","article-title":"The effect of framing and communicating COVID-19 vaccine side-effect risks on vaccine intentions for adults in the UK and the USA: A structured summary of a study protocol for a randomized controlled trial.","author":"N Sudharsanan","year":"2021","journal-title":"Trials."},{"key":"pone.0265011.ref048","doi-asserted-by":"crossref","first-page":"e278","DOI":"10.1016\/S2589-7500(21)00021-2","article-title":"Covid-19 vaccine apps should deliver more to patients","author":"N Dasgupta","year":"2021","journal-title":"The Lancet Digital Health."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0265011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T17:26:33Z","timestamp":1648661193000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0265011"}},"subtitle":[],"editor":[{"given":"Malik","family":"Sallam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,3,30]]},"references-count":48,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0265011","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,30]]}}}