{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T15:15:26Z","timestamp":1742397326720,"version":"3.37.3"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T00:00:00Z","timestamp":1703116800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013202","name":"Touro University California","doi-asserted-by":"publisher","award":["IRAP 2021"],"award-info":[{"award-number":["IRAP 2021"]}],"id":[{"id":"10.13039\/100013202","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>While the San Francisco Bay Area counties rank very low in vaccine hesitancy and high in vaccination rates when compared to national numbers, Solano County has the most residents who are hesitant (6.3%) and the least who are fully vaccinated (51.6%) among Bay Area counties, according to the CDC. No studies to date have been able to provide the in-depth, localized information that would inform county-level public health interventions. This study aims to explore reasons and consequences for remaining unvaccinated in Solano County. Using a qualitative in-depth interview approach, we conducted 32 interviews with unvaccinated adults from Solano County. We used a grounded theory approach to our analysis. Using the socio-ecological model as a framework, we found that reasons for not getting vaccinated were primarily structural (mistrust of public information) and individual (bodily autonomy, personal choice) while consequences were primarily interpersonal (discrimination and stigma from friends, family, and employers). An overarching theme was that the vaccine rollout and messaging felt like an encroachment on personal choice and the feeling of being forced created more mistrust. Participants reported feeling like their decisions made them minorities among their colleagues, friends and family and that they were not persuaded by groupthink or by their relationships. Future public health responses to epidemics and pandemics might consider if a vaccine mandate is the best approach for reaching all county residents.<\/jats:p>","DOI":"10.1371\/journal.pone.0290469","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T18:52:46Z","timestamp":1703184766000},"page":"e0290469","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cIf it wasn\u2019t forced upon me, I would have given it a second thought\u201d: Understanding COVID-19 vaccine hesitancy in an outlier county in the Bay Area, California"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9376-5528","authenticated-orcid":true,"given":"Carinne","family":"Brody","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Szieff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0835-4301","authenticated-orcid":true,"given":"Bilal","family":"Abu-Alrub","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,12,21]]},"reference":[{"journal-title":"State and county health departments, Centers for Disease Control and Prevention.","year":"2022","author":"CDC","key":"pone.0290469.ref001"},{"issue":"7","key":"pone.0290469.ref002","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.vaccine.2021.01.010","article-title":"Predictors of intention to vaccinate against COVID-19: Results of a nationwide survey","volume":"39","author":"JB Ruiz","year":"2021","journal-title":"Vaccine"},{"issue":"2","key":"pone.0290469.ref003","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1007\/s10900-020-00958-x","article-title":"COVID-19 Vaccination Hesitancy in the United States: A Rapid National Assessment","volume":"46","author":"J. 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R. Kerr","year":"2021","journal-title":"Vaccines"},{"issue":"7","key":"pone.0290469.ref012","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.1056\/NEJMms2033790","article-title":"Beyond Politics\u2014Promoting Covid-19 Vaccination in the United States","volume":"384","author":"S Wood","year":"2021","journal-title":"N Engl J Med"},{"key":"pone.0290469.ref013","article-title":"In Solano County, the Bay Area\u2019s COVID outlier, masks are anything but universal.","author":"K Hwang","year":"2021","journal-title":"San Francisco Chronicle."},{"key":"pone.0290469.ref014","article-title":"Solano Co. health officer criticizes indoor mask mandate, but other health officials disagree.","author":"S Sierra","year":"2021","journal-title":"ABC7News.com."},{"key":"pone.0290469.ref015","article-title":"First infant death related to COVID-19 reported in Solano County.","author":"G. Serrin","year":"2021","journal-title":"KCRA.com"},{"key":"pone.0290469.ref016","article-title":"Solano County\u2019s Outspoken Health Officer takes the Heat","author":"R. Freedman","year":"2021","journal-title":"Times Herald"},{"issue":"7898","key":"pone.0290469.ref017","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1038\/d41586-022-00495-8","article-title":"COVID-19: talk of \u2019vaccine hesitancy\u2019 lets governments off the hook.","volume":"602","author":"K Attwell","year":"2022","journal-title":"Nature"},{"issue":"1","key":"pone.0290469.ref018","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.1186\/s12889-022-14335-x","article-title":"Attitudes and personal beliefs about the COVID-19 vaccine among people with COVID-19: a mixed-methods analysis.","volume":"22","author":"M. M. 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