Association between COVID-19 anxiety syndrome and COVID-19 vaccine hesitancy in the postpandemic era: a cross-sectional study in Hong Kong
Abstract Background The COVID-19 pandemic has had profound psychophysiological and socioeconomic effects worldwide. COVID-19 anxiety syndrome (CAS) is a specific cluster of maladaptive coping strategies, including perseveration and avoidance behaviours, in response to the perceived threat and fear o...
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BMC
2025-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-025-21367-6 |
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| author | Timothy Chung Ming Wu Jonathan Ka Ming Ho Sai Kit Choi Yanki Hiu Yan Chan Bella Wing Sze Chan Timmy Tim Ming Li Fu Po Tam Ivan Man Chun Wong Alex Siu Wing Chan |
| author_facet | Timothy Chung Ming Wu Jonathan Ka Ming Ho Sai Kit Choi Yanki Hiu Yan Chan Bella Wing Sze Chan Timmy Tim Ming Li Fu Po Tam Ivan Man Chun Wong Alex Siu Wing Chan |
| author_sort | Timothy Chung Ming Wu |
| collection | DOAJ |
| description | Abstract Background The COVID-19 pandemic has had profound psychophysiological and socioeconomic effects worldwide. COVID-19 anxiety syndrome (CAS) is a specific cluster of maladaptive coping strategies, including perseveration and avoidance behaviours, in response to the perceived threat and fear of COVID-19. CAS is distinct from general COVID-19 anxiety. The level of CAS in the postpandemic era remained unknown. Despite extensive research on general COVID-19 anxiety and COVID-19 vaccine hesitancy (CVH), few studies have investigated the association between CAS and CVH. The present study aimed to assess the level of CAS and the prevalence of CVH and explore the association between CAS and CVH in the general population of Hong Kong. Methods This cross-sectional study was conducted in Hong Kong. Participants were recruited using convenience and snowball sampling methods and completed an online or a paper-based questionnaire comprising two well-validated instruments. The COVID-19 Anxiety Syndrome Scale (C-19ASS), which includes the C-19ASS-P and C-19ASS-A subscales, was used to evaluate CAS in terms of perseveration and avoidance behaviours. The COVID-19 Vaccine Hesitancy Scale (CVHS) was used to determine the presence of CVH. Results This study included 389 participants. The median C-19ASS-P and C-19ASS-A scores were 8 (Interquartile range (IQR) 5–13) and 3 (IQR 0–6), respectively. The CVHS scores revealed a CVH prevalence of 68.1%. A significantly larger proportion of participants with CVH rated “hesitant” compared with those without CVH across all the CVHS items. Furthermore, the median C-19ASS-P and C-19ASS-A scores were significantly higher for participants without CVH than for those with CVH. Conclusions Our findings revealed that CAS persists and CVH is common in the postpandemic era and that CAS is associated with CVH. Comprehensive interventions addressing both informational and psychological aspects are needed to increase the rate of vaccine acceptance and to mitigate the effect of CAS on public health outcomes. |
| format | Article |
| id | doaj-art-3ab76fcf46714aa59e66e6e1f244f5fe |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-3ab76fcf46714aa59e66e6e1f244f5fe2025-01-19T12:41:29ZengBMCBMC Public Health1471-24582025-01-0125111010.1186/s12889-025-21367-6Association between COVID-19 anxiety syndrome and COVID-19 vaccine hesitancy in the postpandemic era: a cross-sectional study in Hong KongTimothy Chung Ming Wu0Jonathan Ka Ming Ho1Sai Kit Choi2Yanki Hiu Yan Chan3Bella Wing Sze Chan4Timmy Tim Ming Li5Fu Po Tam6Ivan Man Chun Wong7Alex Siu Wing Chan8School of Nursing and Health Sciences, Hong Kong Metropolitan UniversitySchool of Nursing and Health Sciences, Hong Kong Metropolitan UniversityInstitutes of Brain Science, Fudan UniversityDepartment of Medicine, Queen Mary Hospital, Hospital AuthorityDepartment of Neurosurgery, Prince of Wales Hospital, Hospital AuthorityDepartment of Medicine, Pamela Youde Nethersole Eastern Hospital, Hospital AuthorityDepartment of Operating Theatre, Union HospitalDepartment of Medicine and Geriatrics, Pok Oi Hospital, Hospital AuthorityDepartment of Social Work, Hong Kong Baptist UniversityAbstract Background The COVID-19 pandemic has had profound psychophysiological and socioeconomic effects worldwide. COVID-19 anxiety syndrome (CAS) is a specific cluster of maladaptive coping strategies, including perseveration and avoidance behaviours, in response to the perceived threat and fear of COVID-19. CAS is distinct from general COVID-19 anxiety. The level of CAS in the postpandemic era remained unknown. Despite extensive research on general COVID-19 anxiety and COVID-19 vaccine hesitancy (CVH), few studies have investigated the association between CAS and CVH. The present study aimed to assess the level of CAS and the prevalence of CVH and explore the association between CAS and CVH in the general population of Hong Kong. Methods This cross-sectional study was conducted in Hong Kong. Participants were recruited using convenience and snowball sampling methods and completed an online or a paper-based questionnaire comprising two well-validated instruments. The COVID-19 Anxiety Syndrome Scale (C-19ASS), which includes the C-19ASS-P and C-19ASS-A subscales, was used to evaluate CAS in terms of perseveration and avoidance behaviours. The COVID-19 Vaccine Hesitancy Scale (CVHS) was used to determine the presence of CVH. Results This study included 389 participants. The median C-19ASS-P and C-19ASS-A scores were 8 (Interquartile range (IQR) 5–13) and 3 (IQR 0–6), respectively. The CVHS scores revealed a CVH prevalence of 68.1%. A significantly larger proportion of participants with CVH rated “hesitant” compared with those without CVH across all the CVHS items. Furthermore, the median C-19ASS-P and C-19ASS-A scores were significantly higher for participants without CVH than for those with CVH. Conclusions Our findings revealed that CAS persists and CVH is common in the postpandemic era and that CAS is associated with CVH. Comprehensive interventions addressing both informational and psychological aspects are needed to increase the rate of vaccine acceptance and to mitigate the effect of CAS on public health outcomes.https://doi.org/10.1186/s12889-025-21367-6COVID-19 anxiety syndromeCOVID-19 vaccine hesitancyMaladaptive copingAvoidance behaviourFearThreat |
| spellingShingle | Timothy Chung Ming Wu Jonathan Ka Ming Ho Sai Kit Choi Yanki Hiu Yan Chan Bella Wing Sze Chan Timmy Tim Ming Li Fu Po Tam Ivan Man Chun Wong Alex Siu Wing Chan Association between COVID-19 anxiety syndrome and COVID-19 vaccine hesitancy in the postpandemic era: a cross-sectional study in Hong Kong BMC Public Health COVID-19 anxiety syndrome COVID-19 vaccine hesitancy Maladaptive coping Avoidance behaviour Fear Threat |
| title | Association between COVID-19 anxiety syndrome and COVID-19 vaccine hesitancy in the postpandemic era: a cross-sectional study in Hong Kong |
| title_full | Association between COVID-19 anxiety syndrome and COVID-19 vaccine hesitancy in the postpandemic era: a cross-sectional study in Hong Kong |
| title_fullStr | Association between COVID-19 anxiety syndrome and COVID-19 vaccine hesitancy in the postpandemic era: a cross-sectional study in Hong Kong |
| title_full_unstemmed | Association between COVID-19 anxiety syndrome and COVID-19 vaccine hesitancy in the postpandemic era: a cross-sectional study in Hong Kong |
| title_short | Association between COVID-19 anxiety syndrome and COVID-19 vaccine hesitancy in the postpandemic era: a cross-sectional study in Hong Kong |
| title_sort | association between covid 19 anxiety syndrome and covid 19 vaccine hesitancy in the postpandemic era a cross sectional study in hong kong |
| topic | COVID-19 anxiety syndrome COVID-19 vaccine hesitancy Maladaptive coping Avoidance behaviour Fear Threat |
| url | https://doi.org/10.1186/s12889-025-21367-6 |
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