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ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1495951

COVID-19 vaccination refusal among the anti-vaccinationists in a Chinese society: A critical medical anthropology study of the vaccination barriers

Provisionally accepted
Judy Yuen-man Siu Judy Yuen-man Siu *
  • Department of Applied Social Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China

The final, formatted version of the article will be published soon.

    Introduction: This study investigated the reasons for COVID-19 vaccination refusal among some Hong Kong residents who were anti-vaccinationists, despite the implementation of a vaccine incentive policy called the Vaccine Pass. The health belief model and the theory of planned behavior have been widely employed to analyze the determinants of COVID-19 vaccination. However, these two theories focus on the micro individual factors, which do not provide a sufficiently comprehensive analysis. Study design: A qualitative descriptive approach with a critical medical anthropology framework. Methods: This study adopts a critical medical anthropology framework that provides a micro and macro analysis at four social levels. A qualitative approach with individual, semi-structured, in-depth interviews was conducted from September 2022 to March 2023 with 30 individuals aged 20 to 59 years who did not receive COVID-19 vaccination in Hong Kong. The participants were recruited through purposive sampling and snowball sampling. A thematic analysis of data was implemented. Results: The reasons for COVID-19 vaccination refusal involved intertwining relationships among factors in the four social levels of the critical medical anthropology framework. The participants' doubts about the safety of COVID-19 vaccines at the individual level were interacting with: (1) their ethnocultural beliefs and the perceived profit-oriented nature of vaccine production and distribution at the macro-social level, (2) their interpretation of the inconsistent advice of medical doctors at the micro-social level, and (3) their distrust in the government's vaccination policies at the intermediate-social level. Conclusions: The participants' refusal of COVID-19 vaccines was correlated with perceived profit motives related to the vaccine, perceived conflict of interest of health-care providers, and the distrust of government.

    Keywords: Anti-vaccination, COVID-19, Barrier, Resistance, political economy, critical medical anthropology anti-vaccination, Critical medical anthropology

    Received: 13 Sep 2024; Accepted: 07 Jan 2025.

    Copyright: © 2025 Siu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Judy Yuen-man Siu, Department of Applied Social Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.