Information Consumption, Trust Dynamics and COVID-19 Vaccine Hesitancy among Older Adults: Implications for Health Messaging

Round 1

Reviewer 1 Report

Thank you for the invitation to review this study. The authors have conducted a qualitative study among older adults with low income background in order to determine vaccine hesitancy and their trust on information related to vaccines. I do not see any major problem in this study, and the authors have presented all the required information in an appropriate way. However, I would like to ask the authors to add the criteria that classify respondents into low income or high income individuals. 

The authors are also requested to extend the information on the type of questions in the interview book. Moreover, duration of interview should also be mentioned in this study. 

Can authors provide demographic information of the participants in a tubular way. The readers would get more precise information of the participants that will help them to interpret the results taking into account various factors affecting perceptions towards disease and vaccines.

Author Response

Thank you so much for your feedback! You can find our detailed responses to your comments in the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

Thank you for the opportunity to review your research on COVID-19 vaccine hesitancy among older adults. The risk of hospitalization and death from COVID has typically been highest among the elderly and individuals with significant health issues. Your work examines key factors in their understanding, attitudes, and behaviors about COVID and related vaccinations. I have made several comments that I hope you will find useful in your current and future work in this area.

Introduction:  I believe that the timing of your study relative to the timing of COVID and COVID vaccine rollout is probably relevant to understanding the attitudes and behaviors of your participants. Specifically, the Spring and Summer of 2021 saw a rapid uptake of people receiving the COVID vaccines. Vaccination rates were leveling off by late summer and the “infodemic” that you describe in your paper had begun to clear. The historic perspective can be helpful for interpreting many of your findings.

Materials and Methods:  You make the assumption that because the senior service provider “primarily” serves low-income older adults, all participants were low-income. It does not appear that you gathered any explicit indicators of income. It would be helpful to know more about the service provider that you partnered with in order to feel confident that your study participants were indeed “low income.”

Please provide a more specific definition of “tabling events.” Were they health fairs, regularly scheduled service events, or something else?  Were these events open to the public or only to individuals who were directly receiving other services from your community partner? Were these selective events or all events sponsored by the service provider during the study period?

How many focus groups and how many interviews were conducted? What was the range of number of participants in the focus groups? Can you be more specific about the percentage of women and men in your study?

Results:  Overall, your results are well presented and easy to follow. The comments and background are organized and provide a clear picture of your qualitative findings.

You note in lines 231-237 that a participant was advised by her doctor to receive the vaccine in early 2020. This is several months before vaccines were developed and almost a year before they were widely available.  Is this a misprint?

Discussion: Most of your participants were Black or LatinX. Despite small numbers of participants from other cultural and ethnic backgrounds, you note that there seem to be some unique responses from Russian and Chinese participants. This may translate to unique responses from other ethnic groups more prevalent in other parts of the country. I also think that more can be said about how long they had been in the United States and their age when they immigrated.  You allude to some of these issues but do not elaborate.

You do not provide much discussion about changes in information sources or trust and attitudes between the period before COVID and the time when vaccines were made available.  This was a major focus of your research and needs more commentary.

Author Response

Author Response File: Author Response.docx

Reviewer 3 Report

The Yiyi Wu and Mark Brennan-Ing paper well reports informations concerning consumption, trust dynamics and COVID-19 vaccine hesitancy among 77 low-income older adults in New York city during a 4-month period (october 2021 - January 2022). Results show the fundamental necessity for clear and unambiguous health messaging to promote confidence in revaccination against SARS CoV-2.

The importance of the pater is very significant.

It is stated that a qualitative analysis was performed. However, it is suggested to schematically summarize in a table the results relating to the five main themes emerged in the analysis, stratifying by participants' demographics.

Author Response

Thank you so much for taking your time to review our paper! We really value all your feedback. Below, you can find our detailed responses to your comment.

Author Response File: Author Response.docx

Round 2

Reviewer 3 Report

I thank the Auhors very much. The additions to the text are apprecciable and make it, in my opinion, more easily understandable. For me, it is publishable in the present form.