In response to the COVID-19 pandemic, scientists coordinated a complex immunization effort that developed and distributed vaccines by December 2020. This study aimed to explain COVID-19 vaccination decision-making process to inform vaccine communication with patients and the public. Building on quantitative research on COVID-19 vaccine hesitancy, we conducted a grounded theory study, collecting 30 qualitative interviews with employees at a U.S. university that provided vaccine eligibility in December 2020. Analysis followed the Sort and Sift, Think and Shift method. Participants who had chosen to receive the vaccine and those who had not both described five factors that impacted their decision-making: emotional response, understanding, personal values, culture, and social norms. Across these factors, we identified three cross-cutting themes: time, trust, and communication tactics. In a time of emerging science and changing answers, the constant introduction of new information created information overload for participants. COVID-19 vaccine development was a “grand experiment globally,” which required trust, not only knowledge, to overcome hesitancy. The complex information environment surrounding COVID-19 vaccination requires multi-level intervention that cannot rely on knowledge translation alone. We need to help patients build trusting relationships with experts that can create scaffolding for future information processing.

为了应对 COVID-19 大流行，科学家们协调了一项复杂的免疫工作，该工作在 2020 年 12 月之前开发和分发了疫苗。本研究旨在解释 COVID-19 疫苗接种决策过程，以告知与患者和公众的疫苗沟通。在对 COVID-19 疫苗犹豫不决的定量研究的基础上，我们进行了一项扎根的理论研究，在 2020 年 12 月对一所提供疫苗资格的美国大学的员工进行了 30 次定性访谈。分析遵循排序和筛选、思考和转移方法。选择接种疫苗的参与者和未接种疫苗的参与者都描述了影响他们决策的五个因素：情绪反应、理解、个人价值观、文化和社会规范。在这些因素中，我们确定了三个交叉主题：时间、信任和沟通策略。在科学不断涌现和答案不断变化的时代，不断引入新信息给参与者带来了信息过载。COVID-19 疫苗开发是一项“全球性的大实验”，它需要信任，而不仅仅是知识，以克服犹豫不决。围绕 COVID-19 疫苗接种的复杂信息环境需要多层次的干预，不能仅依靠知识转化。我们需要帮助患者与专家建立信任关系，从而为未来的信息处理搭建脚手架。