PONE-D-21-16573

COVID-19 Vaccine Uptake and Hesitancy Survey in Northern Ireland and Republic of Ireland:  Applying the Theory of Planned Behaviour

PLOS ONE

Dear Dr. Cavanagh,

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Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: In this manuscript by Cavanagh and colleagues, the authors used the theory of planned behavior to examine COVID-19 vaccine uptake. This is a timely article as many countries are struggling with COVID-19 vaccine uptake during this pandemic and this article has the potential to provide recommendations and suggestions on addressing vaccine hesitancy.

1. The "Aims of the Study" section is a bit confusing because it is a list of aims and isn't clearly connected to the introduction section. It would be helpful if the authors, clearly stated gaps in existing literature and how study aims will fill existing knowledge gaps.

2. The last aim mentions "to consider confidence in giving the COVID-19 vaccine to children..." however, none of the measures focus on vaccine acceptance for children, and there is no mention of this aim in the results or discussion. If this aim is not included in the current paper, then it should be removed from that section.

3. Participant demographics should be in the results section.

4. "Cross-sectional online survey" is not enough information on the research design. Overall, the methods section is missing a lot of information. For example, if social media platforms were used, additional information on the specific platforms used is needed, along with how the study was advertised on these platforms, such as were flyers posted in specific groups? Did the study staff pay social media platforms to advertise the study to specific populations? This section also needs information on incentives provided to participants.

5. Overall, the discussion section seems more like an extensions of the introduction and provides little information about how the results from this study relate to previous studies. Additionally, the authors stated how the aims of this study was to provide suggestions, but suggestions seemed based off of previous literature instead of study results.

Reviewer #2: Preface

The manuscript is well written, and the study well-conducted I very much appreciated the not easy field of why there is reluctance or hesitation to vaccination programs and especially in some age groups also relates to changes in the patient-doctor relationship but also in the communication of vaccination policy by the ministries or political representatives of the different countries in the world.

The Scottish school has previously addressed this issue as well for other vaccinations.

Kennedy C, Gray Brunton C, Hogg R. 'Just that little bit of doubt': Scottish parents', teenage girls’, and health professionals' views of the MMR, H1N1 and HPV vaccines. Int J Behav Med. 2014 Feb;21(1):3-10. DOI: 10.1007/s12529-013-9356-4. PMID: 24198038.

Introduction

It is too rhetorical to put the history of SAR Covid 2 infections and makes the manuscript banal I would immediately introduce the concept of vaccination also citing other examples in which in the last decade in the world and some countries, it is especially in Europe there is a certain reluctance even towards vaccinations already well known as measles, this reluctance is also encountered in booster.

Please see the following manuscripts

Hilton S, Patterson C, Smith E, Bedford H, Hunt K. Teenagers' understandings of and attitudes towards vaccines and vaccine-preventable diseases: a qualitative study. Vaccine. 2013;31(22):2543-2550. doi:10.1016/j.vaccine.2013.04.023

The data collection methodology is corrected, and the results are well depicted.

The statistical analysis was well conducted. Authors should also consider whether to report a multivariate analysis.

In the debate, I would gently stress the fact that we do not yet know the events that the mutation of the virus will determine on its effectiveness and that it is better to explain the truth to those who must undergo vaccination than to be sure of its effectiveness. Too many times we have hesitated in the methods of communication that are not entrusted to the clinicians but politicians and that the patient finds as a reference preferably the family doctor or pediatrician rather than the minister of health.

The authors could add that in the future they will evaluate adherence to vaccination with multiple doses and compliance with other vaccinations that are added to those recommended in the different age groups (guys and elderly and high-risk group)

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Reviewer #1: No

Reviewer #2: Yes: Paola Di Carlo

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COVID-19 Vaccine Uptake and Hesitancy Survey in Northern Ireland and Republic of Ireland:  Applying the Theory of Planned Behaviour

PONE-D-21-16573R1

Dear Dr. Cavanagh,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Prof. Anat Gesser-Edelsburg, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors addressed all previous reviewer comments. The deletion of the last aim helps to clarify the objectives of the article. The additional information in the research design section was also helpful to better understand how participants were recruited for the study.

Reviewer #2: I have suggested only minor revisions, and the authors have sufficiently replied to my comments............

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: Paola Di Carlo