COVID-19 vaccine decision-making in remote Alaska between November 2020 and November 2021

Int J Circumpolar Health. 2023 Dec;82(1):2242582. doi: 10.1080/22423982.2023.2242582.


Vaccine hesitancy is an ongoing barrier to achieve sufficient COVID-19 vaccination coverage. Although there are many studies globally of vaccine hesitancy based on large survey samples, there are fewer in-depth qualitative studies that explore vaccine hesitancy and acceptance as a spectrum of decision-making. In this paper, we begin to describe vaccination decision-making among 58 adults living in remote Alaska based on three waves of online surveys and follow-up semi-structured interviews conducted between November 2020 and November 2021. The survey question of intention was not a predictor of adoption for about one third of the interviewees who were unvaccinated when they took the survey (n=12, 35%). Over half of all interviewees (n=37, 64%) had vaccine-related concerns, including 25 vaccinated individuals (representing 57% of vaccinated interviewees). Most interviewees reported that they learned about COVID-19 vaccines through interpersonal interactions (n=30, 52%) and/or a variety of media sources (n=29, 50%). The major facilitators of acceptance were trust in the information source (n=20, 48% of the 42 who responded), and learning from the experiences of family, friends, and the broader community (n=12, 29%). Further, trust and having a sense of agency appears to be important to interviewee decision-making, regardless of vaccination status and intention.

Keywords: Alaska; Alaska native; COVID-19; vaccine acceptance; vaccine hesitancy.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Alaska
  • COVID-19 Vaccines*
  • COVID-19* / prevention & control
  • Friends
  • Humans
  • Information Sources
  • Vaccination


  • COVID-19 Vaccines

Grants and funding

This work was supported by the National Science Foundation (NSF) Office of Polar Programs under 2033192. The NSF had no role in the design of the study and collection, analysis, interpretation of data, nor in writing the manuscript.