\n<\/p>\n
Reasons for vaccine hesitancy varied, from men not feeling COVID-19 was a personal risk, to women expressing concerns about fertility-related consequences<\/p>\n<\/p><\/div>\n
Most COVID-19 vaccine hesitancy is rooted in concerns that can be addressed and effectively reduced over time, according to a new study involving more than one million people.<\/p>\n
The research from Imperial College London followed people in England between January 2021 and March 2022, when the majority of the public would have received at least one COVID-19 vaccine.<\/p>\n
It found that there was a general decline in vaccine hesitancy during the 15 months following the COVID-19 vaccine roll-out in 2021-2022.<\/p>\n
However, almost two-thirds (65 per cent) of those initially hesitant about getting a COVID-19 vaccine went on to receive one or more COVID-19 vaccinations.<\/p>\n
The findings offer a novel perspective on the main types of vaccine hesitancy during the COVID-19 pandemic. Their potential to be reversed may help inform the targeting and messaging for future roll-outs of novel vaccines.<\/p>\n
\u201cWe show that certain types of vaccine hesitancy are more readily addressed than others, for example concerns relating to pregnancy or breastfeeding,\u201d said co-author Prof. Helen Ward from the UK\u2019s National Institute for Health and Care Research Imperial Biomedical Research Centre.<\/p>\n
\u201cOur study suggests that as the vaccine was rolled out, public confidence increased and the original vaccine scepticism was largely overcome.\u201d<\/p>\n
COVID-19 vaccination roll-out began in the UK on December 8, 2020, with a phased strategy that prioritised vaccines on the basis of age and clinical need.<\/p>\n
\u201cWe wanted to look at COVID-19 vaccine hesitancy in more depth to identify groups with more persistent forms of hesitancy and their main concerns. Understanding these drivers is critical to address vaccine uptake and better control disease spreads,\u201d explained lead author Prof. Marc Chadeau-Hyam from Imperial College London, UK<\/p>\n
Researchers analysed longitudinal survey data from 1.1 million adults (aged 18 and older, 57 per cent female) from the Real-time Assessment of Community Transmission (REACT) Study.<\/p>\n
They compared vaccine attitudes at enrolment with subsequent vaccination uptake from National Health Service (NHS) vaccination records up to May 7, 2024, to identify categories and drivers of vaccine hesitancy.<\/p>\n
During the pandemic, participants were asked whether they had been or intended to get vaccinated. Those who refused the vaccine, or were sceptical about vaccination, were asked about their reasons for hesitancy from a checklist of 23 options as well as a free text option.<\/p>\n
Overall, 3.3 per cent (37,982 of 1.1 million) of participants reported some degree of COVID-19 vaccine hesitancy and subsequent vaccination data was available through NHS records linkage for 24,229 (64 per cent) of them.<\/p>\n
Hesitancy rates declined over time from an initial high of eight per cent of those surveyed in January 2021, to a low of 1.1 per cent at the start of 2022. There was a small uptick in hesitancy to over 2.2 per cent in February and March 2022 during the Omicron wave.<\/p>\n
The researchers identified eight categories of vaccine hesitancy including concerns about effectiveness and side effects, perception of low risk from COVID-19 and mistrust of vaccine developers, and fear of vaccines and reactions.<\/p>\n
Among the hesitant who provided a reason for hesitancy, 41 per cent reported concerns around long-term health effects, 39 per cent that they wanted to wait to see whether the vaccine worked, and 37 per cent that they had concerns about side effects.<\/p>\n
Reasons for hesitancy varied across demographic groups with, for example, men more likely than women to report not feeling COVID-19 was a personal risk (18 per cent vs 10 per cent); women more likely to be worried about fertility-related consequences (21 per cent vs eight per cent), while those aged 74 years or older were more likely to be against vaccines in general compared with 18-24 year olds (12 per cent vs 2.5 per cent).<\/p>\n
The analysis of subsequent vaccination behaviour found that the likelihood of remaining unvaccinated was higher for older people, women, people of Black ethnicity, people who were unemployed or living in deprived areas, those with a history of COVID-19, and people with a lower level of education.<\/p>\n
People who reported the most common reasons for hesitancy (i.e., those related to vaccine efficacy or health concerns), were most likely to change their mind and subsequently get vaccinated against COVID-19.<\/p>\n
In contrast, people expressing hesitancy relating to lack of trust, perception of low personal risk, and general anti-vaccine sentiment were two to three-times less likely to get vaccinated compared to those who did not report these reasons.<\/p>\n
\u201cWhat we learned from the COVID-19 experience is the importance of ensuring that people have access to reliable and trusted information so they can make well-informed decisions about their personal health choices,\u201d said Prof. Paul Elliott from Imperial College London.<\/p>\n
\u201cReliable, easy-to-understand information, for example, on vaccine effectiveness and potential risks, is of particular importance in the case of a public health emergency such as COVID-19, which involved the rapid deployment at-scale of new vaccine technologies.\u201d<\/p>\n
The authors acknowledge some limitations of the study, including that NHS vaccine records and self-reported vaccine status showed some inconsistencies, likely reflecting both imperfect recall and imperfect coverage in the NHS data. Additionally, vaccine hesitant respondents were less likely to consent to NHS record linkage, potentially introducing selection bias, which may limit the generalisability of the findings.<\/p>\n
Writing in a linked Comment, Prof. Silvio Tafuri from the University of Bari Aldo Moro, Bari, Italy (who was not involved with the study) underscored the \u2018valuable contribution\u2019 of the study and concluded, \u2018whereas these data reflect the extraordinary setting of SARS-CoV-2 vaccination, it is crucial to ascertain whether similar drivers of hesitancy affect ordinary (ie, routine or seasonal) vaccinations, in order to guide context-specific public health interventions at the micro, meso, and macro levels\u2019.<\/p>\n<\/p><\/div>\n
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