Understanding the hesitancy of the COVID-19 vaccine

Machingaidze, S., Wiysonge, C. Understanding the hesitancy of the COVID-19 vaccine. Nat Med (2021). https://doi.org/10.1038/s41591-021-01459-7

Commentary

This new study provides insight into the complexities of COVID-19 vaccine hesitancy and acceptance across low-, middle-, and high-income countries.

Globally, there are currently more than 125 vaccine candidates, 365 vaccine trials in progress, and 18 vaccines against COVID-19 that have been approved by at least one country.

In this context, studies conducted and published primarily in high-income countries have stated that one reason for hesitation is the rapid pace of vaccine development and concerns about the safety of COVID-19 vaccines. However, this has been limited by data from low- and middle-income countries (LMIC).

Vaccine hesitancy itself was a growing concern even before the COVID-19 pandemic, and a framework developed from studies conducted in high-income countries, called the 5C Model of Drivers of Vaccine Avoidance, provides five key individual-level determinants of vaccine avoidance.

The analysis included seven studies in low-income countries, five studies in lower-middle-income countries, and one study in a high-income country. The authors compared their findings with those of two countries at the forefront of vaccine research and development: Russia and the United States.5 Overall, the study found that vaccines were more effective in low-income countries than in middle-income countries.

From the results, they found that the average acceptance rate across the entire LMIC study set was 80.3%, with the lowest acceptance rates in Burkina Faso (66.5%) and Pakistan (66.5%). Furthermore, the acceptance rate for all LMIC samples was found to be higher than that of samples from the United States (64.6%) and Russia (30.4%).

The explanation for the acceptance of the vaccine could be explained as protection against SARS-CoV-2, and concern about side effects was the most common reason for hesitation. It was also reported that health care providers were the most reliable source of guidance on vaccines. However, this report does not necessarily lead to vaccination behavior, according to the report.

Another survey was

conducted by the African Centre for Disease Control and Prevention, in collaboration with the London School of Hygiene and Tropical Medicine, in 15 African countries from August to December 2020. The survey found that the majority of African respondents (79%) would be vaccinated if the COVID-19 vaccine was deemed safe and effective.

The inference is that the experience of the spread of vaccine-preventable diseases, causing thousands of deaths each year, has raised awareness of the need for and value of vaccines. In contrast, because high-income countries have successfully eradicated or eradicated many vaccine-preventable diseases, many people, including health professionals, are unaware of the devastating effects of these diseases in their respective countries. This factor can lead to complacency, altered risk calculations, and limited joint responsibility for vaccination decisions.

However, since it is still difficult to know about decisions regarding vaccination, it seems necessary to understand the reasons why people recommend or refuse vaccination.