As immunisation against Covid-19 begins in the UK, concerns about the safety and long-term effects of the vaccine – against a backdrop of global misinformation about vaccines – are affecting the public’s willingness to participate, particularly among the most vulnerable.
This week, 90-year-old Margaret Keenan became the first person in the UK to be inoculated against Covid-19, following the approval of the Pfizer vaccine.
While this news has been widely met with great optimism, the pandemic is occurring amid a backdrop of misinformation and mistrust in vaccines globally. Specifically, there are questions about the vaccine’s safety and its long-term side effects, as well as conspiracy theories about ill-intentions on the part of governments in vaccinating their citizens. So as the NHS launches its largest ever vaccination campaign, to what extent will the public be willing to participate?
A recent report, based on a survey of 32,361 individuals in the UK, finds that 64% of people intend to receive the Covid-19 vaccine when one becomes available (the survey was conducted in September 2020 before the UK’s approval of the Pfizer vaccine). As Figure 1 shows, this compares with 23% who are uncertain and 14% who are unwilling (Paul et al, 2020).
Figure 1: Likelihood of receiving the Covid-19 vaccine when one is available
Source: Paul et al (2020)
The report then examined factors associated with four domains of negative attitudes towards vaccines in general: mistrust of vaccine benefits; worries about unforeseen future effects; concerns about commercial profiteering; and preference for natural immunity over vaccination. Indeed, 16% of respondents display high levels of distrust about vaccine safety related to one of more of these factors.
Of particular concern is the finding that those who are more vulnerable to illness and death from Covid-19 – individuals from ethnic minority backgrounds or in lower socio-economic groups, as well as those with poor knowledge of the virus and poor adherence to Covid-19 guidelines – are also more likely to express mistrust in and negative attitudes towards vaccines – see Figure 2.
The researchers examine how these attitudes and other factors in turn relate to uncertainty and unwillingness to receive the Covid-19 vaccine when it becomes available. Individuals with lower annual income (less than £16,000), who did not receive a flu vaccine last year, who showed poor adherence to Covid-19 government guidelines, who are women and who live with children are all more likely to be uncertain and unwilling to receive the vaccine (Paul et al, 2020).
High levels of doubts about vaccine safety and concerns around future side effects are the most important determinants of both uncertainty and unwillingness to vaccinate against Covid-19 (Paul et al, 2020).
Related question: Why are people in some socio-economic groups more vulnerable to coronavirus?
Related question: How is coronavirus affecting inequalities across ethnic groups?
Figure 2: Predictors of negative attitudes towards vaccines
Source: Paul et al (2020)
Widespread negative attitudes towards immunisations and unwillingness to be vaccinated can pose a serious threat to public health, and in this case, overcoming the Covid-19 pandemic. Public health messaging should therefore be tailored to addressing the public’s most pressing concerns about vaccines, namely uncertainty about their effectiveness and fears about potential long-term effects.
Where can I find out more?
Anti-vaccine attitudes and risk factors for not agreeing to vaccination against COVID-19 amongst 32,361 UK adults: Implications for public health communications: Report by Elise Paul, Daisy Fancourt and Andrew Steptoe.
COVID-19 vaccination intention in the UK: Results from the COVID-19 Vaccination Acceptability Study (CoVAccS), a nationally representative cross-sectional survey: Study by Susan Mary Sherman and colleagues.
