Does political instability reduce confidence in vaccines?

A pillar of the COVID-19 mitigation exit strategy has been the emphasis on vaccination as the path to herd immunity. But at a time of division when public trust in public health is eroded, buy-in has become a major concern for SARS-CoV-2 vaccine implementation plans.

New research published in The lancet can provide information; the work maps recent trends in vaccine confidence around the world. Data were collected between 2015-2019 from 149 countries.

The study authors expressed concern that areas of political instability would see particularly high increases in vaccine skepticism. Several findings stood out in the results, which were collected from more than 284,000 adults.

• Confidence in vaccines in Europe remains low compared to other regions, ranging from 19% (Lithuania) to 66% (Finland) of people in December 2019 who fully agree that vaccines are safe.
• There are signs that public confidence in the safety of vaccines is increasing in the EU, particularly in Finland, France, Italy and Ireland, as well as in the UK.
• In contrast, six countries globally saw significant increases in the proportion of respondents strongly disagreeing that vaccines are safe: Azerbaijan (2% of respondents strongly disagreeing with vaccines are safe in 2015 and increased to 17% in 2019), Afghanistan (2% – 3%), Indonesia (1% –3%), Nigeria (1% –2%), Pakistan (2% –4%) and Serbia (4% –7%), reflecting trends of political instability and religious extremism.
• Hoping for the COVID-19 vaccine, the authors say that regular assessment of public attitudes and rapid response to declining confidence should be the top priority to provide the best opportunity to ensure adoption of new vaccines that save lives.

While some parts of Europe are experiencing increased public confidence, several countries experiencing instability and extremism are experiencing increased hesitation.

“It is vital with new and emerging disease threats, such as the COVID-19 pandemic, that we regularly monitor public attitudes to quickly identify countries and groups with declining confidence, so that we can help guide where we need to. build confidence to optimize uptake of new life-saving vaccines, ”said study author Heidi Larson, PhD, professor at the London School of Hygiene and Tropical Medicine.

A total of 290 nationally representative surveys were incorporated into the study, and models were used to estimate trends in public thought.

The authors estimate that confidence in the importance, safety, and efficacy of vaccines declined in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea.

The team also found significant increases in respondents who strongly disagreed that vaccines are safe in Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan and Serbia.

On the other hand, confidence has improved between 2018 and 2019 in EU member states such as Finland, France, Ireland and Italy.

Interestingly, safety was not the strongest association with uptake.

“Confidence in the importance of vaccines (rather than safety or efficacy) had the strongest univariate association with vaccine absorption compared to other determinants considered,” the authors wrote.

The findings also indicated that members of minority religious groups tended to be less likely to be accepted.

“To our knowledge, this is the largest study on global confidence in vaccines to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to drive interventions. to build and maintain confidence in the vaccine, “the team concluded.