The goal of the research, Mobarak explained, was to establish a clearer understanding of global vaccination attitudes by using a large and diverse sample of countries. “Before designing any interventions to overcome vaccine hesitancy, we’re trying to understand the basic facts,” he said.
With this foundational information in hand, the researchers hope to shift “from hunch-based policy to evidence-based policy,” Omer said.
The survey responses revealed notably different attitudes toward the Covid-19 vaccine between wealthy and less wealthy nations, with 80.3% of people in LMICs expressing willingness to get the vaccine when available. Just 64.6% percent of Americans and 30.4% of Russians said the same.
To Mobarak, the high levels of acceptance in LMICs suggest that prioritizing distribution to these countries could have important benefits. “If the goal is to maximize global vaccination coverage, distributing vaccines to countries in Asia and Africa that don’t currently have them is going to be a lot easier and cheaper than trying to convince the last 30% of Americans to get vaccinated,” he said.
Improving access in LMICs, where vaccination rates are currently extremely low, could also help to prevent the emergence and spread of new Covid-19 variants. “If we ended up with a new variant coming out of Latin America, Africa, or Asia, and the Pfizer and Moderna vaccines are not effective against it, then we’re basically back to square one,” Mobarak explained. “Our paper shows that distributing vaccines to the rest of the world would be a high-return activity, because most people there are ready to take it.”
Why are wealthier nations so much more hesitant than LMICs? While the survey results don’t directly address this question, the researchers have a few theories. “In a lot of low- and middle-income countries, the pandemic response – good or bad – has been a national response,” said Omer. “Unfortunately, in a lot of high-income countries, it’s been a political response. So that’s part of it. If you politicize a response, you lose half the country one way or another.”
Residents of LMICs also have more recent experiences with the life-saving benefits of other vaccines. “People have the memory – both personal and institutional – of diseases like measles and polio,” Mobarak noted. “People know what problems non-vaccination can cause.”
Hearteningly, the survey results also suggest that most vaccine hesitancy does not appear to be especially deep-rooted. Among vaccine-hesitant survey respondents, the most commonly cited reason for reluctance was concern about side effects; relatively few, except in Russia and Burkina Faso, mentioned conspiracy theories.
“The concerns are really of a health expertise nature,” Mobarak said. “Like, ‘I’m worried about side effects,’ or ‘I’m worried about whether this vaccine is really effective.’ Which are rational concerns, and not irrational things, like ‘Somebody is using this vaccine to implant a chip in me.’”
“It’s not that conspiracy theories are not important, and it doesn’t mean that they won’t play a role going forward,” Omer added. “But at this point, it’s the basic characteristics of the vaccines that people are talking about.”
In high- and low-income countries alike, respondents reported that health workers were their most trusted source of vaccine information, followed by the government in some countries and friends and family in others. Celebrities received low marks, suggesting the limits of star-studded vaccine rollout efforts.
“Even amongst those who are skeptical of vaccines, the most trusted source of vaccine information remains healthcare providers,” Omer said. “That’s important to keep in mind as we deploy a strategy. So yes, a soccer player can attract attention to the vaccine issue, but they do not replace healthcare workers as a trustworthy source.”