Covid vaccine: what makes some people wary while others want to be first in the queue?

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Keri Wong.

This week, the UK rolled out its largest vaccination campaign in history: “a decisive turning point in the battle against coronavirus” according to the NHS England chief executive Sir Simon Stevens. Some people say it’s too soon; others say it hasn’t come soon enough. Yet still others are skeptical and have been so for months.

In our UCL-Penn Global COVID Study launched in April 2020, we have been following-up our participants for the second survey where we asked our participants (N = 495):

“Should a COVID-19 vaccine be available to you in the next couple months, how likely are you to take it?”

The majority of the respondents said they were likely/very likely to take the COVID vaccine (63%), about a fifth were unsure (21.8%), and the remainder said they were unlikely/very unlikely (15.2%). These numbers are aligned with a large poll conducted across seven European countries where 40% of participants report vaccine hesitancy in the latest September survey (University of Hamburg). In another rapid report in November, 36% of Britons said they were uncertain/unlikely to take the vaccine (British Academy and the Royal Society).

Why might this be?

Our follow-up question may shed some light.

By inviting our participants to respond freely about the reasons for their choice above we have collected a corpus of detailed reasons for both vaccine hesitancy and adoption. With the most commonly used word presented in larger text in word clouds below, we begin to understand people’s views towards vaccinations. From left-to-right:

Figure 1. Likelihood of taking the COVID vaccine.

Unlikely and Very Unlikely:

Respondents who were unlikely or very unlikely to take a vaccine spoke about the “lack of trust in the government”, the “unknown long-term side-effects” of the vaccine, “not feeling safe enough” to inject something into their body, and think it is better to wait and see as they are “not high-risk”.

Here’s what people said:

• “Don’t trust a vaccine that has been developed so quickly without real understanding of possible long term dangers.”
• “I am not in the high-risk group, I keep fit, healthy and considerate of my immune system. I also follow all the rules to protect other. The vaccine is very new and I would prefer not to take it and continue looking after mine and others health as I have been so far. I do take flu vaccine every year, had one this year already.”
• “Not inclined to vaccines in general. I believe that our children our dangerously over-vaccinated and that their general well-being is impaired as a result. Definitely not intending to take a vaccine that has been rushed to market.

Unsure:

Respondents who were unsure were “afraid of the risks” and “side-effects” of vaccination. They spoke of the unknowns surrounding vaccine development, that they needed to do more research or wait for longitudinal findings to see if there are side-effects as they feel this was a “rushed” job. And again, a general sense of “distrust towards the government” for pushing for the vaccine.

• “As a scientist myself I would want to be convinced of the science behind the vaccine and see proven efficacy in enough subjects before taking it myself.”
• “Feel like others both within the UK and around the world are in need of it more than me.”
• “I don’t really trust my government to create such important tasks like this. Who knows how many corners they cut? They still implement a highly unreliable rapid tests as a clearance for traveling and other outdoor activities. I think that says a lot about their capability.”

Likely and Very Likely:

Respondents who were likely and willing to have the vaccine spoke about the strong “belief in science” and scientists, that “the world’s greatest minds are working on this”. Many people spoke about health as a public good, this was the “right thing to do”, wanting to “protect their loved ones and their community”, this is the way to get back to a “safe” community, “getting back to normality” and “help” stop the virus. Even within this group, there was a sliver of doubt about where the message is coming from: if the vaccine is endorsed by scientists/CDC/WHO people are more likely to adopt it while the growing sentiment of distrust in the government means people are less likely to take it.

• “Belief in science, wanting more freedom to travel and go out.”
• “Great university’s researching vaccines in the UK.”
• “I have a friend who lost his life to it [COVID], another who suffered permanent lung & kidney damage, I don’t want to infect or put others in danger if I get it. I would like to know for myself obviously as well.”
• “If CDC and WHO approves, I’d likely take it. I’m supportive of vaccines and trust scientific research. If pushed by the government, I’d be significantly less likely to trust it. It may also depend on how willing whoever produces the vaccine is willing to share it worldwide and continue with appropriate safety precautions.”
• “It’s the right thing to do and I want COVID to get under control as soon as possible. Downloading an app on my phone and getting vaccinated is the least I can do to honour the efforts of all the frontline workers who have and are RISKING THEIR LIVES to keep us all safe.”

Many of the comments from our participants resonated with those of other studies including key concerns about the side-effects of the vaccine, and distrust in the government. Of course these are legitimate concerns that ought to be addressed. Even within the Likely/Very Likely group there is some doubt over the longer-term side-effects and whether individuals with pre-existing conditions may have bad reactions to the vaccine.

So what does this mean for society and policy?

This means we must come together as a global community. It is also evident from these comments that governments’ role in endorsing vaccines, perhaps well-intentioned, may not be perceived that way by the population. Thus, this means letting the scientists and science communicators do the talking. Have clear, smart, and accessible global campaigns to make sure everyone is up to speed on the facts about the vaccine. This means bringing together the smartest minds in marketing and PR to work with our scientists to take control of this virus.

We need an 80% community-level uptake of the COVID vaccine to protect all of us. One suggestion would be to try to convince the 20% ‘unsure’ group as they are perhaps more likely to swing to the adoption side than the antivaxxers. This means addressing people’s worries about side-effects and providing them with a clear cost-benefit analysis that reflects the true risk of not vaccinating.

This means, marketing widely clear explanations for why scientists have been able to develop a COVID vaccine in such lightning speed as supposed to non-pandemic times (e.g., extra resources, investment, global effort) – preferably using infographics that are easily accessible. While all of the above information is available online from credible sources like the WHO, access to such information is arguably skewed and low.

The next few weeks will be crucial. All sorts of things may go wrong: from the supply-chain to the distribution of the Pfizer vaccine in a frozen box at -70C degrees and the receiving of two shots three weeks apart. Knowing about the psychological barriers towards the COVID vaccination, what we – the global community – need to focus on now is how to overcome this imminent hurdle.

Echoing two of the five recommendations from the British Academy and Royal Society rapid review, there is an urgent need to: 1) start an open and transparent dialogue with the general public surrounding the side-effects of the vaccine, efficacy and safety of the vaccination roll-out and 2) counter misinformation and fake news by empowering the public with the tools to spot and report misinformation.

With the scientists working non-stop to develop an effective vaccine to protect our community, essential workers working around the clock to keep our community running, what role will you choose to play in keeping our community safe?

Want to share your thoughts about vaccine and how COVID has impacted you? Visit UCL-Penn Global COVID Study or follow us on Twitter @GlobalC19Survey.