How to Improve the Vaccination Campaign and Achieve Global Immunity to COVID-19
An international study conducted with the participation of HSE University researchers has found that people in developing countries are much more willing to get vaccinated, the most common reason for not getting vaccinating is fear of side-effects, and attitudes towards vaccination are primarily influenced by doctors and health professionals.
Nature Medicine has published an article on attitudes towards COVID-19 vaccination in several countries in the Global South (developing countries in Asia, Latin America and Africa). It was written by an interdisciplinary team of scientists from over 30 research centres in more than 10 countries, including ‘Innovations for Poverty Action’ (IPA), the International Growth Centre (IGC), the Berlin Social Science Center (WZB) and Yale University. Ekaterina Borisova, Deputy Director of HSE University’s International Center for the Study of Institutions and Development (ICSID), and Georgiy Syunyaev, Research Fellow at the Center, also contributed to this article.
The study draws on data from more than 20,000 respondents surveyed in 15 projects in 10 low- and middle-income countries in Asia, Africa and South America, as well as more than 24,000 respondents in Russia and the United States. All the data was collected between June 2020 and January 2021, with the first surveys conducted before the start of phase III clinical trials for COVID-19 vaccines. In the US and Russia, data collection took place at a time when the governments of these countries had already approved or were close to approving vaccines for mass use.
While data on attitudes to vaccination in many developed countries has been published before, no systematic studies had previously been conducted in developing countries. The authors of the study found that the average vaccine acceptance rate in these countries was 80%, ranging from 67% (in Burkina Faso and one sample in Pakistan) to 97% (in Nepal). These rates were significantly higher than in countries that have pioneered vaccine development and mass production, with acceptance rates of 65% in the USA and 30% in Russia .
Among the most common reasons for vaccine hesitance among those surveyed was the fear of side effects. This was a deciding factor for 79% of those surveyed in the US, 41% in developing countries and 37% in Russia. 19% of respondents in developing countries doubted the effectiveness of vaccines, a position shared by 30% in Russia and 47% of those surveyed in the United States.
Georgiy Syunyaev, one of the study's first co-authors, comments that ‘An important reason for distrust in vaccines in Russia and the United States may be their rapid regulatory approval, which was not supported by a clear and transparent information campaign from health professionals and the media. As a result, both doctors and the general public have relied on unrepresentative and unverified data, which can create misconceptions about the benefits and risks of vaccination’.
‘It is also telling that a significant proportion of respondents in Russia had difficulty giving a definitive answer—almost 28% of them’, continues Ekaterina Borisova. ‘These are people who did not have enough information to make a decision and who can react quickly to it. Building confidence in vaccines is the primary means of promoting them, and there is still the potential to do this.’
Another explanation for the differences in willingness to vaccinate between developing and developed countries may be the fact that the risks of epidemics are higher in developing countries. For example, the latest wave of the 2018 Wellcome Global Monitor showed that people in higher-income countries are more likely to be sceptical about the safety of vaccines in general. This may be a consequence of the fact that serious disease outbreaks are already under control in these countries. In contrast, the problem remains acute in poorer countries, so vaccines and the risks associated with them may be perceived very differently.
The authors argue that to achieve global immunity quickly and prevent new mutations of the SARS-CoV-2 virus, leaders of developed countries should focus on supporting vaccination campaigns in developing countries where vaccine acceptance rates are much higher. The researchers recommend that such campaigns be based primarily on health workers, rather than government representatives or celebrities. Doctors were cited as the most authoritative source of information by 48% of respondents in developing countries, 36% in Russia and 35% in the USA.