Attitudes towards vaccines are shifting rapidly across the world. While public trust in vaccine safety is improving in some parts of Europe, the spread of online misinformation continues to sew doubt in the mind of many. In other parts of the world, there is also growing distrust of vaccines due to ongoing political instability and religious extremism, which is threatening to undermine vaccination programs worldwide.

All of these trends in vaccine confidence have been mapped out as part of a new study published in The Lancet. The researchers hope that by identifying the hotspots of vaccine hesitancy, health authorities can work on their communications with the public and improve trust in immunization. After all, declining confidence in vaccines has been a major contributor to the rising number of preventable disease outbreaks across the world, including measles, polio, and meningitis.

The study, part of the Vaccine Confidence Project, is based on 290 nationally representative surveys conducted between September 2015 and December 2019, along with previously published data from nearly 250,000 survey responses with 50,000 additional interviews from 2019.

Interestingly, the findings appear to show that the public generally appreciates the value and importance of vaccines. However, there is growing skepticism of their safety and effectiveness. 

The researchers found that confidence in the importance, safety, and effectiveness of vaccines had slipped between 2015 and 2019 in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. Specifically in regards to safety, they also found confidence in vaccines fell significantly in Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. 

Indonesia saw one of the largest declines in public trust worldwide between 2015 and 2019. Perception of vaccine safety fell from 64 percent to 50 percent, appreciation of the importance of vaccines fell from 75 percent to 60 percent, and perceptions of their effectiveness dropped 59 percent to 47 percent.

“Our findings suggest that people do not necessarily dismiss the importance of vaccinating their children even if they have doubts about how safe vaccines are,” Clarissa Simas, study co-lead author from the London School of Hygiene & Tropical Medicine in the UK, said in a statement. “The public seem to generally understand the value of vaccines, but the scientific and public health community needs to do much better at building public trust in the safety of vaccination, particularly with the hope of a Covid-19 vaccine.”

Elsewhere, trust in vaccines was on the up, especially in Europe. The study found that confidence improved between 2018 and 2019 in Finland, France, Ireland, the UK, and Italy. Recent decades have seen a huge distrust of vaccines in France. However, there has been a marked rise in confidence, from 22 percent of those surveyed strongly agreeing vaccines are safe in 2018 to 30 percent in 2019. In the UK, confidence in vaccine safety rose from 47 percent in 2018 to around 52 percent in 2019. 

Of course, it’s worth pointing out that most vaccine scares are not supported by robust scientific evidence and instances of vaccines causing negative side-effects are exceedingly rare. However, it would be foolish to dismiss vaccine hesitancy as sheer ignorance. Cases such as the Dengvaxia controversy, in which hundreds of people in the Philippines died as the result of a dengue vaccine, sparked a huge amount of vaccine hesitancy, arguably understandably so. 

The key takeaway from this study is that health authorities need to gain a better understanding of how to communicate the overwhelming benefits of vaccines by using messages that resonate with a range of population groups.