healthHealth and Medicine

Vaccine Hesitancy Is Mainly A Rich World Condition


Stephen Luntz

Stephen has a science degree with a major in physics, an arts degree with majors in English Literature and History and Philosophy of Science and a Graduate Diploma in Science Communication.

Freelance Writer

indonesia vaccination

In the last month Indonesia has become the epicenter of the COVID-19 epidemic, making vaccinations like this one in central Java critical. Yet so far studies of vaccination hesitancy have been largely restricted to the rich world. Image Credit: Fadil Fauzi

A cross-country comparison of people's willingness to take a COVID-19 vaccine shows little hesitancy in most poorer countries. Tragically, it's the places that both need the vaccine the most, and where the willingness to take it is highest, that are having the most trouble getting stocks.

Well before vaccines were even approved polling companies started asking residents of richer nations how they felt about taking a vaccine. Changes in the mood as developments unfolded have been tracked with interest, but there has been much less information about how residents of poorer countries felt.


Researchers from more than 30 institutions came together to remedy this gap, polling more than 20,000 people in 27 countries. Their findings have been published in Nature Medicine

"As COVID-19 vaccine supplies trickle into developing countries, the next few months will be key for governments and international organizations to focus on designing and implementing effective vaccine uptake programs," said Niccoló Meriggi, of the International Growth Center Sierra Leone in a statement. "Governments can use this evidence to develop communications campaigns and systems to ensure that those who intend to get a vaccine actually follow through."

The data was collected between June 2020 and January 2021. We know developments have changed thinking in places where there have been many polls over time. However, relative differences between countries may have been more enduring.

By far the most vaccine-hesitant country among those polled was Russia, where just 30 percent of respondents said they would get a vaccine health authorities considered safe and effective. In the United States the figure was 65 percent, consistent with other data at the time. Meanwhile, in Africa, South Asia, and Colombia the average was 80 percent, reaching 95 percent in Nepal.


"Across countries, we observe that acceptance of COVID-19 vaccines is generally somewhat lower than for other vaccines, perhaps because of their novelty,” Dr Alexandra Scacco of the WZB said

It seems likely pre-existing attitudes to other vaccines are influential. Of the low and middle-income nations surveyed, Pakistan had the equal lowest willingness to be vaccinated (66.5 percent). Suspicion of polio vaccinations is reported to have increased dramatically after a fake vaccination drive was used to find Osama Bin Laden. On the other hand, for most countries, the experience with other vaccines has been far more positive.

The paper notes; “Perhaps it may be that lived experience in [low and medium income countries], where many vaccine-preventable infectious diseases are still causing thousands of deaths annually, results in higher perceived need for or value of vaccines.”The proportion of parents agreeing it is “important for children to have” vaccines against childhood diseases was 99 percent in four countries, but just 87 percent in the United States and 80 percent in Russia.

Nevertheless, other factors also play a part. The exceptionally low Russian response probably reflects the lack of transparency around the Sputnik V vaccine, perhaps backed by a general suspicion of government. The surveys explored demographic drivers, as well as the reasons given by those who were uncertain.


Currently, these nations' challenge is to get access to enough vaccines, currently mostly going to wealthy countries. Once that changes, many will still face the problem of distribution, particularly outside urban areas. Nevertheless, eventually, the focus will turn to convincing people of the vaccine's value, against the anti-vaccination campaigns on social media. "We hope that evidence from our study can help inform strategies to expand global COVID-19 vaccination,” Scacco said. Perhaps most usefully, participants answered who they would most trust to offer advice on getting the vaccine, with health workers topping the poll in almost every country.


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