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Abstract

There can be no question that the COVID-19 pandemic has wrought devastation on the lives of billions of people, yet the high casualty rates are as much ideological and psychosocial phenomena as biological. Vaccines are front and centre of the effort to control the COVID-19 pandemic, an effort that has often been thwarted by political incompetence and failed leadership. The determinants of vaccine hesitancy exist within the microsocial and macrosocial systems. Traditional accounts of vaccination hesitancy focus on individuals within a microsocial system that makes individuals responsible for vaccine non-acceptance, yet macrosocial factors and neoliberal ideology strongly affect vaccine availability and are generally ignored. Politicization, dissemination of conspiracy beliefs, safety fears, mounting generalized distrust of science, medicine, the pharmaceutical industry and governmental authorities are all involved. To build preparedness for future pandemics, remedial efforts are necessary to restore generalized trust in science, political structures and governmental systems. In these spheres, transparency, open discussion and debate are necessary foundation stones.