Measuring Vaccine Confidence: Introducing a Global Vaccine Confidence Index

Abstract

Background. Public confidence in vaccination is vital to the success of immunisation programmes worldwide. Understanding the dynamics of vaccine confidence is therefore of great importance for global public health. Few published studies permit global comparisons of vaccination sentiments and behaviours against a common metric. This article presents the findings of a multi-country survey of confidence in vaccines and immunisation programmes in Georgia, India, Nigeria, Pakistan, and the United Kingdom (UK) – these being the first results of a larger project to map vaccine confidence globally. Methods. Data were collected from a sample of the general population and from those with children under 5 years old against a core set of confidence questions. All surveys were conducted in the relevant local-language in Georgia, India, Nigeria, Pakistan, and the UK. We examine confidence in immunisation programmes as compared to confidence in other government health services, the relationships between confidence in the system and levels of vaccine hesitancy, reasons for vaccine hesitancy, ultimate vaccination decisions, and their variation based on country contexts and demographic factors. Results. The numbers of respondents by country were: Georgia (n=1000); India (n=1259); Pakistan (n=2609); UK (n=2055); Nigerian households (n=12554); and Nigerian health providers (n=1272). The UK respondents with children under five years of age were more likely to hesitate to vaccinate, compared to other countries. Confidence in immunisation programmes was more closely associated with confidence in the broader health system in the UK (Spearman’s ρ=0.5990), compared to Nigeria (ρ=0.5477), Pakistan (ρ=0.4491), and India (ρ=0.4240), all of which ranked confidence in immunisation programmes higher than confidence in the broader health system. Georgia had the highest rate of vaccine refusals (6 %) among those who reported initial hesitation. In all other countries surveyed most respondents who reported hesitating to vaccinate went on to receive the vaccine except in Kano state, Nigeria, where the percentage of those who ultimately refused vaccination after initially hesitating was as high as 76%) Reported reasons for hesitancy in all countries were classified under the domains of “confidence,” “convenience,” or “complacency,” and confidence issues were found to be the primary driver of hesitancy in all countries surveyed.

Determinants of trust in the flu vaccine for African Americans and Whites

“…Individual and group influences include personal perceptions, beliefs, and attitudes related to vaccines as well as the influence of one’s peer environment. Vaccine influences include aspects specific to an individual vaccine including modes of administration, costs, and vaccination schedule (Larson et al, 2015). As such, we recognized the need to explore a wide range of potential predictors for trust.…”

Acceptation, refus et hésitation à la vaccination au Canada : défis et approches proposées

“…L'hésitation à la vaccination est une question importante qui doit être examinée afin de maintenir une couverture vaccinale élevée et uniforme dans l'ensemble du pays et de réduire l'incidence des maladies évitables par la vaccination et leurs conséquences. (63) 2 La plupart des stratégies s'appliquent à tous les groupes 3 Les spécialistes de certains pays offrent des cliniques pour les enfants qui ont présenté des événements indésirables après la vaccination (66) …”

“…Cet article décrit l'étendue et les causes de l'hésitation à la vaccination au Canada et propose des démarches possibles pour l'aborder. 3 Université Western, London (Ontario) 4 Centre de contrôle des maladies de la Colombie-Britannique, Vancouver (Colombie-Britannique)…”

An injection of confidence

“…One such factor was a deep historical distrust of Western powers by some Muslim populations. Another was political interests and tension between the northern Islamic regions of the country and the central government [3].…”

“…There has always been opposition to vaccination, and there have always been crises that have put vaccination programs at risk. But crises have been overcome; MMR vaccination rates are back to normal in the UK, and polio vaccination has returned to India and Nigeria [3]. There is still a lot to be done, but the health community can learn from these experiences-about the importance of transparency, about the central role of health providers in building confidence, and the importance of listening and responding to the need of specific societal groups.…”