Vaccine hesitancy in the era of COVID-19: could lessons from the past help in divining the future?

Abstract

Vaccine hesitancy, which embodies the unwillingness to receive vaccines when vaccination services are available and accessible, is one of the greatest threats to global health. Although vaccine hesitancy has existed among a small percentage of people for centuries, its harmful effects are likely to be more pronounced during the COVID-19 pandemic than ever before. COVID-19 vaccine hesitancy will pose substantial risks for both people who delay or refuse to be vaccinated and the wider community. It will make communities unable to reach thresholds of coverage necessary for herd immunity against COVID-19, thus unnecessarily perpetuating the pandemic and resulting in untold suffering and deaths. Vaccine hesitancy is pervasive, misinformed, contagious, and is not limited to COVID-19 vaccination. Our work shows that vaccine hesitancy is a complex and dynamic social process that reflects multiple webs of influence, meaning, and logic. People's vaccination views and practices usually comprise an ongoing engagement that is contingent on unfolding personal and social circumstances, which can potentially change over time. Therefore, as COVID-19 vaccination rolls out globally, scientists and decision-makers need to investigate the scale and determinants of vaccine hesitancy in each setting; so that tailored and targeted strategies can be developed to address it.

Health Communication in COVID-19 Era: Experiences from the Italian VaccinarSì Network Websites

“…In this context, recently published protocols [ 13 , 14 , 15 , 19 , 20 , 22 , 23 ] and systematic literature reviews describe the importance of e-Health applied to certain healthcare contexts [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. In particular, these describe how the use of online channels, instant messaging (SMS) or Short-Messages sent via apps to communicate with patients can—(i) facilitate user participation by increasing the attendance rate for health appointments [ 13 ]; (ii) tackle the misinformation prevailing on the web; (iii) improve therapeutic compliance [ 27 , 28 , 29 , 30 , 31 ]; and (iv) provide remote psychological support in patients with particular clinical conditions [ 31 , 32 ]. Conversely, digital communication tools in Public Health can act as a channel for incorrect and misleading information [ 36 , 37 , 38 , 39 ].…”

“…In this context, the use of e-health by health institutions to counter the phenomenon of Vaccine Hesitancy and to facilitate access to services has acted as an opportunity to educate citizens towards informed and conscious health decisions [ 31 , 32 , 33 , 34 ].…”

Awareness and Acceptance of COVID-19 Vaccines among Pharmacy Students in Zambia: The Implications for Addressing Vaccine Hesitancy

“…We have seen vaccine hesitancy, de ned as 'delay in acceptance or refusal of vaccination despite the availability of vaccination services in other situations across countries (50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63). Similar variable hesitancy rates have been reported regarding the acceptance of the COVID-19 vaccine (46,(63)(64)(65)(66). In his systematic review, Sallam (2021) found low acceptance rates in Kuwait (23.6%) and Jordan (28.4%) versus appreciably higher acceptance rates in China (91.3%), Indonesia (93.3%) and Malaysia (94.3%) (66).…”

Coronavirus disease 2019 (COVID-19) vaccination in systemic lupus erythematosus and anti-neutrophil cytoplasmic antibody-associated vasculitis

“…Such barriers may persist and prevent uptake of the COVID-19 vaccination among patients with SLE and AAV. Other authors have similarly highlighted that past experience with other vaccines in identifying individual-level determinants of vaccine hesitancy (known as the 5C model of drivers of vaccine hesitancy, namely confidence, complacency, convenience or constraints, calculation of risk, and collective responsibility) can help focus research into COVID-19 vaccine acceptance or hesitancy and tailor strategies to address their concerns [10]. In the meantime, we eagerly anticipate more information regarding the effectiveness and safety of COVID-19 vaccination in individuals with SLE and AAV on various immunosuppressive therapies to allow physicians and patients alike to make informed decisions about COVID-19 vaccination.…”