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Largest global vaccine confidence survey shows hesitancy hotspots: The Lancet

Several countries experiencing political instability and religious extremism are witnessing growing scepticism around safety of vaccines due to misinformation online.

By: Express News Service | Pune | September 11, 2020 4:30:59 am
Coronavirus vaccine, Oxford University, AstraZeneca, Indian express newsOn September 12, the UK’s Medicines and Healthcare Regulatory Agency certified it safe, after a review by an independent committee. (Representational)

Public confidence in vaccines varies widely between countries and regions around the world, with signs that trust may be improving in parts of Europe. Several countries experiencing political instability and religious extremism, however, are witnessing growing scepticism around safety of vaccines due to misinformation online, in turn threatening vaccination programmes worldwide.

The new research mapping global trends in vaccine confidence across 149 countries between 2015 and 2019, published in The Lancet, is based on data from over 2,84,000 adults (aged 18 years and above) about their views on whether vaccines are important, safe, and effective.

There are signs that public trust in vaccine safety is increasing in the European Union, particularly in Finland, France, Italy, and Ireland as well as in the UK. In contrast, in six countries globally significant increases were noted in the proportion of survey respondents strongly disagreeing vaccines are safe. This includes Azerbaijan (2 per cent of those surveyed strongly disagreeing vaccines are safe in 2015 rising to 17 per cent in 2019), Afghanistan (2 per cent to 3 per cent), Indonesia (1 per cent to 3 per cent), Nigeria (1 per cent to 2 per cent), Pakistan (2 per cent to 4 per cent), and Serbia (4 per cent to 7 per cent) — mirroring trends in political instability and religious extremism.

The analysis suggests that overall confidence in vaccines, including safety, effectiveness and importance, fell in Indonesia, Philippines, Pakistan, and South Korea between November 2015 and December 2019. For example, risks of a dengue vaccine (Dengvaxia) in the Philippines in 2017 led to a dramatic drop in public confidence on vaccine safety. This impacted the uptake of routine vaccines, causing the country to drop out of the top 10 countries with highest overall vaccine confidence in 2015 (82 per cent of those surveyed strongly agreeing that vaccines safe, 92 per cent important, 81 per cent effective) to ranking no higher than 70th in 2019 (58 per cent strongly agreeing vaccines are safe, 70 per cent important, 57 per cent effective).

In South Korea, online mobilisation efforts against childhood immunisation by communities such as ANAKI (Korean abbreviation of “raising children without medication”), have been identified as a key barrier to vaccination.

Public trust in immunisation is an increasingly important global health issue, with World Health Organization declaring vaccine hesitancy as one of the top 10 threats to global health in 2019. Declining confidence can result in delays or refusals, which is contributing to a rising number of vaccine preventable disease outbreaks, including measles, polio and meningitis, worldwide.

“It is vital, with new and emerging disease threats such as the Covid-19 pandemic, that we regularly monitor public attitudes to quickly identify countries and groups with declining confidence, so we can help guide where we need to build trust to optimise uptake of new life-saving vaccines,” said Professor Heidi Larson from London School of Hygiene & Tropical Medicine, UK, who led the research.

In this study, researchers analysed data from 290 nationally representative surveys conducted between September 2015 and December 2019 — combining previously published data from nearly 2,50,000 survey responses with 50,000 additional interviews from 2019. Modelling was used to estimate trends in public perceptions about safety and effectiveness of vaccines, and the importance of vaccinating children.

Indonesia has witnessed one of the largest falls in public trust worldwide between 2015 and 2019 (absolute difference in perception of safety fell by 14 per cent, importance by 15 per cent, effectiveness by 12 per cent).

In 2019, Iraq (95 per cent), Liberia (93 per cent) and Senegal (92 per cent) had the highest proportion of respondents agreeing that it is important for children to be vaccinated, while Hong Kong (36 per cent), Russia (34 per cent), and Albania (26 per cent) reported the lowest proportion strongly agreeing on the importance of vaccines.

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