COVID-19 vaccine hesitancy on the rise

A recent survey from the Melbourne Institute found that, in the past four months, Australians’ willingness to get vaccinated against COVID-19 has declined substantially across all population subgroups.

According to the survey, the percentage of Australians willing to be inoculated fell from 74.4% in October 2020 to 66.2% in February 2021.

Among those unwilling to receive a COVID-19 vaccine, more than 19% are vaccine refusers. There are also those who are unsure and people who have no problem with vaccination but are apathetic, says Professor Bruce Thompson, Dean of the School of Health Sciences at Swinburne University.

“They’re the ones that we really need to get across the line because we really do need the large majority of the population to be vaccinated to keep the virus at bay, keep everything open, and, most importantly, to protect our healthcare network,” he says.

Since October, the portion of refusers has increased by 7 percentage points, while the hesitant group has increased from 13.6% to 14.4% of the population.

“Hesitancy is always a problem for any vaccination program or, in effect, for any medication,” says Thompson. “There’s always been a group of people who don’t believe in the construct of vaccination in any form. So for COVID, it’s going to be no different.”

And it’s not different in the rest of the world. In Europe, the general trend of willingness to be vaccinated is slightly on the rise, but the percentage of people keen to receive a jab falls as low as 49% in France. In Hong Kong, only 35% of the population is willing to be vaccinated. In the US, about 32% of people say they are likely or certain to refuse a COVID-19 vaccine.

“We’ve never had this level of media scrutiny for any medication,” Thompson says. “This is sort of a reality TV on a global scale in pharmaceutical manufacturing, design and treatment of pandemics.”

Thompson says it’s completely understandable that people have concerns, but hesitancy is a rate-limiting step we need to address.

Some countries, such as the UK, are trialling “vaccine passports”. Israel has recently released a “green pass” for citizens to show whether they have been fully inoculated against COVID-19. Green pass holders get exclusive access to gyms, hotels, theatres, and concerts.

While restricting people’s activity with vaccine passports might push a few over the line, it raises ethical questions around leaving people to freely make their personal choice.

“It is hard,” says Thompson, “but we really need to vaccinate people and do whatever it takes to address people’s concerns.”

Israel, where more than half of the population is already fully immunised, has had to combat widespread scepticism, especially among ultra-orthodox Jewish communities.

When Israel was hit by the pandemic, the virus spread fast in these devout communities. Many ignored restrictions against congregating and kept meeting in large numbers for prayer.

To fight vaccine hesitancy among such groups, the Israeli health minister hired an ultra-orthodox PR consultant who facilitated the vaccine discussion with rabbis. These religious leaders have the most influence on their followers.

In a recent report published in The Lancet, researchers propose a bottom-up approach to achieve meaningful engagement with diverse communities in COVID-19 vaccine uptake.

The authors claim that a successful vaccine roll-out can only be achieved by ensuring effective community engagement. This includes overcoming cultural, socioeconomic, and political barriers, establishing trust with communities and building effective communication and public health messaging.

“What you need to do is get down to a micro-level,” says Thompson. “The community don’t necessarily listen to the prime minister or the health minister, or the people that sit on television. They listen to the leader of their local football club.”

“It’s really important to get the community on fire, to get community leaders to help advocate and get the message across,” he says. “But if we went down a vaccination passport pathway that’s going to help as well.”

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