Context matters: How to research vaccine attitudes and uptake after the COVID-19 crisis

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ABSTRACT

The pandemic dramatically accelerated research on vaccine attitudes and uptake, a field which mobilizes researchers from the social sciences and humanities as well as biomedical and public health disciplines. The field has the potential to contribute much more, but the growth in research and the deeper connections between disciplines brings challenges as well as opportunities. This perspective article assesses the recent development of the field, exploring progress whilst emphasizing that not enough attention has been paid to national and local contexts. This lack of contextual attention limits the progress of research and hinders our capacity to learn from the COVID-19 crisis. We suggest three concrete responses: building and recognizing new publishing formats for reporting and synthesizing studies at a country level; establishing country-level interdisciplinary networks to connect research and praxis; and strengthening international comparative survey work by enhancing the focus on local contextual factors.

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Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study

Alexandre de Figueiredo, Clarissa Simas, Emilie N Karafillakis … (2020)

Summary Background There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019. Methods In this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty. Findings Between November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake. Interpretation To our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence. Funding European Commission, Wellcome, and Engineering and Physical Sciences Research Council.

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Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination

Cornelia Betsch, Philipp Schmid, Dorothee Heinemeier … (2018)

Background Monitoring the reasons why a considerable number of people do not receive recommended vaccinations allows identification of important trends over time, and designing and evaluating strategies to address vaccine hesitancy and increase vaccine uptake. Existing validated measures assessing vaccine hesitancy focus primarily on confidence in vaccines and the system that delivers them. However, empirical and theoretical work has stated that complacency (not perceiving diseases as high risk), constraints (structural and psychological barriers), calculation (engagement in extensive information searching), and aspects pertaining to collective responsibility (willingness to protect others) also play a role in explaining vaccination behavior. The objective was therefore to develop a validated measure of these 5C psychological antecedents of vaccination. Methods and findings Three cross-sectional studies were conducted. Study 1 uses factor analysis to develop an initial scale and assesses the sub-scales’ convergent, discriminant, and concurrent validity (N = 1,445, two German convenience-samples). In Study 2, a sample representative regarding age and gender for the German population (N = 1,003) completed the measure for vaccination in general and for specific vaccinations to assess the potential need for a vaccine-specific wording of items. Study 3 compared the novel scale’s performance with six existing measures of vaccine hesitancy (N = 350, US convenience-sample). As an outcome, a long (15-item) and short (5-item) 5C scale were developed as reliable and valid indicators of confidence, complacency, constraints, calculation, and collective responsibility. The 5C sub-scales correlated with relevant psychological concepts, such as attitude (confidence), perceived personal health status and invulnerability (complacency), self-control (constraints), preference for deliberation (calculation), and communal orientation (collective responsibility), among others. The new scale provided similar results when formulated in a general vs. vaccine-specific way (Study 2). In a comparison of seven measures the 5C scale was constantly among the scales that explained the highest amounts of variance in analyses predicting single vaccinations (between 20% and 40%; Study 3). The present studies are limited to the concurrent validity of the scales. Conclusions The 5C scale provides a novel tool to monitor psychological antecedents of vaccination and facilitates diagnosis, intervention design and evaluation. Its short version is suitable for field settings and regular global monitoring of relevant antecedents of vaccination.

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Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination.

Noel Brewer, Gretchen B. Chapman, Frederick X. Gibbons … (2007)

Risk perceptions are central to many health behavior theories. However, the relationship between risk perceptions and behavior, muddied by instances of inappropriate assessment and analysis, often looks weak. A meta-analysis of eligible studies assessing the bivariate association between adult vaccination and perceived likelihood, susceptibility, or severity was conducted. Thirty-four studies met inclusion criteria (N = 15,988). Risk likelihood (pooled r = .26), susceptibility (pooled r = .24), and severity (pooled r = .16) significantly predicted vaccination behavior. The risk perception-behavior relationship was larger for studies that were prospective, had higher quality risk measures, or had unskewed risk or behavior measures. The consistent relationships between risk perceptions and behavior, larger than suggested by prior meta-analyses, suggest that risk perceptions are rightly placed as core concepts in theories of health behavior. (c) 2007 APA, all rights reserved

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Journal

Journal ID (nlm-ta): Hum Vaccin Immunother

Journal ID (iso-abbrev): Hum Vaccin Immunother

Title: Human Vaccines & Immunotherapeutics

Publisher: Taylor & Francis

ISSN (Print): 2164-5515

ISSN (Electronic): 2164-554X

Publication date (Electronic, pub): 19 June 2024

Publication date (Electronic, collection): 2024

Publication date PMC-release: 19 June 2024

Volume: 20

Issue: 1

Electronic Location Identifier: 2367268

Affiliations

[a ]CERMES3 (INSERM, CNRS, EHESS, Université de Paris); , Villejuif, France

[b ]Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA); , Marseille, France

[c ]Observatoire régional de la santé PACA (ORS Paca), Aix-Marseille Université; , Marseille, France

[d ]Anthropology Department, Laval University; , Québec, Laval, Canada

[e ]Centre de Recherche du CHU de Quebec, Universite Laval; , Quebec, Laval, Canada

[f ]VaxPolLab, School of Social Sciences, University of Western Australia; , Perth, Western Australia

Author notes

CONTACT Jeremy K. Ward jeremy.ward@ 123456inserm.fr CERMES3 (INSERM, CNRS, EHESS, Université de Paris), Campus CNRS, 7, rue Guy Môquet - BP 8, Villejuif Cedex 94801, France.

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Jeremy K. Ward https://orcid.org/0000-0003-3389-6870

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Publisher ID: 2367268

DOI: 10.1080/21645515.2024.2367268

PMC ID: 11188828

SO-VID: 622c7c4f-d173-4f35-b2a9-977642918238

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This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

Context matters: How to research vaccine attitudes and uptake after the COVID-19 crisis

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Most cited references 82

Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study

Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination

Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination.

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