COVID vaccines are a safe way to reduce the chance that SARS-CoV-2 will put you in the hospital and are an important part of the public health campaign against the pandemic. Yet in the United States, there is much controversy and outright anger over efforts to expand vaccine use, and a significant portion of the population appears to be avoiding vaccinations. For political reasons.
The extreme polarization of American politics has not gone away, and the controversy is evident New in the minds of some politicians, so it is easy to expect that vaccine hesitancy will not go away. But an international survey of covid vaccine attitudes suggests that the US has seen a big boost in covid vaccine adoption and now has similar attitudes to other western democracies. Elsewhere in the world, the survey reveals clear regional patterns in vaccine uptake, although there are differences everywhere.
In 2020, the survey began as a series of questions about whether people would want to receive vaccines once they became available. In the intervening years, survey takers have added more countries (now up to 23) and changed the questions to account for vaccine availability, the addition of boosters and the development of treatments for Covid-19. The survey involved 1,000 participants in all 23 countries, generally reflecting the country’s population.
The survey focuses on so-called vaccine hesitancy, which is defined as not wanting to get a dose if or when a dose is available. Questions about boosters took the same form, but were specific to those who had already received the vaccines.
Overall, the news is good. Globally, average vaccine hesitancy has decreased with each survey edition and is now more than 20 percent. That’s right where America finds itself right now, with less than 20 percent indicating they didn’t get the first shot. (This appears similar to the percentage who have had at least one shot calculated from CDC data.)
This makes the United States more typical of its peer group of Western democracies, which are in the 15-20 percent vaccine-hesitancy range. Spain is on the low side at 10 percent reluctance, but rates rise as you move eastward across Europe, with Sweden and Germany above 20 percent. Poland has the highest rate of reluctance among European democracies, at 36 percent, perhaps influenced by neighboring Russia, where reluctance approaches 40 percent. The U.S. is now typical of this group, with a nearly 20 percent increase in those reported to have been vaccinated in the past year alone.
There is no clear pattern when it comes to boosters. France, where vaccine reluctance was less than 20 percent, saw booster reluctance at more than 25 percent, while Germany saw booster reluctance at just 11 percent. So, although local factors seem to be more important here, it is clear that any message that works for vaccinees cannot automatically be expected to trickle down to boosters.
Spread across the globe
The rest of the world is relatively underrepresented, and countries within it often highlight the exceptions. For example, in South American countries (Brazil, Ecuador and Peru) vaccine reluctance is around 10 percent, while further north in Mexico, reluctance more than doubles to 26 percent. Acceptance was highest in East and South Asia (from 11 percent reluctance in South Korea to less than 2 percent in India), whereas it was much lower in African countries, with Nigeria, at almost 30 percent reluctance.
Notably, South Africa saw a 20 percent drop in vaccine uptake—the largest in the survey—and more than half of its population now expresses vaccine reluctance. South Korea is also unusual in that, despite high vaccine acceptance, 27 percent of participants report hesitation about boosters, second only to Russia.
It is important to note that in many countries with low GDP, people still answer the question without the option to be vaccinated. More equitable vaccine access may allow more people in these countries to receive vaccines despite their reluctance. Elsewhere, other research has identified vaccine misinformation, low education levels, and mistrust of science and government as factors driving reluctance.
Medical education appears to be particularly effective in vaccine acceptance, with only 4.6 percent of health care workers expressing reluctance—and that number is still falling.
Another thing that comes up with familiarity is parents’ willingness to vaccinate their children. Globally, this has risen slightly and is now approximately 70 percent.
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