Vaccine hesitancy in the COVID-era

As we approach the one-year anniversary of the start of the COVID-19 pandemic, candidates for a potential vaccine have been making global headlines. Pfzier‘s BNT162b2 and Moderna‘s mRNA-1273 in particular are showing encouraging effectiveness rates of +90% in providing protection against the virus in clinical trials. Today, the UK Government will begin vaccinating Britons with Pfzier’s vaccine who are part of high priority groups such as adults aged 80+, adults in care homes and frontline health care workers. Until more of the groups have been vaccinated, it is important that we all continue to follow government guidelines, social distance, and wear masks.

These past weeks leading up to the vaccine rollout, I had several conversations with people who tried to convince me that COVID-19 is “a hoax” and that they would not be taking the vaccine when it becomes available to them. These conversations inspired me to look deeper into what health experts are calling the next challenge in the fight against COVID-19: Vaccine hesitancy.

Vaccine hesitancy: where did it come from?

Vaccine hesitancy is defined as the refusal, delay or acceptance of doubts concerning the safety and usefulness of vaccines. Vaccines have been called one of the most important innovations in the history of medicine. However, vaccination rates have declined all across the world. This shift in attitudes towards vaccines is commonly attributed to an article published in The Lancet by Andrew Wakefield (1998), who proclaimed a false link between the MMR vaccination and onset of autism spectrum disorder. Wakefield was consequently struck off the medical register and is now an avid campaigner for anti-vaccine movements in the US.

From our UCL-Penn Global Covid Study (see webinar), we investigated vaccine hesitancy too. Over 65% of our participants were likely/very likely to take the vaccine, but the remaining 35% were either unsure or unlikely/very unlikely to take the COVID vaccine.

Findings presented at the Wharton Club & Penn Club UK webinar on 3 December. Slides available for download and detailed reading here:

Why is this the case?

Our participants tell us that some are ‘unsure’ because it’s a bigger issue regarding vaccines in general, they don’t know whether it will work. Participants talk about vaccination going against their core beliefs and won’t need it if they are healthy. In a smaller group, some participants tell us they don’t really need it because they are not at-risk, there is a lot of talk about distrust in the government on vaccine development, and a general hesitancy towards injecting something that we don’t yet know much about was also a common consensus. As with the majority who are likely/very likely to get vaccinated, themes of gauranteeing freedom of travel and interaction with loved ones was very common, the belief in science and the rigorous development process, as well as public health as a common good, doing the right thing to control the virus and keeping everyone else safe.

What causes vaccine hesitancy?

Three factors have been globally identified to cause vaccine hesitancy: confidence, complacency (seeing vaccines as not useful), and convenience (seeing too many barriers to access health or vaccination services). The particular factor of confidence has been suggested to depend on an individual’s confidence in:

  • Health care professionals
  • The health care system
  • Science
  • The social-political context

The Global Vaccine Confidence Index study (2015) surveyed participants from Nigeria, the UK, India, Pakistan and Georgia (US). The researchers found a medium-to-high confidence rate in vaccines and immunisation programs, and vaccine hesitancy was relatively rare. However, the researchers also found a minority of individuals who were vaccine hesitant in each country. The researchers concluded that even small groups of hesitant individuals can severely undermine immunisation programs in health emergencies.

In addition, researchers have identified the popularity of anti-vaccine conspiracy theories as a factor that promotes vaccine hesitancy. In a 2014 study, British parents completed questionnaires measuring the strength of their beliefs in anti-vaccine conspiracy theories and the likelihood that they would vaccinate a fictional child. The researchers found that the stronger the beliefs, the less likely the parents would vaccinate the fictitious child. This relationship was influenced by the parents’ perceived dangers of vaccines, feelings of powerlessness, and mistrust in authorities.

How can we reduce vaccine hesitancy?

A 2020 study analysed over 1900 anonymous questionnaires about willingness to take prospective COVID-19 vaccine(s). COVID healthcare workers and individuals who consider themselves to be more vulnerable to contracting the virus were more likely to report taking the vaccine compared to healthcare workers and individuals who were not responsible for the care of individuals with COVID-19.

Research has identified ways on how to improve attitudes towards vaccination including persuasion using expert sources and emphasising getting vaccinated is something you should do to protect yourself and others.

Want to learn more?

Vaccines & Other Findings: Global COVID Study Wave 1 & 2 (Wharton x Penn Club Webinar). Presentation slides can be accessed via UCL’s data repository DOI: 10.5522/04/13333568 or by emailing the author (

This post was co-written by Ms. Kyleigh Melville (@MelvilleKyleigh), an MEd Psychology and Education student at the University of Cambridge, and Dr. Keri Wong (@DrKeriWong).

What are your thoughts on the COVID-19 vaccines? What evidence would you need to get vaccinated? Did you learn anything new about vaccines? Get in touch at or tag us on @GlobalC19Study (Twitter) and GlobalC19Study (Instagram). We’d love to hear from you!


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