What to Do About Vaccine Hesitancy During COVID-19

Research gives some hints for the best way to encourage vaccination.

Posted Dec 19, 2020

weyo/Adobe Stock
Source: weyo/Adobe Stock

Developing a COVID-19 vaccine in record time is a major accomplishment for the U.S. health care system. Now, as drug companies begin to distribute the vaccine across the country, public health experts must confront another challenge: convincing enough people to take it.

A systematic review conducted by British psychologists and published earlier this month combined data from 20 studies in 13 countries to find out how many people intend to get the vaccine.

In surveys conducted from June through October, the researchers learned that 60 percent of participants plan to get the COVID-19 vaccine, 20 percent plan to refuse the vaccine and 20 percent are undecided.  Women, younger people, those with a lower education level or less income, and those belonging to an ethnic minority group were all more likely to refuse the vaccine.

Interestingly, when people were surveyed earlier in the pandemic—from March to May 2020—they were more willing to be vaccinated; 79 percent planned to get the vaccine, 19 percent more than the people surveyed later in the year.

Experts aren’t sure how many people will need the vaccine to achieve herd immunity, a term that means the entire population will be protected. Achieving herd immunity depends on the specific attributes of a disease. For the measles, for example, more than 90 percent of a population must be vaccinated to achieve herd immunity. Epidemiologists estimate that between 70 and 90 percent of a population would have to be vaccinated to achieve herd immunity for COVID-19—significantly more than the 60 percent who said they plan to get the vaccine.

Luckily, public health researchers have studied the best ways to encourage people to get vaccinated. In a systematic review published in 2015, researchers examined the effectiveness of interventions that encourage people to get vaccinated.

Researchers found a mixed bag of evidence on the best ways to encourage people to get vaccinated. For children, requiring vaccines for school attendance improves vaccination rates in high-income countries, but doesn’t address the underlying issue behind vaccination reluctance and raises concerns about civil liberties. In low-income countries, these types of requirements can be a barrier to education.

The review found traditional education tools, such as information pamphlets, did little or nothing to encourage people to receive vaccines. And in one study, educational materials to refute the false claim that the MMR vaccine can lead to autism led to hesitancy among some parents who intended to vaccinate.

There is some evidence that mass media campaigns improve attitudes towards vaccines and ultimately lead to higher rates of vaccination.  But the data are not completely clear because it can be difficult to quantify the results of these types of campaigns.

The data are clear that conversations between patients and healthcare providers are the best way to promote confidence in vaccination. Making simple, fact-based educational materials available to health care providers is a key strategy to encourage these helpful conversations.

The take-home message: Millions of people across the globe are hesitant to receive a COVID-19 vaccine. In order to protect an entire population from COVID-19, public health officials will need to use evidence-based strategies to build confidence in the vaccine so that we can achieve herd immunity.

Visit Cornell University’s Bronfenbrenner Center for Translational Research’s website for more information on our work.