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Global Declines in Vaccine Confidence from 2015 to 2022: A Large-Scale Retrospective Analysis
23 Pages Posted: 8 May 2023More...
The latest WHO/UNICEF estimates of national childhood immunisation coverage have revealed the largest declines in routine immunisation uptake globally in three decades. Although the COVID-19 pandemic has contributed to these falls via supply-side disruptions impacting vaccine availability, the extent to which the COVID-19 pandemic has impacted demand-side barriers, such as vaccine confidence, is not yet well understood. Through a large-scale retrospective modelling study, we investigate the extent to which vaccine confidence has changed globally using pre- and post-pandemic data. A total of 165,729 individual interviews across 55 countries as part of nationally representative surveys were conducted between 2015 and 2022. Vaccine confidence is measured using three items that probe perceptions towards the importance, safety, and effectiveness of vaccines. Changes in national-level confidence are evaluated for the sampled populations and within age and sex subgroups via nonparametric tests and a Bonferroni correction is used to adjust study-wide p-values to account for multiple hypotheses. Since the pandemic, perceptions towards the importance of vaccines for children have seen significant decreases in 46 of 55 countries studied, with significant increases found only in China, India, and Mexico. Vaccines are perceived to be less safe in 24 countries, less effective in 28, with only four countries reporting increases in confidence around vaccine safety and five for effectiveness. Among demographic subgroups, a widening gap between older and younger groups is found, with younger groups becoming less confident over time. Declining global confidence in vaccines, particularly among younger age groups, may be contributing to the backslide in routine childhood immunisation uptake. Growing hesitancy among younger age groups should be investigated as a public health priority to better understand confidence among parents.
Funding: Data in this study was funded by the European Commission, Africa CDC, UNICEF, and AIR@InnoHK administered by the Innovation and Technology Commission.
Declaration of Interest: Within the last two years, HJL was involved in collaborative grants with GlaxoSmithKline, Merck and Johnson & Johnson. HJL has also received other support for participating in Merck meetings and GlaxoSmithKline advisory round tables. Within the last two years, AdF has been funded by the Merck Investigator Studies Program and has performed consultancy work for Pfizer Inc. Within the last two years, LL has been funded by the Merck Investigator Studies Program, GlaxoSmithKline, and Vaccine Confidence Fund, sponsored by Merck and Meta. MISSING AUTHORS
Ethical Approval: All data used in this study is fully in the public domain at https://www.vaccineconfidence.org/vci/data-and-methodology/.
Keywords: Vaccine confidence, vaccine hesitancy, determinants of health, COVID-19, vaccine confidence age-gap
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