Bruno Lage, then-manager of the football team Wolverhampton Wanderers, receives his COVID-19 vaccination in December 2021.Credit: Jack Thomas – WWFC/Wolves via Getty
Although some people were initially hesitant to be vaccinated against COVID-19 during the pandemic, many did eventually go on to get at least one dose, according to a study of more than one million people in the United Kingdom1.
Researchers used data from the REACT study, which tracked the prevalence of SARS-CoV-2 in England and collected data on demographics, health and behaviour during the first two years of the pandemic. The authors linked the information to subsequent vaccine uptake using participants’ National Health Service (NHS) records. They analysed the records of 1.1 million people sampled between January 2021, when questions about vaccination status and attitudes were added to the survey, and March 2022.
Over the course of the study, almost 38,000 people reported some form of vaccine hesitancy, a rate of 3.3%. Rates of hesitancy peaked at 8% in early 2021 and hit a low of 1.1% at the start of 2022, before rebounding to 2.2%. But 65% of those who were initially hesitant went on to get one or more vaccinations later.
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Marc Chadeau-Hyam, a computational epidemiologist at Imperial College London who led the study, which was published in The Lancet on Monday, says the reasons for hesitancy could be grouped into eight broad clusters, including concerns about the vaccine’s efficacy and side effects, difficulties with travelling to vaccination sites, lack of trust in vaccine makers and personal health concerns.
“What we’ve identified here could help improve adherence to vaccination quicker if we target the right people,” he says.
Addressing concerns
The most common reasons for vaccine hesitancy related to vaccine efficacy and health concerns, and people who reported those worries were most likely to go on to get vaccinated. But “some of the stickier reasons, such as those related to a lack of trust in medicine, are more difficult to overcome”, says Chadeau-Hyam.
The study found that hesitancy — and persistent failure to get vaccinated — was more common in people living in economically deprived areas, those who were unemployed and those with a low level of education. Women were also more likely to be hesitant than men, but less likely to remain unvaccinated after expressing hesitancy, perhaps because some of their reasons for hesitancy, such as being pregnant or breastfeeding, were time-limited.
Chadeau-Hyam hopes the results will help with the roll-out of future vaccines, by focusing efforts on people whose hesitancy is rooted in concrete concerns that can be allayed with the right information.
But Noni MacDonald, a paediatric infectious-disease specialist at Dalhousie University in Halifax, Canada, doubts that the results of this study will be much use outside the context of a pandemic. “It’s a beautifully done study on an incredible data set, but it is also a very specific context that is not so relevant now,” she says.
