Rising vaccine hesitancy needs urgent addressing

With the rollout of COVID-19 vaccines commencing over the next few months in Australia, addressing vaccine hesitancy will prove challenging for all healthcare workers. Achieving an adequate level of herd immunity and protecting those most vulnerable in the community depends not only on adequate COVID-19 vaccine supplies, but on a high level of vaccine support and uptake.

In comparison to other countries such as the USA and France, Australia is considered to have a low level of COVID-19 vaccination refusal1. In June 2020, an online survey of nearly 5000 Australians aged 18 years and over found that 4.9% would not get the COVID-19 vaccine, 9% reported an indifference to a COVID-19 vaccine and 86% said they would get a vaccine if it became available.

This survey was conducted during April 2020, when Australians were in the midst of lockdowns and the fear of serious COVID-19 outbreaks and disease was high amongst community members2.

A few months later, another online survey of Australian parents (n=2018) during June 2020 showed that 75% of respondents said they would be vaccinated against COVID-19, 17% were unsure and 8% were unwilling to get COVID-19 vaccinations1. Thus, vaccine hesitancy increased by approximately 10% during the period from April 2020 to June 2020 and this may be partially explained by the relaxation of lockdowns and the perceived lower risk of COVID-19 disease amongst the community.

Of those parents who were unsure or unwilling to accept the COVID-19 vaccine, 83% were concerned about vaccine efficacy and safety and 27% believed that vaccination against COVID-19 was unnecessary1. Research by Dror et al suggests that most safety concerns are around quality control, particularly associated with the speed of development, as well as side effects3.

These surveys showed that patients were more likely to display vaccine hesitancy if they had lower levels of education, had poor health literacy, and were younger than sixty years of age 1,2. Other research suggests that COVID-19 vaccine hesitancy is more likely amongst females, those with populist views, those who felt that COVID-19 was overstated and those who are highly religious4.

Vaccine hesitancy has been also observed amongst many health professionals, though it is less frequently observed when healthcare workers have been involved in the care of patients with COVID-193. Both health care workers and community members have expressed even greater vaccine hesitancy regarding vaccination of children3. Perhaps unsurprisingly, annual influenza vaccination is a strong predictor of acceptance of a COVID-19 vaccine3.

Effectively communicating and building trust with our patients is vital to reducing vaccine hesitancy. All health care workers should ensure they are adequately educated and able to provide support regarding COVID-19 vaccines. This is crucial so that healthcare workers are confident about these vaccines and are able to adequately address vaccine concerns5. Additionally, early public health education campaigns are an important part of the approach to reducing vaccine hesitancy as they may reduce COVID-19 vaccine fear3.

This public health information should be appropriate for people from diverse cultural and linguistic backgrounds, Indigenous populations, and those from a low health literacy or education population5. Other effective ways to reduce vaccine hesitancy include messaging delivered by trusted members of the community, such as community or religious leaders4. We must all play our part in educating and informing the general public, aiming to minimise vaccine hesitancy wherever possible.