Bruno Lage, then manager of Wolverhampton Wanderers Football Club, receives the coronavirus vaccination in December 2021.Credit: Jack Thomas – WWFC/Wolves via Getty
Although some people were initially reluctant to get vaccinated against COVID-19 during the pandemic, many eventually got at least one dose, according to a study of more than 1 million people in the United Kingdom.1.
The researchers used data from the REACT study, which tracked the spread of SARS-CoV-2 in England and collected data on demographics, health and behavior 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 analyzed records from 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, nearly 38,000 people reported some form of vaccine hesitancy, a rate of 3.3%. Frequency rates peaked at 8% in early 2021, then bottomed at 1.1% at the start of 2022, before recovering to 2.2%. But 65% of those who were initially hesitant went on to get one or more vaccinations later.
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Mark Shadow Hyam, a computational epidemiologist at Imperial College London who led the study, which was published in the journal The scalpel On Monday, he says reasons for hesitancy can be grouped into eight broad groups, including concerns about the vaccine’s effectiveness and side effects, difficulties traveling to vaccination sites, lack of trust in vaccine makers and personal health concerns.
“What we have identified here could help improve vaccination adherence more quickly if we target the right people,” he says.
Address concerns
The most common reasons for vaccine hesitancy related to vaccine efficacy and health concerns, and people who reported these concerns were the most likely to continue vaccination. But “some difficult reasons, such as those related to a lack of confidence in medicine, are difficult to overcome,” says Shadow Hyam.
The study found that hesitancy – and consistent failure to get vaccinated – was more common in people living in economically deprived areas, the unemployed, and those with a low level of education. Women were also more likely to be hesitant than men, but were less likely to remain unhesitant after expressing hesitation, perhaps because some of the reasons for their hesitation, such as pregnancy or breastfeeding, were time-limited.
Shadow Hyam hopes the findings will help deploy future vaccines, by focusing efforts on people whose hesitancy is rooted in tangible fears that can be allayed with the right information.
But Noni MacDonald, a specialist in pediatric infectious diseases at Dalhousie University in Halifax, Canada, doubts that the results of this study will be of much use outside the context of a pandemic. “It’s a great study done on an amazing data set, but it’s also very context specific, which is not very relevant now,” she says.