The first findings from a new Vaccine Confidence Index reveals wide variations in vaccine hesitancy and refusals in five countries. Surveys found parents in the UK had the highest rates of hesitancy at 24.5%, while Georgia had the highest percentage of hesitants who refuse vaccination (60%), according to the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine. Other countries surveyed were India, Pakistan and Nigeria.
Following a March 26 presentation on The State of Vaccine Confidence 2015 at the Consortium of Universities for Global Health conference in Boston, Global Health NOW had a few questions for project director Heidi J. Larson, PhD.
What’s the most important finding from the report?
The most important finding I think is our highest rate of hesitancy was in a highly educated, well-off country—the UK. And at the other end of the spectrum, the highest percentage of the refusers was in Kano State in Nigeria where 74% of the hesitant refused.
The good news is overall confidence is high, but there is this slice of refusers.
The other thing we found was how much confidence in immunization services correspond with vaccine hesitancy. High confidence in the system [results in] low refusal, and low confidence in the system in higher hesitancy. I would say the message to countries is if you keep a good, public-friendly service that delivers vaccines when you say you are going to deliver them and do it in way people feel welcome, you are going to reduce your hesitancy
Why do we need a vaccine confidence index?
I think we need an index because we want to monitor it over time. This is something that may look small one day, and it just may grow in very small increments but we need to understand if it’s becoming a bigger or small issuer. If it’s getting bigger, it can lead to pockets of refusals and that can be a problem for herd immunity.
Any similarities between vaccine hesitancy and refusals in developed and developing countries?
Ironically we find that hesitation is highest of these five countries in the UK but the refusals were lower. The UK had nearly 25% say they hesitate at some point and 27% [of them] ultimately refused.
This is just the first five countries of what is going to be a global rollout. I think if I had to answer that question based on our broader work and systematic reviews, I would say you cannot group countries according to rich to poor because you have some poorer countries more enthused about vaccines. And Europe is a real problem. They are kind of reasonably high but not high enough they hang there between 75 and 85 and barely 90, and they are not getting higher than that.
—Brian W. Simpson