Vaccine Confidence Varies Widely: Q&A with Heidi Larson

child in thailand receiving vaccine
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An infant in Surin, Thailand, receives a routine vaccination during his well-child visit at the local clinic.© 2016 Eve Ostrowski, Courtesy of Photoshare

Attitudes about vaccines are primarily positive around the world, according to a new survey, but confidence in vaccines varies widely across different countries—with a surprising show of skepticism in Europe, for example.  

A new global vaccine confidence survey across 67 countries—the largest to date—asked nearly 66,000 people to share their thoughts on whether vaccines are important, safe, effective and compatible with their religious beliefs.

The new study, led by researchers from the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine, together with co-authors at Imperial College London and the Saw Swee Hock School of Public Health, National University of Singapore, will be published today in EBioMedicine.

GHN's Dayna Kerecman Myers reached out to Heidi J. Larson, director of The Vaccine Confidence Project, with a few questions about their findings, including the country whose faltering confidence surprised the authors the most, and the steps policymakers need to take most urgently to build trust.

Do you see any patterns in the countries that express low confidence in the safety, but not importance, of vaccines?
A number of factors can contribute to low confidence in safety:  1) safety scares following adverse events following immunization (although often deemed coincidental rather than caused by the vaccination, negative perceptions can persist in the population); 2) distrust in government; 3) high trust (overconfidence) in alternative medicine/ naturopathy/homeopathy

Which country’s results surprised you the most?
Although I was aware that there were trust issues and safety concerns about particular vaccines in France -- especially Hepatitis B, HPV and H1N1 vaccine--I was surprised at how much lower the confidence in safety was compared to other countries (41% disagreed that vaccines were safe, compared to the global average (12%) who disagreed that vaccines were safe.)

What steps should policymakers take most urgently to build greater public trust in vaccines?
Addressing anxieties about safety is the most urgent priority. Aside from keeping even the most basic diseases such as measles and diphtheria at bay, one day we will face a potentially highly fatal influenza pandemic, and if the world's acceptance of vaccines is as poor as it was around the 2009 H1N1 pandemic, we will be unable to contain the spread of debilitating and fatal disease.

Given the varied responses and reasons for mistrust, is there room for a global campaign on vaccine safety and efficacy or does this require country-specific efforts?
While there is a need for global standards for regulating and monitoring the safety of vaccines, country-specific efforts are needed tailored to the local concerns, which vary across and within countries.

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