The Barrier to Vaccination Is Not Vaccine Hesitancy: Patterns of COVID-19 Vaccine Acceptance over the Course of the Pandemic in 23 Countries

  1. Ammina Kothari
  2. Gerit Pfuhl
  3. David Schieferdecker
  4. Casey Taggart Harris
  5. Caitlin Tidwell
  6. Kevin M Fitzpatrick
  7. Stephanie Godleski
  8. Saurabh Sanjay

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Abstract

Background

At present, evidence is inconclusive regarding what factors influence vaccine intent, and whether there are widespread disparities across populations and time. The current study provides new insights regarding vaccine intent and potential differences across 23 countries and over time.

Methods

Our data come from a unique longitudinal survey that contains responses from Facebook users (N=1,425,172) from the 23 countries from four continents collected in 18 waves from July 2020 through March 2021.

Results

We find that vaccine intent varies significantly across countries and over time. Across countries, there are notable disparities in intent to vaccinate. Regarding time, intent has recently reached an all-time high. Our data demonstrates that intent to vaccinate has increased as countries have deployed vaccines on larger scales with undecidedness declining. However, there are some countries where vaccine intent is stagnant and in one country – Egypt – where it seems to have declined.

Interpretations

Large numbers of citizens across the world are willing to get vaccinated. In the vast majority of countries in our sample, these were high enough to reach more conservative levels of herd immunity 1 if combined with numbers of persons already infected. As such, the main barrier to vaccination is not vaccine hesitancy, but the shortage of vaccines. This sends a clear message to politicians who need to work on a quick and fair distribution of vaccine; and to scientists who need to focus their attention on understanding remaining pockets of vaccine skepticism or undecidedness and on factors that explain actual vaccine behavior, rather than intent.

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  1. ScreenIT

    SciScore for 10.1101/2021.04.23.21253857: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.04.23.21253857v1 on medRxiv