Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA

Abstract

he spread of SARS-CoV-2, the causative agent of COVID-19, has resulted in an unprecedented global public health and economic crisis 1,2. The outbreak was declared a pandemic by the World Health Organization on 11 March 2020 3 , and development of COVID-19 vaccines has been a major undertaking in fighting the disease. As of December 2020, many candidate vaccines have been shown to be safe and effective at generating an immune response 4-6 , with interim analysis of phase III trials suggesting efficacies as high as 95% 7-9. At least two vaccine candidates have been authorized for emergency use in the USA 10,11 , the UK 12,13 , the European Union 14 and elsewhere, with more candidates expected to follow soon. For these COVID-19 vaccines to be successful, they need to be not only be proven safe and efficacious, but also widely accepted. It is estimated that a novel COVID-19 vaccine will need to be accepted by at least 55% of the population to provide herd immunity, with estimates reaching as high as 85% depending on country and infection rate 15,16. Reaching these required vaccination levels should not be assumed given well-documented evidence of vaccine hesitancy across the world 17 , which is often fuelled by online and offline misinformation surrounding the importance, safety or effectiveness of vaccines 18-20. There has been widely circulating false information about the pandemic on social media platforms, such as that 5G mobile networks are linked with the virus, that vaccine trial participants have died after taking a candidate COVID-19 vaccine, and that the pandemic is a conspiracy or a bioweapon 21-23. Such information can build on pre-existing fears, seeding doubt and cynicism over new vaccines, and threatens to limit public uptake of COVID-19 vaccines. While large-scale vaccine rejection threatens herd immunity goals, large-scale acceptance with local vaccine rejection can also have negative consequences for community (herd) immunity, as clustering of non-vaccinators can disproportionately increase the needed percentage of vaccination coverage to achieve herd immunity in adjacent geographical regions and encourage epidemic spread 24. Estimates of acceptance of a COVID-19 vaccine in June 2020 suggest that 38% of the public surveyed in the UK and 34.2% of the public in the USA would accept a COVID-19 vaccine (a further 31% and 25% were, respectively, unsure that they would accept vaccination against COVID-19) 25. Worryingly, more recent polling in the USA (September 2020) has shown significant falls in willingness to accept a COVID-19 among both males and females, all age groups, all ethnicities and all major political groups 26 , possibly due to the heavy politicization of COVID-19 vaccination in the run up to the 2020 presidential election on both sides of the political debate 27,28. The public's willingness to accept a vaccine is therefore not static; it is highly responsive to current information and sentiment around a COVID-19 vaccine, as well as the state of the epidemic and perceived risk of contractin...

Racial and ethnic differences in COVID-19 vaccine hesitancy and uptake

“…A recent study of U.K. HCWs showed substantially lower vaccine uptake among racial and ethnic minorities. 34 Our results significantly extend these data by concurrently examining vaccine hesitancy and receipt within the same participants from sizable community-based samples in two countries. Importantly, we found that even among the U.S. vaccine-willing population, Black individuals were less likely to receive a vaccine, whereas in the U.K., no consistent disparities in vaccine uptake were observed.…”

“…Our findings of greater vaccine hesitancy among minority populations has been previously shown in smaller, more limited investigations. 32 Deep-rooted and ongoing mistrust of the medical system among people of color 33 and a lack of diverse representation in clinical trials 34 likely play a substantial role in explaining this hesitancy. The speed with which vaccines were approved has raised suspicions over whether regulatory standards meant to protect vulnerable populations were relaxed for expediency.…”

Gender differences in the determinants of willingness to get the COVID-19 vaccine among the working-age population in Japan

“…15 Our study was conducted in December 2020, right after the start of the COVID-19 vaccination program in the UK and the US, and the media coverage of adverse effects was exaggerated. 34,35 Another reason is that people of working age have been found to be less willing to get the COVID-19 vaccine compared with older adults, 19 which would affect the present results. These findings have important implications for vaccination intentions, although vaccination acceptance may change after the vaccine is available for administration among the working-age population.…”

Effect of information about COVID-19 vaccine effectiveness and side effects on behavioural intentions: two online experiments

“…Palm et al (2021) find that messages highlighting vaccine efficacy and safety had a marginally significant effect on vaccine intentions relative to a control group, while an opposite message claiming planned vaccines were neither effective nor safe had no main effect on intentions. Conversely, in a pre-post design experiment Loomba et al (2021) report that exposure to a range of factual information about potential COVID-19 vaccines has no effect on vaccine intentions, while COVID-19 vaccine misinformation decreases vaccination intentions. Duquette (2020) reports that short messages framing vaccination as protecting either oneself or others have no effect on reported vaccination intentions (but notes that there are some experimental effects among non-white participants).…”