A report in Nature Medicine was based on data collected in the previously validated COVID-SCORE survey of a sample of more than 13,400 respondents from 19 countries that have been hard-hit by the virus. Results indicate that 72% of participants would likely take the vaccine, according to the research team lead by the Barcelona Institute for Global Health (ISGlobal) in Spain with involvement from the City University of New York Graduate School of Public Health and Health Policy and Georgetown University Law School in Washington, DC. Of the remaining 28%, 14% would refuse, while 14% would hesitate, the authors write.

More than 90 COVID-19 vaccines are in development, with half of these undergoing human trials, but the level of uptake remains unclear.

“We found that the problem of vaccine hesitancy is strongly related with a lack of trust in government. Vaccine confidence was invariably higher in countries where trust was higher,” said Jeffrey V. Lazarus, ISGlobal researcher and study coordinator.

“We need to increase vaccine confidence, and we need to improve the public’s understanding of how they can help control the spread of COVID-19 in their families and their communities,” added Ayman El-Mohandes, Dean of CUNY SPH, and co-coordinator of the study.

China, at 87%, was the country with the highest score of positive responses to “taking a proven, safe and effective vaccine”; it also had the lowest percentage of negative responses (0.7%). Conversely, Poland had the highest number of negative responses (27%), while Russian respondents gave the lowest number of positive responses (55%).

In the U.S., 76% of respondents answered positively, 11% were negative, and 13% had no opinion.

When asked if “you would accept a vaccine if it were recommended by your employer and was approved safe and effective by the government,” 32% of respondents completely agreed, while 18% somewhat or completely disagreed. The authors note that China had the highest percentage of positive responses (84%) and the lowest percentage of negative responses (4%) to that question, with Russia having the highest percentage of negative responses (41%) and the lowest percentage of respondents (27%) who were likely to accept their employer’s recommendation. As for U.S. respondents, 52% had confidence in an employer’s recommendation, and 25% did not.

Age also was a factor in vaccine acceptance, and, overall, older people were more positive than those aged younger than 22 years. Higher income and education level also were positively related to likelihood of getting a vaccine, according to the survey. One surprising finding was that respondents who had recovered from COVID-19 or had relatives who had contracted the infection weren’t more likely to respond positively, the researchers pointed out.

It will be tragic if we develop safe and effective vaccines and people refuse to take them. We need to develop a robust and sustained effort to address vaccine hesitancy and rebuild public confidence in the personal, family and community benefits of immunizations,” warned study coauthor Scott C. Ratzan, distinguished lecturer at CUNY SPH. “Our findings are consistent with recent surveys in the US, which show diminished public trust in a COVID-19 vaccine.”

In the months since the survey was conducted in late June 2020, vaccine-related issues have become increasingly politicized and the antivaccine movement has become more aggressive, the authors noted. That  suggests that vaccine hesitancy might be a greater threat today, they said.
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