Public opinion surveys could be used to understand regional variation in vaccine hesitancy, say experts

Reviewed by Emily Henderson, B.Sc.Jun 29 2021

Public opinion surveys could be used more widely to understand regional variation in vaccine hesitancy, experts have recommended.

The research shows vaccine uptake rates for childhood vaccines are significantly lower in regions where hesitancy observed in mass public opinion surveys is more pronounced.

This data is often not widely available, which makes it challenging for experts to analyse the links between attitudes and real-world behaviour. The study says this data should be used by public health officials to understand where vaccines are more likely to be rejected, and who should be the target of information campaigns.

The research published in the journal Vaccine, was carried out by Dr Florian Stoeckel and Professor Jason Reifler from the University of Exeter, Professor Ben Lyons from the University of Utah and Charlie Carter from the London School of Economics.

They analysed regional level data for the EU from 2019 for the uptake of various childhood vaccines in 177 regions of 20 European countries - DTP3 (diphtheria, tetanus toxoids, and pertussis), MCV1 (the first dose of the measles-containing vaccine), and MCV2 (second dose of the measles vaccine) for 2019. Data on vaccine hesitancy was taken from the Eurobarometer survey of Spring 2019, which included about 1,000 respondents from each EU country except for Luxembourg, Cyprus, and Malta, where about 500 individuals were interviewed.

Our analysis shows public opinion surveys can play a valuable role in public health as a tool to understand immunization behavior. It is currently high time for more opinion surveys on citizens' attitudes towards vaccines. Assessing the link between survey responses and actual uptake is important, because public opinion survey data on vaccine hesitancy is only useful if it is in fact related to behavior."

Dr Florian Stoeckel, University of Exeter

"We found statistically significantly lower regional vaccine immunization rates in regions where vaccine hesitancy is more pronounced. Surveys can be used to observe where vaccine uptake is likely to be low (when vaccine uptake data is incomplete) and to learn from regions with high uptake (despite high vaccine hesitancy) so that best practices could be applied elsewhere."

Vaccine uptake for the childhood vaccines that we examined differs both between countries and within countries. Most national uptake rates of the childhood vaccines examined are above 90 percent. For instance, average national level uptake of the MCV1 vaccine varies between 85.94 percent in Cyprus and 99.87 percent in Hungary. However, there is a considerable amount of variation within countries. Uptake of MCV1 in Croatia ranges from 73.24 percent to 98.38 percent.

The analysis shows average country level vaccine hesitancy is lowest in Denmark and highest in Latvia. The least vaccine hesitant sub-national region in Latvia is more vaccinate hesitant than the most vaccine-hesitant region in Denmark.