Study Finds Transparent Communication Key to Overcoming Vaccine Hesitancy

A new study published in The Lancet examining COVID-19 vaccine hesitancy found that delivering clear, timely and transparent information is crucial if populations are to embrace vaccination campaigns. The study followed people over time, tracking not only their stated reasons for hesitancy but whether they ultimately went on to be vaccinated.

The research team analysed survey data from the Real-time Assessment of Community Transmission (REACT) studies, which monitored the prevalence of SARS-CoV-2 in England during the COVID-19 pandemic. Just over 1.1 million people's data was analysed. In total, 37,982 (3.3%) participants reported vaccine hesitancy. Hesitancy rates peaked at 8.0% in early 2021 at the start of vaccine roll-out, and this dropped to 1.1% at the start of 2022. Hesitancy rose again slightly to 2.2% in early 2022, just after an Omicron surge.

Strikingly, a majority of hesitant people went on to get vaccinated: of the 24,229 participants who indicated hesitancy and consented to data linkage, 15,744 (65.0%) went on to receive one or more vaccinations.

Early in the roll-out, many concerns were tied to novelty. The researchers identified clusters of hesitancy related to vaccine effectiveness, potential side-effects and specific issues such as fertility and breastfeeding. But the study showed that these concerns reduced during the roll out, potentially related to evidence accumulating. There was a drop in hesitancy in the first few months of the pandemic, which may be related to the emergence of reassuring information on the vaccine technology and effectiveness during the roll-out.

The study was able to link attitudes to outcomes, which showed that hesitancy doesn't always lead to a refusal of the vaccine. There were participants who initially described themselves as hesitant but later chose vaccination as well as those who remained unvaccinated. The authors' analysis of subsequent vaccination behaviour showed that some factors linked to hesitancy – including previous COVID-19 infection, lower levels of education and deprivation – were also associated with remaining unvaccinated among those who initially expressed doubt.

However, some patterns reversed over time. Older adults were less likely to report hesitancy at first, but if they did, they were more likely to remain unvaccinated, possibly because their concerns – such as previous bad reactions to vaccines or underlying health conditions – were more persistent. Women, by contrast, were more likely than men to initially express hesitancy, yet less likely to remain unvaccinated, which may, among other things, reflect time-limited concerns such as pregnancy or breastfeeding.

This suggests that vaccine sentiment can shift over time, and that targeted outreach and improved communication may help address concerns, particularly in communities at higher risk. For future pandemics, the delivery of timely information is crucial if populations are to adhere to a vaccine campaign.