Acceptance of COVID-19 vaccines increased globally by about 4% in 2022, according to a survey of 23 countries that represent more than 60% of the world’s population. In 2021, acceptance was recorded at 75.2%, but the latest survey puts acceptance at 79.1% in 2022.
However, vaccine acceptance decreased in eight countries and almost one in eight vaccinated respondents, particularly younger men and women, were hesitant about receiving a booster dose.
An international collaboration led by Jeffrey Lazarus, of the Barcelona Institute for Global Health in Spain and City University of New York (CUNY) performed a series of surveys starting in 2020 across 23 highly populated countries that were hit hard by the pandemic—Brazil, Canada, China, Ecuador, France, Germany, Ghana, India, Italy, Kenya, Mexico, Nigeria, Peru, Poland, Russia, Singapore, South Africa, South Korea, Spain, Sweden, Turkey, the United Kingdom and the United States. The data reported in Nature Medicine this week correspond to the third survey conducted between June and July 2022.
Of the 23,000 survey respondents—1,000 per country—79.1% supported vaccination against COVID-19 during 2022. That is opposed to the 75.2% that supported vaccination a year earlier, in 2021.
The United States found itself just barely above the global average at 80.2%. The highest recorded vaccine acceptance was in India at 98.3%, China at 96.6% and Singapore at 92.5%. South Africa was the lowest at 47.9%, followed by Ghana at 58%. Most of the other countries fell in the upper 80s, with a few in the upper 70s and upper 60s.
Still, compared with 2020, the most recent numbers are significant. Between 2020 and 2022, 21 of the 23 countries experienced an increase in vaccine acceptance—South Africa (-41.3) and Mexico (-3.5) being the only exceptions.
From 2021 to 2022, 15 countries experienced an increase in vaccine acceptance, while the UK, Turkey, South Africa, Mexico, Kenya, Ghana, China and Brazil recorded a decrease in acceptance. However, four of those countries (UK, China, Turkey and Brazil) experienced a less than 3% change.
Despite the generally high acceptance numbers, 12% of those already vaccinated were hesitant or reported refusal to receive a booster dose. Unlike previous studies that reported greater booster hesitancy among older persons, the findings from this survey indicate that booster hesitancy is higher at younger ages, specifically 18 to 29. The United States is just slightly above the global average at 13% for booster hesitancy. China and Nigeria are the lowest at 1%, while Russia is the highest at 29%, followed by South Korea at 27% and France at 26%.
Parental willingness to vaccinate their children increased slightly from 67.6% in 2021, when COVID-19 vaccines for children were awaiting regulatory approval, to 69.5% in 2022. This time, the U.S. came in above the global average with 33.1% of all parents hesitant to vaccinate their children. Parental hesitancy was highest in Russia and South Africa at 71.1% and 60.8%, respectively, while China was the lowest at 0.1%, followed by India (6.4%), Ecuador (12.2%), and Peru (13.1%).
“Key variables were low perception of vaccine safety and younger parental age, which might represent potentially less-experienced parenting, as well as parents who themselves had not been vaccinated,” the authors explain in their paper.
Indeed, among parents who were hesitant to vaccinate themselves, the percentage of hesitance for child vaccinations was abnormally high—in the 90s and 80s across almost all 23 countries.
Almost 40% of survey respondents said they now pay less attention to new information about COVID-19 vaccines compared with 1 year ago. Nonetheless, two-thirds of all respondents (66.6%) still prefer vaccination to prevent COVID-19 illness, although one-quarter (25.2%) indicated they are now less likely to get vaccinated due to perceived lesser disease severity.
Lastly, survey respondents reported the use of ivermectin as frequently as the use of approved medications and products, despite the fact that ivermectin is not recommended by the World Health Organization (WHO) and other leading agencies. Respondents who reported ivermectin use tended to reside in low- and middle-income countries.
Overall, “our findings may offer insight to policymakers and public health officials regarding message content and targeting,” the authors concluded in their paper. “Strategies to improve vaccine literacy could include messages that emphasize compassion over fear, message framing based on audience demographics and psychographics, as well as the use of trusted messengers, particularly healthcare providers, and various types of incentives.”