Top 11 Reasons for COVID-19 Vaccine Hesitancy – First: Mistrust of Government

People’s trust in the government’s approval of a safe and effective vaccine against COVID-19 is the biggest driver of vaccine uptake, an Australian study has found.

Second on the list of motivations identified in the study is the perceived effectiveness of the vaccine to protect others in the community.

The next two most common drivers of vaccine hesitancy were found to be “free-riding,” where individuals believe they can benefit from others taking up the vaccine without being immunized themselves, and conspiracy beliefs about vaccination, capturing the attitudes of “anti-vaxxers.”

The study, conducted by researchers from the Centre for Business Intelligence & Data Analytics at the University of Technology Sydney (UTS), sampled more than 4300 respondents in Australia, New Zealand, the United States, Canada, and the United Kingdom, and found 11 factors were enablers or barriers to COVID-19 vaccination. 

“This study offers strong insights for improving vaccination coverage, with the challenge of implementing one of the most important vaccination programs in human history,” said Associate Professor Paul Burke, Deputy Director, Centre for Business Intelligence & Data Analytics at UTS Business School.

“While the development of effective vaccine offerings is essential, unless people are going to be vaccinated such programs will not be successful. This study tells us the who and the why to encourage more significant uptake.” 

Overall, 66 percent of respondents agreed they would receive COVID-19 vaccination. Australians had the highest rates of intention (73 percent), followed by Canada (66 percent), United Kingdom (64 percent), New Zealand (62 percent), and the United States (55 percent).

At the bottom of the list of vaccination drivers were individuals’ concerns about the severity of COVID-19 if caught and how susceptible they were to becoming infected, although both were significant in explaining vaccine hesitancy.

“Many factors drive vaccine hesitancy. Using the health-beliefs model as a starting point, we examined a number of factors relating to the perceived threat of the disease balanced against the benefits and risks of vaccination. What was interesting is that we also accounted for how people judged these risks for themselves, but also others in their community,” Associate Professor Burke said.

The model controlled for individual differences such as age, income, and gender, as well as the general healthiness of the individual.

Individuals found to have lower rates of vaccine uptake intentions were more likely to be younger or unemployed, but not looking for work. Higher rates of COVID-19 vaccine uptake were identified among older individuals, unemployed individuals looking for work, and those who had previously been vaccinated against influenza. People who held more altruistic and collectivist beliefs were also significantly more likely to be vaccinated. 

Drivers of COVID-19 vaccination uptake intentions (largest to smallest)

1.    Trust in government approval of safe & effective COVID-19 vaccine (+)
2.    Perceived effectiveness of COVID-19 vaccination for others (+)
3.    Perceived ability to free-ride (-)
4.    Conspiracy beliefs about vaccination (-)
5.    Perceived side-effects of COVID-19 vaccine (+)
6.    Perceived effectiveness of COVID-19 vaccination for the individual (+)
7.    Perceived COVID-19 vaccine availability (+)
8.    Perceived disease severity for others (+)
9.    Perceived susceptibility to COVID-19 for others (+)
10.  Perceived disease severity for the individual (+)
11.   Perceived susceptibility to COVID-19 for the individual (+)

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