Europe Seen to Have Least Confidence in Vaccine Safety in Global Survey

Europe Seen to Have Least Confidence in Vaccine Safety in Global Survey

Public confidence in vaccines diverges between countries and world regions, with Europe being the region most distrustful of vaccine safety, according to the results of the largest global survey of confidence in vaccines published in the journal EBioMedicine.

With recent disease outbreaks caused by people refusing vaccination, the researchers believe the study, “The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey,” offers important insights that could assist policymakers in identifying and addressing these issues, resulting in higher rates of vaccination against several pathogens, including human papilloma virus, the major cause of cervical cancer.

Investigators from the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine, and colleagues from the Imperial College London and the Saw Swee Hock School of Public Health, a National University of Singapore, conducted a large survey — one they believe represents the largest survey on confidence in immunization to date — examining the perceptions of vaccine importance, safety, effectiveness, and religious compatibility among 65,819 individuals across 67 countries.

They found that the overall opinion of vaccinations was positive across all 67 countries, but they also found a wide variability between countries and across world regions. Vaccine safety-related sentiment was  particularly negative in the European region, which has seven of the 10 least confident countries, with 41% of respondents in France and 36% of respondents in Bosnia & Herzegovina reporting that they disagree that vaccines are safe (compared to a global average of 13%).

Researchers believe that the negative attitudes toward vaccination in France may be related to controversy over the side effects of the Hepatitis B and HPV vaccines, and the hesitancy of general practitioners (GPs) as to the effectiveness of some vaccines.

Public trust in immunization is an increasingly important global health issue. Diminished confidence in vaccines and immunization program can lead to vaccine reluctance and refusal, risking disease outbreaks and challenging immunization goals in high- and low-income settings.

The World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization and the U.S. immunization program have called for better monitoring of vaccine confidence and hesitancy to avert confidence crises and their public health consequences.

“Our findings give an insight into public opinion about vaccines on an unprecedented scale,” Heidi Larson, from the London School of Hygiene & Tropical Medicine, and the study’s lead author, said in a news release. “It is vital to global public health that we regularly monitor attitudes towards vaccines so that we can quickly identify countries or groups with declining confidence. We can then act swiftly to investigate what is driving the shift in attitudes. This gives us the best chance of preventing possible outbreaks of diseases like measles, polio and meningitis which can cause illness, life-long disability and death.

“It’s striking that Europe stands out as the region most sceptical about vaccine safety. And, in a world where the internet means beliefs and concerns about vaccines can be shared in an instant, we should not underestimate the influence this can have on other countries around the world,” he added.

Survey results also revealed that some countries (especially France, Bosnia & Herzegovina, Iran, Japan, Vietnam, and Mongolia), have more confidence in the importance of vaccines than in their safety, which indicates that people do not necessarily dismiss the value of vaccines even if they question their safety.

“Our study suggests that the public largely understands the importance of vaccines, but safety is their primary concern,” Larson said. “This could reflect a worrying confidence gap and shows that vaccine acceptance is precarious. The findings underline that the scientific and public health community needs to do much better at building public trust in the safety of vaccination.”

The researchers also found that oldest age group (65+) and Roman Catholics (among all faiths surveyed) were associated with positive views toward vaccines, while the Western Pacific region reported the highest level of religious incompatibility with vaccines.

Interestingly, countries with high levels of schooling and good access to health services were associated with lower rates of positive sentiment, pointing to an emerging inverse relationship between vaccine sentiments and socio-economic status.

Although the authors note that their survey cannot show whether attitudes were related to certain vaccines, or give motives behind the attitudes stated, they believe their findings can be used as a baseline to compare future surveys on vaccine hesitancy, so as to monitor its evolution.

The results also point to the importance of continued worldwide monitoring of confidence in vaccines, so that policymakers can monitor the effects of their interventions on immunization attitudes and acceptance, and more effectively allocate resources to address hesitancy issues and build confidence.

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