News | The Lancet study: 65% of people hesitant about COVID-19 vaccination were eventually vaccinated
A long-term study of more than 1.1 million adults in England found that COVID-19 vaccine hesitancy was not static or irreversible. About 65% of those initially hesitant eventually received at least one dose. The Imperial College London-led study was published January 13 in The Lancet.
Researchers analyzed data from 1.1 million adults aged 18 or older who joined the REal-time Assessment of Community Transmission (REACT) study between January 2021 and March 2022. They linked attitudes to NHS vaccination records through May 2024 to identify types, causes, and changes in hesitancy.
Hesitancy fell from about 8% in January 2021 to 1.1% in early 2022, briefly rising to around 2.2% during the Omicron wave. Overall, about 3.3% of respondents expressed some hesitancy.
Study lead and epidemiology professor Marc Chadeau-Hyam said the aim was not simply to count hesitant people, but to distinguish concerns that were easier to change from those that persisted. Understanding these drivers is critical to vaccination uptake and infectious-disease control.
The team identified eight categories, including concerns about efficacy and side effects, low perceived infection risk, distrust of vaccine developers, and fear of vaccines. Among those giving reasons, 41% feared long-term health effects, 39% wanted to wait and see whether the vaccine worked, and 37% worried about side effects.
Reasons varied by group. Men more often considered COVID-19 a low personal risk (18% versus 10% of women); women more often feared effects on fertility or pregnancy (21% versus 8% of men); and general anti-vaccine views were more common at age 74 or older than at ages 18–24 (12% vs 2.5%).
Remaining unvaccinated was more likely among older adults, women, Black people, unemployed people, residents of socioeconomically disadvantaged areas, those previously infected, and people with less education.
People concerned about efficacy or health safety were most likely to change their minds. Those motivated by distrust, low risk perception, or strong anti-vaccine views were only one-third to one-half as likely to be vaccinated.
Co-author Helen Ward of Imperial College London and the NIHR Biomedical Research Centre said some hesitancy can inherently be addressed and eased, including concerns about pregnancy, breastfeeding, and long-term health.
Professor Paul Elliott said the pandemic showed the importance of clear, trusted, accessible information during public health emergencies, especially when vaccines must be deployed rapidly at scale.
Limitations included discrepancies between self-reports and NHS records and possible selection bias because some hesitant participants declined data linkage.
In a related commentary, University of Bari Aldo Moro professor Silvio Tafuri called the study highly valuable evidence and said researchers should determine whether the same drivers apply to routine or seasonal vaccines.
News | The Lancet study: 65% of people hesitant about COVID-19 vaccination were eventually vaccinated
News | The Lancet study: 65% of people hesitant about COVID-19 vaccination were eventually vaccinated
A long-term study of more than 1.1 million adults in England found that COVID-19 vaccine hesitancy was not static or irreversible. About 65% of those initially hesitant eventually received at least one dose. The Imperial College London-led study was published January 13 in The Lancet.
Researchers analyzed data from 1.1 million adults aged 18 or older who joined the REal-time Assessment of Community Transmission (REACT) study between January 2021 and March 2022. They linked attitudes to NHS vaccination records through May 2024 to identify types, causes, and changes in hesitancy.
Hesitancy fell from about 8% in January 2021 to 1.1% in early 2022, briefly rising to around 2.2% during the Omicron wave. Overall, about 3.3% of respondents expressed some hesitancy.
Study lead and epidemiology professor Marc Chadeau-Hyam said the aim was not simply to count hesitant people, but to distinguish concerns that were easier to change from those that persisted. Understanding these drivers is critical to vaccination uptake and infectious-disease control.
The team identified eight categories, including concerns about efficacy and side effects, low perceived infection risk, distrust of vaccine developers, and fear of vaccines. Among those giving reasons, 41% feared long-term health effects, 39% wanted to wait and see whether the vaccine worked, and 37% worried about side effects.
Reasons varied by group. Men more often considered COVID-19 a low personal risk (18% versus 10% of women); women more often feared effects on fertility or pregnancy (21% versus 8% of men); and general anti-vaccine views were more common at age 74 or older than at ages 18–24 (12% vs 2.5%).
Remaining unvaccinated was more likely among older adults, women, Black people, unemployed people, residents of socioeconomically disadvantaged areas, those previously infected, and people with less education.
People concerned about efficacy or health safety were most likely to change their minds. Those motivated by distrust, low risk perception, or strong anti-vaccine views were only one-third to one-half as likely to be vaccinated.
Co-author Helen Ward of Imperial College London and the NIHR Biomedical Research Centre said some hesitancy can inherently be addressed and eased, including concerns about pregnancy, breastfeeding, and long-term health.
Professor Paul Elliott said the pandemic showed the importance of clear, trusted, accessible information during public health emergencies, especially when vaccines must be deployed rapidly at scale.
Limitations included discrepancies between self-reports and NHS records and possible selection bias because some hesitant participants declined data linkage.
In a related commentary, University of Bari Aldo Moro professor Silvio Tafuri called the study highly valuable evidence and said researchers should determine whether the same drivers apply to routine or seasonal vaccines.
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