Trinity College Dublin: COVID-19 vaccine acceptance higher in low- and middle-income countries than richer countries

Trinity College researchers have joined colleagues from institutions across the globe to examine vaccine acceptance and hesitancy in 10 low- and middle-income countries in Asia, Africa, and South America.

Their research published in Nature Medicine reveals that willingness to get a COVID-19 vaccine was considerably higher in developing countries (80% of respondents) than in the United States (65%) and Russia (30%).

The study provides one of the first insights into vaccine acceptance and hesitancy in a broad selection of low- and middle-income countries (LMIC), covering over 20,000 survey respondents and bringing together researchers from over 30 institutions including Trinity College, the International Growth Centre (IGC, a global network of researchers working in development), Innovations for Poverty Action (IPA), WZB Berlin Social Science Center, the Yale Institute for Global Health, the Yale Research Initiative on Innovation and Scale (Y-RISE), and HSE University (Moscow, Russia).

Personal protection against COVID-19 was the main reason given for vaccine acceptance among LMIC respondents (91%), and concern about side effects (44%) was the most common reason for vaccine hesitancy. Health workers are considered the most trusted sources of information about COVID-19 vaccines.

Study co-author Assistant Professor Andrea Guariso, Department of Economics, Trinity College
The study comes at a critical juncture when vaccine shipments are still slow to arrive to the majority of the world’s population, and COVID-19 cases are surging in many parts of Africa, Asia, and Latin America. The findings suggest that prioritising vaccine distribution to low- and middle-income countries should yield high returns in expanding global immunisation coverage.

The researchers, who conducted the surveys between June 2020 and January 2021, point out that vaccine acceptance may vary with time and the information that people have available to them. While the evidence on the safety and efficacy of available COVID-19 vaccines has become more clear in the last six months, severe, but rare, side effects may have undermined public confidence.

Andrea Guariso, Assistant Professor of Economics, Department of Economics at Trinity College, who co-authored the study said:

Right now, we are seeing how vaccine hesitancy across Europe, the US, and other countries is complicating policy decisions and endangering the progress made so far. The high vaccine acceptance we observe in low- and middle-income countries gives us reason to be optimistic, but governments and international organizations need to quickly develop effective vaccine uptake programs, engaging trusted people like health workers to deliver clear and accurate messages to the public.

Niccoló Meriggi, Country Economist for IGC Sierra Leone and study co-author said:

As COVID-19 vaccine supplies trickle into developing countries, the next few months will be key for governments and international organisations to focus on designing and implementing effective vaccine uptake programmes. Governments can use this evidence to develop communications campaigns and systems to ensure that those who intend to get a vaccine actually follow through.

Researchers on this study represent the following institutions: WZB Berlin Social Science Center, Innovations for Poverty Action (IPA), International Growth Centre (IGC), Wageningen University & Research, International Center for the Study of Institutions and Development (HSE University, Moscow, Russia), Yale Institute for Global Health, Nova School of Business and Economics, Lahore University of Management Sciences, The Institute for Fiscal Studies, University of St. Andrews & The Institute for Fiscal Studies, Stockholm School of Economics and Misum, Economics Department of Ghent University, Institute of Development and Economic Alternatives, Trinity College Dublin, Cornell University, University of Illinois Chicago, NYU Abu Dhabi, Yale Research Initiative on Innovation and Scale (Y-RISE), Princeton University, Institute for International Economic Studies (IIES) at Stockholm University, Tufts University, Kellogg School of Management at Northwestern University, London School of Economics and Political Science, Columbia University, Yale University, Centre for Economic Research in Pakistan (CERP), Institute of Development and Economic Alternatives (IDEAS) – Pakistan, University of Michigan, Busara Center for Behavioral Economics (Nigeria and Kenya), Centre for the Study of Labour and Mobility (CESLAM) – Nepal, and Morsel Research & Development (India).

Trinity College Dublin