The Need to Address Vaccine Hesitancy
The significant increase of vaccine hesitancy following the COVID-19 pandemic has been concerning. Historically, routine immunization vaccine uptake was often a default behavior, requiring minimal contemplation. However in the uncertain and dynamic context of the pandemic, the decision to take the COVID-19 vaccine became an active and deliberate choice. Misinformation during the pandemic continues to exacerbate public skepticism, distrust and hesitancy, affecting not only the acceptance of the COVID-19 vaccine but also other vaccines.
As new vaccines are developed and introduced, increased vaccine hesitancy among the population threatens the efficacy of vaccines in preventing infectious diseases. This hesitancy exposes vulnerable populations—such as children, individuals with pre-existing conditions, and marginalized communities—to heightened risks, undermining public health efforts and increasing susceptibility to disease outbreaks.
It thus becomes critical to collaborate with governments, donors, and implementing partners to understand the drivers and barriers to current and future vaccine uptake and co-design interventions to address these.
COVID Context
Prior to the COVID-19 pandemic, routine immunizations for infants and children was a default decision due to high familiarity, high disease salience and influential norms. However, the introduction of the COVID-19 vaccine led to adults actively assessing the decision to vaccinate themselves and their dependents.
While many accepted COVID-19 vaccines, concerns about their swift development and long-term effects raised doubts about their safety, which contributed to increased vaccine hesitancy. Additionally, misinformation during the pandemic further fueled public skepticism. These factors not only affected COVID-19 vaccine acceptance but also caused spillover hesitancy toward other vaccines, such as HPV and the overall feelings of emotional and cognitive risk associated with routine immunization as well.
Misinformation
The COVID-19 context highlighted misinformation. Even with trusted sources like government bodies and the education system, individuals sought information from channels like social media, peers, and religious institutions. They faced a torrent of information about risk factors, vaccine safety, mandates, cures, and more. Digital media rapidly spread false information and emphasized negatives, delaying decision-making and increasing vaccine hesitancy. This infodemic caused confusion, skepticism, and insecurity about vaccine safety for many.
Exposure to confusing and conflicting information about vaccines made people stick to the status quo and perceive action as risky. Therefore, it is crucial to manage accurate information flow and help people understand the right information to ensure vaccine uptake.
Trust
Positive interactions with trusted healthcare providers enhance vaccine confidence, while distrust from past experiences or perceived biases increases hesitancy. Trust in the health system is crucial for vaccine uptake. High trust in healthcare providers who promote vaccination boosts acceptance, while distrust leads to hesitancy and refusal.
Trust in health systems and governments, and their pandemic response, shape perceptions of vaccine benefits and trust in vaccines. Misinformation erodes this trust, leading to lower vaccine confidence. Furthermore, the post-COVID world challenged the perception of routine immunization as a default healthcare service.
General Hesitancy
Despite high reported intentions to vaccinate, adoption rates remain low due to complex behaviors, trust in the health system, beliefs about vaccine efficacy and safety, and access to resources. Vaccination involves a web of people, funding, policies, and permissions. The ideal of smooth vaccine supply meeting demand has been challenged, particularly during the COVID-19 pandemic, revealing that vaccination hesitancy exists on a continuum influenced by context, trade-off evaluations, and mental models.
Concerns about vaccine safety and practical barriers often lower vaccination intentions. Individuals may overemphasize potential harms from vaccination while downplaying the risks of not vaccinating. These emotional, contextual, and cognitive factors increase hesitancy towards future vaccine introductions and their uptake.
Insights and Learnings
COVID-19 Disease Appraisal
What do I feel about the COVID-19 disease?
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Seeking Mitigation Strategies
How can I cope with the
COVID-19 risk?
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COVID-19 Vaccine Appraisal
How do I feel about the COVID-19 Vaccine?
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Coping with Vaccine Risk
How can I cope with vaccine risk?
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Vaccination Uptake
How can I get this vaccine?
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Vaccination Adherence
Should I get the second dose?
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Our approach to understanding and addressing vaccine hesitancy
Human behavior is complex, influenced by environment, emotions, and beliefs. At Final Mile, we tackle these complex challenges using a multidisciplinary approach including behavioral science and human-centered design. Our goal is to understand and predict the preferences of target populations across different contexts and geographies, embracing uncertainty to create effective interventions.
Our vaccine work
COVID-19
Developing a safe and efficacious vaccine against COVID-19 in record time has been a success, but swift and comprehensive rollout of the vaccine has been marred by a number of challenges.
On the supply side, these include funding, accessibility, and the logistical complexity of transporting, storing, and administering vaccines. On the demand side, one key challenge is vaccine hesitancy and resistance. Low confidence in COVID-19 vaccines, and low willingness to receive them, is a significant and growing risk to beating the pandemic globally.
HPV
Cervical cancer, the most common manifestation of HPV, ranks as the second leading cause of female cancer and the most common cancer in African women aged 15 to 44 years. Despite the proven effectiveness of the HPV vaccine, many individuals remain hesitant to allow their children to be vaccinated or receive the vaccine themselves.
RI
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About Final Mile
Final Mile addresses complex behavioral challenges through a deep understanding of personal and social context, a range of mixed research methods, and a collaborative, community-based approach that supports stakeholders with the strategies and tools they need. Our approach aims for collaborative, effective and sustainable behavior change.