Citation, abstract, extracts and comments from me below.
CITATION: Profiling vaccine attitudes and subsequent uptake in 1·1 million people in England: a nationwide cohort study
Whitaker M et al. The Lancet 2026
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2825%290...
SUMMARY
Background: Despite highly effective vaccines against SARS-CoV-2, COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic, with rates and motivations for hesitancy varying by demographic group. Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread. We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service (NHS) data.
Methods: We conducted an initial cross-sectional analysis of vaccine hesitancy at baseline, followed by a longitudinal analysis of vaccine uptake in the hesitant cohort...
Findings: Our analyses included 1 137 927 adults (aged 18 years and older) surveyed between Jan 6, 2021, and March 31, 2022. Across the whole study period, 37 982 (3·3%) participants indicated some form of vaccine hesitancy. Hesitancy rates peaked at 8·0% in early 2021, subsequently decreasing to a low of 1·1% at the start of 2022, and increasing to 2·2% in early 2022. Of the 24 229 participants who indicated hesitancy and consented to NHS data linkage, 15 744 (65·0%) went on to receive one or more vaccinations. Cluster analysis identified eight stable categories of vaccine hesitancy, including concerns about effectiveness and side-effects, perception of low risk from COVID-19 and mistrust of vaccine developers, and fear of vaccines and reactions. The most prevalent categories of hesitancy, related to effectiveness and health concerns, declined substantially over the roll-out period and were not strongly associated with the likelihood of later vaccination. Some forms of hesitancy, primarily related to low trust, low risk perception, and general anti-vaccine sentiment, were more resistant, rebounded in 2022, and were strongly associated with a lower likelihood of subsequent vaccination.
Interpretation: Our findings suggest that most COVID-19 vaccine hesitancy was rooted in concrete concerns that can be addressed and successfully overcome with time and increasing availability of information. These findings should help future vaccination roll-outs to encourage vaccine acceptance.
SELECTED EXTRACTS
We observed a general decline in vaccine hesitancy, mainly due to decreased concerns over side-effects, vaccine effectiveness, and long-term health effects...
Those who were hesitant because of a generalised anti-vaccine sentiment, low trust in vaccine developers, or low perception of risk from COVID-19 were particularly unlikely to change their minds and get vaccinated.
COMMENTS (NPW): It would be interesting to review these findings against:
1. Trends in information and misinformation among the UK population
2. Comparisons with findings in other countries.
3. Discussions on HIFA (2020), which were published in the Journal of Medical Internet Research: https://infodemiology.jmir.org/2022/1/e30167
This discussion highlighted the importance of distrust in health authorities, inconsistent public health messaging, and misinformation on social media.
'HIFA discussion during the earlier months was centered around access to verified health information, translation of public health guidelines, understanding what can be done to prevent the spread of COVID-19, and the preparedness of different health systems. Discussion around the prevalence of the infodemic and misinformation took place mostly during May and June 2020. The end of June going into July 2020 saw the discussion focused on the impacts of a lockdown, including its economic consequences, its effects on marginalized communities, and its toll on mental health. Discussion during August and September 2020 revolved around COVID-19 fatigue and changing public health guidelines amid a second wave. Finally, vaccine production, distribution and administration as well as addressing the infodemic were discussed in October 2020.'
Posted on HIFA Twitter/X: https://x.com/hifa_org/status/2012079502067708335
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org