Willingness to vaccinate against COVID-19 in Australia
Authors: Rachael H Dodd, Erin Cvejic, Carissa Bonner, Kristen Pickles, Kirsten J McCaffery, Julie Ayre, Carys Batcup, Tessa Copp, Samuel Cornell, Thomas Dakin, Jennifer MJ Isautier, Brooke Nickel
Journal: The Lancet Infectious Diseases (2020)

More than half of the world's population faces long-term restrictions as the new normal to prevent the spread of COVID-19. If a vaccine becomes available, it might be possible to develop herd immunity and protect those who are most vulnerable to serious consequences of COVID-19. The population coverage required to achieve herd immunity through vaccination varies across diseases and is dependent on the basic reproduction number (R0).1Randolph H Barreiro L Herd immunity: understanding COVID-19.Immunity. 2020; 52: 737-741Summary Full Text Full Text PDF PubMed Scopus (747) Google Scholar Modelling estimates R0 to be around 2·5 for severe acute respiratory syndrome coronavirus 2 when no restrictions or physical distancing measures are in place,2Ferguson NM Laydon D Nedjati-Gilani G et al.Report 9. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand.https://doi.org/10.25561/77482Date accessed: May 27, 2020Google Scholar and R0 reached almost 4·0 in Wuhan in early-mid January, 2020.3Inglesby TV Public health measures and the reproduction number of SARS-CoV-2.JAMA. 2020; (published online May 1.)DOI:10.1001/jama.2020.7878Crossref Scopus (87) Google Scholar Vaccination uptake for herd immunity would need to be at least 67% with an R0 of 3·0.1Randolph H Barreiro L Herd immunity: understanding COVID-19.Immunity. 2020; 52: 737-741Summary Full Text Full Text PDF PubMed Scopus (747) Google Scholar In their Comment, the COCONEL Group reported that 26% of French adults would not accept a COVID-19 vaccine.4The COCONEL GroupA future vaccination campaign against COVID-19 at risk of vaccine hesitancy and politicisation.Lancet Infect Dis. 2020; 20: 769-770Summary Full Text Full Text PDF PubMed Scopus (387) Google Scholar We similarly explored this question among a diverse sample of Australian adults. We conducted an online survey of 4362 Australians aged 18 years and older during April 17–21, approximately 4 weeks after lockdown measures had been activated in Australia and at a time when potential deaths and health system capacity were still of great concern. We asked participants about actions or intentions toward the flu vaccine ("I have or I will get the flu vaccine this year") and a potential COVID-19 vaccine ("If a COVID-19 vaccine becomes available, I will get it"). In this sample, 630 (14·4%) participants said they would not get the flu vaccine this year, 394 (9·0%) were indifferent, and 3338 (76·5%) said they have or will get the flu vaccine this year. For a COVID-19 vaccine, 213 (4·9%) said they would not get the vaccine, 408 (9·4%) were indifferent, and 3741 (85·8%) said they would get the vaccine if it became available. Individuals who said they would not get a COVID-19 vaccine were more likely to believe the threat of COVID-19 has been exaggerated (43·7% [93/213]) than those who said they would get the vaccine if it became available (11·5% [429/3741]) and those who were indifferent (19·9% [81/408]). Inadequate health literacy and lower education level were significantly associated with a reluctance to be vaccinated against both influenza and COVID-19 (p<0·001; appendix). Notably, a high proportion overall were confident in the state (75·4% [3288/4362]) and federal (65·2% [2845/4362]) government's response. In Australia, attitudes towards a COVID-19 vaccine appear to be more positive than reported in France in late March,4The COCONEL GroupA future vaccination campaign against COVID-19 at risk of vaccine hesitancy and politicisation.Lancet Infect Dis. 2020; 20: 769-770Summary Full Text Full Text PDF PubMed Scopus (387) Google Scholar which might in part reflect greater confidence in the government. However, our data show efforts are needed to target vaccine education to those with lower education and health literacy.5Lin L Savoia E Agboola F Viswanath K What have we learned about communication inequalities during the H1N1 pandemic: a systematic review of the literature.BMC Public Health. 2014; 14: 484Crossref PubMed Scopus (132) Google Scholar It remains to be seen whether Australia's high intentions towards vaccine uptake will remain when restrictions are relaxed and the immediate perceived threat diminishes. We declare no competing interests. Download .pdf (.17 MB) Help with pdf files Supplementary appendix A future vaccination campaign against COVID-19 at risk of vaccine hesitancy and politicisationJust a few weeks ago, more than half of the world's population was on lockdown to limit the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Scientists are racing against time to provide a proven treatment. Beyond the current outbreak, in the longer term, the development of vaccines against SARS-CoV-2 and their global access are a priority to end the pandemic.1 However, the success of this strategy relies on people's acceptability of immunisation: what if people do not want the shot? This question is not rhetorical; many experts have warned against a worldwide decline in public trust in immunisation and the rise of vaccine hesitancy during the past decade, especially in whole Europe and in France. Full-Text PDF