COVID-19 vaccine acceptance higher ‘in poor countries’

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South Africa's President Cyril Ramaphosa joins healthcare workers to receive J&J Coronavirus vaccination in February. Researchers say that prioritising vaccine distribution in low- and middle-income countries would be an effective way to boost global immunisation coverage. Copyright: GCS, (CC BY-ND 2.0).

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  • People in low- and middle-income countries ‘more willing to take COVID-19 jab’ - study
  • Researchers say findings support prioritisation of vaccines in poorer countries
  • Data points to huge economic toll of slow vaccine rates in developing countries

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[NEW DELHI] People in low- and middle-income countries (LMICs) appear more willing to take a COVID-19 vaccine than those living in richer countries such as Russia and the US, according to a study published in Nature Medicine.

An international team of researchers from countries including the US, UK, Germany, India, and Sierra Leone, say the findings suggest that prioritising vaccine distribution in poorer countries would be an effective way to expand global immunisation coverage.

Cases of COVID-19 are surging in many parts of Africa, Asia, and Latin America, as vaccination rates lag far behind those in the global North. Many African countries have not yet vaccinated two per cent of their populations, official figures show.

“In developing countries vaccines literally mean life or death and people see that on a day-to-day basis.”

Amesh Adalja, senior scholar, Johns Hopkins Center for Health Security

“Over 3.5 billion vaccines have been distributed globally, but more than 75 per cent of those have gone to just ten countries,” WHO director-general Tedros Adhanom Ghebreyesus told the World Trade Organization last week.

The study, which looked at 44,260 people, is based on surveys carried out between June 2020 and January 2021, in 10 LMICs in Africa, Asia, and South America, as well as Russia and the US.

The average vaccine acceptance rate in the LMICs was around 80 per cent, compared to 65 per cent in the US and 30 per cent in Russia, the study found.

Niccolo Meriggi, study co-author and country economist for the International Growth Centre (IGC), Sierra Leone, said: “We believe the study is particularly important in informing the global strategy for vaccine distribution. If we want to maximise global coverage, we should prioritise sending more vaccines to low- and middle-income countries where vaccine acceptance is higher.”

Personal protection against COVID-19 infection was the most cited reason for being willing to take a vaccine in LMICs (91 per cent), as well as in the US (94 per cent) and Russia (76 per cent). In many countries, concern about side effects was commonly cited as a cause for vaccine reluctance.

Vaccination campaigns, say the researchers, now need to focus on translating stated vaccine acceptance into actual uptake of vaccines.

When it comes to guidance on immunisation, health workers are counted as the most trusted sources, according to the study. “Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analysed LMICs,” it said.


Lawrence Gostin, professor of global health law at Georgetown University in the US and director of the World Health Organization (WHO) Collaborating Center on National and Global Health Law, believes high-income countries should immediately donate large quantities of COVID-19 vaccines — not just excess vaccines — and pledge vaccines for the future.

“We should stop trying to vaccinate young healthy people or seek boosters until health workers and the vulnerable are fully vaccinated in LMICs,” said Gostin.

In the US, 49.6 per cent of the population is fully vaccinated, while in Russia the figure is 13.7 per cent, according to Our World in Data. Both countries have seen the continued rise of vocal anti-vaccination movements during the pandemic.

Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, in the US, says the anti-vaccine movement is much more prevalent in high income countries where “people have the luxury of not seeing people dying from vaccine-preventable illnesses”.

“In developing countries, vaccines literally mean life or death and people see that on a day-to-day basis,” said Adalja, whose work focuses on emerging infectious diseases.

A “Global Dashboard” on COVID-19 vaccine equity, developed jointly by the WHO, the United Nations Development Program and the University of Oxford, estimates that if low-income countries could keep up the same COVID-19 vaccination rate as high-income countries, they could add $38 billion to their GDP forecast for 2021.

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However, according to a WHO statement: “richer countries are projected to vaccinate quicker and recover economically quicker from COVID-19, while poorer countries haven’t even been able to vaccinate their health workers and most at-risk population and may not achieve pre-COVID-19 levels of growth until 2024.”

Lulu Bravo, professor emeritus of pediatric infectious and tropical diseases at the University of the Philippines Manila, believes that leaders from both rich and countries can always find ways to encourage people to accept the vaccines.

“The conditions prevailing in different countries are never the same. It may take more people working together to educate and explain why vaccination can save lives and end the pandemic,” she said.

This piece was produced by SciDev.Net’s Global newsdesk.

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