Jab or no jab?

Dr Katie Atwell, UWA

With all eyes on Australia’s COVID-19 vaccination program, the field of vaccination social science offers insights from many years of interdisciplinary analysis. Consumer attitudes towards vaccines are important to the success of all vaccination programs, but they are not the only factor that matters.

For example, governments need to assure the supply and availability of appropriate vaccines. This is no mean feat when both the virus and vaccines are new, and circumstances continue to evolve through new strains and pharmacovigilance.

Reaching the population through effective vaccination services is yet another challenge. And health and medical providers need appropriate training and support in how to deliver the vaccines and record their administration.

But at all levels – from governments to providers and everyone in between – effective communications about the benefits and minor risks of vaccines are essential to public acceptance.

The COVID-19 pandemic experience has exacerbated global divides, not just between the economically privileged and those who live in poverty, but also between those countries that pursued local suppression of the virus and those which prioritised keeping businesses and borders open, often with a great cost in human lives. Australia’s successful employment of the first strategy, particularly through State-based policies, has made us one of the safest countries in the world.

However, the lack of COVID-19 locally makes vaccine acceptance more challenging. Our relative safety within State bubbles may make us feel less motivated to vaccinate, particularly for people who are not involved in work that depends directly on travel in or out of the country. Compare this to Europe, where hard lockdowns still apply and outbreaks continue, and the personal protection that vaccines offer is more tangible.

That said, survey data from the last year tells us that many countries face a broadly similar spread of attitudes, although there is local variation.

Across the globe, majorities of at least two-thirds indicate that they will accept the vaccine. Generally small minorities indicate that they will likely not. The remaining hesitant cohort are often concerned about the relative newness of the vaccines.

It is important not to consider this hesitant group resistant to vaccines in general. With very high rates of childhood vaccination globally, vaccination remains the social norm. Supporting those who are on the fence about COVID-19 vaccination requires empathy and leadership, rather than polarising discourse.

A small minority of Australians contribute to anti-vaccination messaging, spreading disinformation and connecting to broader conspiracies through groups such as QAnon. The information hygiene efforts of major social media companies have had some success in removing these messages from mainstream platforms, reducing their impact on other audiences. However, such efforts remain incomplete.

For researchers, studying vaccination attitudes during COVID-19 mirrors many of the challenges of rolling out the vaccines themselves. Everything has a much longer lead time than the public would imagine. Australian human ethics reviews for social research are highly bureaucratic and time consuming, especially for research using state health department facilities. Researchers in Europe do not face similar requirements; nor do the market research companies that governments often engage instead of utilising university scholars’ expertise.

Once researchers are out in the field, a constantly shifting information environment and program ecosystem make it challenging to gather data and interpret findings. For scholars of social media, the platforms’ disinformation restrictions generate complexities in finding and studying the spread of that disinformation.

When it comes to publications, peer review processes means they are often out of date by the time scholars can discuss them.

In the midst of all this, vaccination social scientists are frequently asked by the media to comment upon emerging events and crises. We face pressures to draw upon or report data, support the integrity of the vaccination system, bolster public trust, and communicate transparently and ethically.

This goes very much further than the role of 'just' being a researcher, which is a huge task in and of itself!

Fortunately, we have years of experience to draw upon in studying vaccine attitudes and experiences in other populations and for other vaccines. And despite these challenges, it is an exhilarating time to be a researcher in this field.

My 'Coronavax' team, based across the University of Western Australia and Telethon Kids Institute, conducts qualitative research into the West Australian population’s attitudes towards coronavirus vaccination. It’s exciting to do this research because there are real gaps in what the quantitative studies of the last year can tell us, particularly regarding why people feel a certain way.

As a specialist on mandatory vaccination, I’m very interested in what the public think about government or business requirements to vaccinate, and what people think about collective requirements for coverage in order to open our borders.

I’m generally interested in what motivates people in my state to vaccinate given that we have been almost unscathed by COVID-19. I’m also eager to learn what people think about eventually giving COVID-19 vaccines to their children.

Our study segments different age and population groups, so we will be able to compare young and older people, for example. And we can make the best of sudden policy changes, like the recent pivot away from Astra-Zeneca vaccination for under 50s by adjusting our methodologies. We have early data already, but in keeping with the considerations described above, I won’t offer spoilers!