Key drivers of vaccine hesitancy in the Covid-19 pandemic. A series of semi-structured qualitative interviews into the perspectives of unvaccinated individuals

Abstract

Background: Vaccinations are essential to achieving and sustaining herd immunity against COVID-19 thus reducing unnecessary illness and mortality. A small but significant percentage of the adult population in the UK are, however, hesitant about receiving vaccines. There is a lack of qualitative research exploring the specific barriers to COVID-19 vaccination in depth. 

Methods: A set of ten qualitative semi-structured interviews were conducted using videoconferencing software and in person. Participants were interviewed from a set of twelve open ended questions and relevant tangents were explored to capture as much of the wider context surrounding vaccine hesitancy as possible. The interviews were recorded and transcribed for analysis. Participants were recruited using convenience and snowball sampling techniques, alongside a social media advertisement. Data was analysed using thematic analysis which categorised the data into six key themes.

Results: Findings demonstrated safety concerns to be the most significant barrier to vaccination. Participants lacked trust in government, and health systems and perceived the speed at which COVID-19 vaccines were developed as a concern. A preference for immunity via natural infection was found amongst participants, with every participant having either received a positive COVID-19 test or suspecting they had caught the virus at some stage. Complacency levels about the severity of COVID-19 was present throughout the participants, with many lacking concern that it posed any significant threat to the health of non-vulnerable populations. Despite predicted concerns about convenience barriers, this was not an issue for the majority of participants. Findings suggested the majority of participants felt strongly that they were unwilling to be vaccinated under any circumstances however a small minority suggested they would reconsider in light of longer-term safety and efficacy testing.

Conclusion: This research demonstrated that the primary reason for health eligible adults to refuse the vaccine was low confidence levels in vaccine safety. Low levels of belief in vaccine efficacy, widespread government mistrust and complacency surrounding Covid-19 risk were secondary barriers. Education to increase Covid-19 vaccine uptake should be coupled with prevention measures and further research to understand how these attitudes vary across the unvaccinated and partially vaccinated population.