A substantial proportion of the world’s population remains willing to get vaccinated against diseases including COVID-19, according to a new survey across 23 countries that represent more than 60% of the world’s population.

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Source: CDC

In this 2020 photograph, captured inside a clinical setting, a health care provider and patient, consult on influenza vaccine options.

The study, published in Nature Medicine, was co-led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation, and the Graduate School of Public Health and Health Policy of the City University of New York (CUNY SPH).

The severe human impact of the COVID-19 pandemic led to the rapid research and development of safe and effective vaccines based on existing models, and resulted in the largest vaccination campaign in history. Just one year after COVID-19 was declared a pandemic, more than 250 million people worldwide had been vaccinated against SARS-CoV-2, the virus that causes it.

Although no longer considered a significant public health threat, the virus continues to circulate and mutate. This means that variant-adapted boosters are still needed, especially for the many people at higher risk of severe disease and death. 

Major challenges

“Today, vaccine hesitancy, pandemic fatigue and vaccine fatigue are major challenges to ensuring that people stay up to date with their vaccinations, including COVID-19 boosters” says Jeffrey V. Lazarus, head of the Health Systems Research Group at ISGlobal, Professor of Global Health at CUNY SPH, and coordinator of the study.

Through a series of annual surveys across 23 countries over the course of the pandemic, Lazarus and his colleagues have been assessing global trust in information sources and vaccines. In this fourth survey of 23,000 adults, conducted in October 2023, the research team found that the intent to get a COVID-19 booster was slightly lower (71.6% of respondents) compared to 2022 (87.9%). However, the global population’s overall trust in vaccination did not diminish. More than 3 in 5 participants (60.8%) said they were more willing to get vaccinated for diseases other than COVID-19 as a result of their experience during the pandemic, while only 23.1% were less willing.

“This finding suggests there is a general openness to vaccination that can be used to boost confidence in new generations of COVID-19 vaccines and boosters,” says Ayman El-Mohandes, study co-author and Dean of the City University of New York School for Public Health & Health Policy. “We must design targeted messages for trusted communicators to encourage vaccine uptake.”

Public trust

The new survey also evaluated public trust in information sources used during the pandemic. Overall, the most trusted sources were healthcare providers (with a score of 6.9 out of 10) and the World Health Organization (6.5 out of 10), highlighting the importance of continuing to rely on these sources in future communication campaigns. There was, however, some variability between countries. For example, religious leaders ranked 3.16 in Sweden but 6.72 in India.

Public trust in the ability of authorities, scientists, and health organisations to manage future pandemics presented a mixed picture. “The great variability of trust observed across countries makes it clear that improving vaccine confidence globally will require more culturally appropriate local communication strategies,” says Lazarus. “There is an urgent need to catch up on routine immunisations and prepare for potential new pandemic threats, so we must continue to monitor vaccine confidence,” he adds.

The survey data are highly representative for different geographic regions in the world and different demographic groups (age, gender, education level) within each country.