Cited by 2,904Vaccine Coverage and HesitancySARS-CoV-2 and COVID-19 ResearchRisk Perception and Management

The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index; 1 of the 11 sources its claims cite were checked for support.

A global survey of potential acceptance of a COVID-19 vaccine

Open access

Abstract

Several coronavirus disease 2019 (COVID-19) vaccines are currently in human trials. In June 2020, we surveyed 13,426 people in 19 countries to determine potential acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Of these, 71.5% of participants reported that they would be very or somewhat likely to take a COVID-19 vaccine, and 48.1% reported that they would accept their employer’s recommendation to do so. Differences in acceptance rates ranged from almost 90% (in China) to less than 55% (in Russia). Respondents reporting higher levels of trust in information from government sources were more likely to accept a vaccine and take their employer’s advice to do so. Survey data from across 19 countries reveal heterogeneity in attitudes toward acceptance of a COVID-19 vaccine and suggest that trust in government is associated with vaccine confidence.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In June 2020, a 19-country survey of 13,426 adults found that 71.5% would be very or somewhat likely to take a COVID-19 vaccine, but only 48.1% would accept their employer’s recommendation to do so. Acceptance varied widely by country and was strongly associated with trust in government.

Key findings

  • Overall, 71.5% reported they would take a proven safe and effective COVID-19 vaccine, and 48.1% said they would accept an employer recommendation to get vaccinated.
  • Country variation was large: China had the highest positive response for the general vaccine question (631/712, 88.6%) and Russia the lowest (373/680, 54.9%); Poland had the highest negative response (182/666, 27.3%). For employer recommendation, China had 83.7% positive responses (596/712), while Russia had the lowest willingness (184/680, 27.1%) and highest negative response (278/680, 40.9%).
  • Trust in government was associated with acceptance: OR = 1.67 (95% CI 1.54, 1.80) for the general vaccine question and OR = 4.35 (95% CI 4.01, 4.72) for the employer-recommendation question.
  • Older age and higher income/education were positively associated with acceptance. For example, respondents aged 65+ vs 18–24 had OR = 1.73 (95% CI 1.48, 2.02) for the general question, and those earning >$32/day vs <$2/day had OR = 2.18 (95% CI 1.79, 2.64). Men were slightly less likely than women to respond positively (OR = 0.84; 95% CI 0.78, 0.91), and self/family COVID-19 sickness was not associated with acceptance (OR = 0.97; 95% CI 0.87, 1.08).

Methods

  • The study analyzed two vaccine-acceptance questions from the COVID-SCORE online survey, collected June 16–20, 2020, from 13,426 respondents aged 18+ in 19 countries, with 619–773 participants per country.
  • Participants were recruited through multiple international online panel providers; sampling was random and described elsewhere.
  • Responses used a five-point Likert scale. Logistic regressions coded “completely agree” or “somewhat agree” as 1 and all other responses as 0, with univariate models against age, gender, income, education, COVID-19 sickness in self/family, country cases and mortality per million, and trust in government.

Limitations

  • The paper states that public surveys are snapshots at a point in time, the survey occurred in a highly dynamic COVID-19 landscape, and reported willingness may not predict actual acceptance. It also notes that events after the survey may have increased hesitancy, and that employment status was not investigated for the age/employer-recommendation finding.
  • The text makes evident that the regressions are univariate rather than multivariable-adjusted, so associations may not be independent.
  • The online panel design may limit representativeness despite random sampling, and the outcomes are self-reported intentions rather than observed vaccination behavior.

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Integrity signals

Registry

Crossref · 10.1038/s41591-020-1124-9

Cites

19 of 19 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

23 Own result · 8 Not checked yet · 6 Own method · 4 Own interpretation · 1 Partly supported · 1 No basis given · accuracy not yet measured

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Show all 25 claims

  • It may state two separate claims as one. 7
  • The quote only partly states this claim. 1
  • Probably not a substantial claim. 11
18 of 18
  • The paper relies on this without support.

    The level of vaccine acceptance required for community immunity is higher than the levels of willingness observed in most of the 19 countries.

    “In most of the 19 countries surveyed in our study, current levels of willingness to accept a COVID-19 vaccine are insufficient to meet the requirements for community immunity.”
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Metadata

Authors
Lazarus, J. V., Ratzan, S. C., Palayew, A., Gostin, L. O., Larson, H. J., Rabin, K., Kimball, S., & El-Mohandes, A.
Affiliations
  • Barcelona Institute for Global Health (ES)
  • City University of New York (US)
  • Georgetown University (US)
  • London School of Hygiene & Tropical Medicine (GB)
  • Emerson College (US)
Corresponding author
Lazarus, Jeffrey V.
Venue
Nature Medicine
Published
2020-10-20
Volume
27
Issue
2
Pages
225-228
ISSN
  • 1078-8956 (ISSN-L)
  • 1546-170X
OpenAlex
W3093974194
Cited by
2,904
References
19
Citations by year
2026: 91 · 2025: 109 · 2024: 276 · 2023: 541 · 2022: 950 · 2021: 901 · 2020: 32
FWCI
335.12
Type
journal article
Language
en
Open access
Locations
  • Nature Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • Scholarship - GEORGETOWN LAW (Georgetown University) (submittedVersion)
  • SSRN Electronic Journal (submittedVersion)
Funders
  • City University of New York
  • Ministerio de Ciencia, Innovación y Universidades (CEX 2018-000806-S)
  • Centres de Recerca de Catalunya (CEX2018-000806-S)
  • Generalitat de Catalunya (CEX2018-000806-S)
  • Università Bocconi
Topics
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Social Sciences › Sociology and Political Science › Risk Perception and Management
Keywords
COVID-19 vaccines, vaccine acceptance, vaccine hesitancy, vaccine confidence, public trust in government, cross-national comparison, vaccine attitudes
MeSH terms
COVID-19, SARS-CoV-2, COVID-19 Vaccines, Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Surveys and Questionnaires, Regression Analysis, Internationality, Young Adult

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