High-income regions less certain about safety of vaccines compared to low-income countries, says survey

An overwhelming majority of people in lower-income areas ‘agree’ (‘somewhat’ or ‘strongly’) that vaccines are safe, says Wellcome Global Monitor report

                            High-income regions less certain about safety of vaccines compared to low-income countries, says survey

At a time when lack of vaccination efforts and insufficient vaccination rates have led to a massive global measles outbreak, a global report reveals that people in high-income regions are less likely to agree that vaccines are safe, compared to people in low-income countries.

The findings are significant as public confidence in vaccines is critical in tackling deadly but preventable diseases, and in maintaining high vaccination rates.

“In high-income regions, there is less certainty about the safety of vaccines, with 72% of people in Northern America and 73% in Northern Europe agreeing that vaccines are safe. In Western Europe, this figure is even lower, at 59%, and in Eastern Europe, it stands at only 40%,” says the Wellcome Global Monitor report.

This is the first global survey of public attitudes to science, scientists, and health, conducted by Wellcome, an independent foundation. It covered 140,000 people aged 15 and older, in more than 140 countries.

The World Health Organization (WHO) has identified vaccine hesitancy – which the organization defines as "the delay in acceptance or refusal of vaccines despite the availability of vaccination services" – as one of the top 10 global health threats in 2019.

According to the WHO, vaccines prevented at least 10 million deaths between 2010 and 2015, and many millions of more lives were protected from illnesses. Hence, say experts, mistrust in vaccines can lead to a dangerous health problems.

Globally, eight in ten people (79%) ‘somewhat’ (18%) or ‘strongly agree’ (61%) that vaccines are safe, while 7% ‘somewhat’ or ‘strongly disagree’. Another 11% ‘neither agree nor disagree’, and 3% said they ‘don’t know’, says the study.

Perceived safety of vaccines by region: Percentage of people who answered ‘strongly agree’, ‘somewhat agree’, ‘neither agree nor disagree’, ‘somewhat disagree’, ‘strongly disagree’ or ‘no opinion’. (Wellcome Global Monitor report)


Worldwide, 63% of people ‘strongly agree’ and 21% ‘somewhat agree’ that vaccines are effective, or 84% who agree to some extent with this statement. Only 5% either strongly or somewhat disagree that vaccines are effective, while another 12% either said they did not agree or disagree or said they had no opinion, say the findings.

The researchers explain that in most regions, people who have high trust in doctors and nurses are very likely to consider that vaccines are safe. However, this is less true in Western and Eastern Europe, they add. “There is a positive relationship between overall trust in scientists and overall attitudes towards vaccines, though the relationship is strongest among high-income countries. In general, people are more likely to believe vaccines are safe if they trust scientists and medical professionals – though the relationship is strongest for trust in doctors and nurses. Worldwide, people who said they trust doctors or nurses ‘a lot’ are very likely to believe that vaccines are safe, at 87%,” the report says.

The researchers say that people’s decision not to vaccinate – for whatever reason – is not just a personal choice of risk-taking; it also poses a risk to others. “Being vaccinated protects an individual from being infected themselves, and if enough people are vaccinated, it stops the disease from being spread to the larger population. This provides what epidemiologists refer to as ‘herd immunity’, or protection from the disease for the entire population, including people who cannot be vaccinated for medical reasons. But for herd immunity to work, a large proportion of the population needs to be vaccinated; how large depends on how contagious the disease is. For example, approximately 90–95% of the population needs to be vaccinated against measles for herd immunity to work,” the researchers say.

In sharp contrast to high-income countries, an overwhelming majority of people in lower-income areas ‘agree’ (‘somewhat’ or ‘strongly’) that vaccines are safe, says the report. The highest such proportions are in South Asia, where 95% of people say they ‘agree’ that vaccines are safe, and in Eastern Africa, where the figure stands at 92%.

The findings further reveal that globally, 92% of people strongly or somewhat agree that it is crucial for children to have vaccines. Reflecting the high proportion who agree that vaccines are important for children to have, 92% said that to the best of their knowledge, one or more of their children had received a vaccine to prevent them from getting childhood diseases, while 6% said they did not, and 2% said they did not know.

The highest percentage of parents who said their children did not receive a vaccine were in Southern Africa (9%) and East Asia and Southeast Asia (8%).

According to the researchers, skepticism about vaccine safety does not always translate into skepticism about vaccine effectiveness. “In several regions where people are least likely to agree that vaccines are safe, the percentage who agree that they are effective is significantly higher; the biggest gaps are seen in Western Europe (59% safe, 77% effective) and Eastern Europe (50% safe, 65% effective),” says the report.

The researchers say this gap suggests that some people accept that they are effective at preventing certain diseases, even if they also believe some vaccines may have negative side-effects.

The French are the most skeptical people in the world about the safety of vaccines, with one in three (33%) disagreeing that vaccines are safe. “This level of skepticism is present and consistent across several demographic groupings within French society; it does not vary significantly by education, age, gender, urban or rural status, or whether people are parents,” the findings state.