New research published in The Lancet highlights that delivering clear, timely, and transparent information is essential for encouraging populations to embrace vaccination campaigns, particularly during health crises like the COVID-19 pandemic. The study tracked individuals over time, examining not only their initial reasons for vaccine hesitancy but also whether they ultimately received a vaccination, providing unique insight into the dynamics between hesitancy and actual uptake.
The research analysed data from over 1.1 million participants in the Real-time Assessment of Community Transmission (REACT) studies in England. Of these, 37,982 people (3.3%) reported vaccine hesitancy, with rates peaking at 8% early in 2021 during the start of the vaccine roll-out. Hesitancy declined to 1.1% at the start of 2022 but rose slightly to 2.2% after the Omicron surge. Many early concerns were tied to the novelty of COVID-19 and the use of new mRNA vaccine technology.
The study revealed that a significant majority of initially hesitant individuals went on to receive a vaccination: 65% of the 24,229 hesitant participants who consented to data linkage ultimately received one or more doses. Hesitancy was often context-specific, reflecting worries about vaccine effectiveness, side effects, fertility, and breastfeeding. These concerns decreased over time, likely due to accumulating evidence and reassuring information.
The analysis also showed that vaccine sentiment is dynamic. Some hesitant individuals later accepted vaccination, while others remained unvaccinated, with persistent hesitancy linked to prior COVID-19 infection, lower education levels, and socio-economic deprivation. Patterns varied by demographic: older adults who expressed hesitancy were more likely to remain unvaccinated, whereas women were initially more hesitant but often chose vaccination later, reflecting temporary concerns such as pregnancy or breastfeeding.
The findings underscore that transparent and timely communication is crucial for successful vaccine campaigns. Targeted outreach and clear messaging can address specific community concerns, particularly among higher-risk groups. For future pandemics, the study emphasizes investing in effective communication strategies to ensure widespread, non-selective vaccination uptake.
Overall, the research highlights that hesitancy is not uniform and that population behaviors differ, even within a single country. Careful, evidence-based information delivery can positively influence public perception and vaccination decisions, offering lessons for both current and future public health campaigns.





