Public attitudes towards COVID-19 vaccination in the UK: a qualitative interview study

Problem

Primary care staff have a critical role in the successful roll-out of the COVID-19 vaccine. Although a safe and effective COVID-19 vaccine has been approved for use in the UK, there have been some public concerns expressed particularly relating to the speed of the vaccine approval. Primary care staff are likely to be engaged with conversations with patients about vaccine concerns and will need to address questions and allay fears. National surveys assessing likely uptake to a COVID-19 vaccine have been undertaken in a number of countries. In the UK, estimates for vaccine uptake are around 76% (Royal Society of Public Health) and in our own survey research we have found likely uptake around 80%. As anti-vaccine attitudes are an important predictor of vaccination behaviour, we set out to understand in more depth public attitudes and beliefs towards the COVID-19 vaccination in the UK in order to provide advice on how the vaccine roll-out could be supported.

Approach

We conducted remote (skype, zoom and telephone) semi-structured interviews with 27 adult members of the public in the UK. Participants were purposefully sampled from our larger longitudinal online survey of public experiences of COVID-19 promoted using social media (n=2,386). Data for this presentation were collected in May 2020 (prior to any regulatory approval of any COVID-19 vaccine or data about its effectiveness); repeat interviews will be conducted in March 2021. Data were audio-recorded, transcribed, and thematically analysed supported by the NVIVO12 software using the theoretical framework provided by the Health Beliefs model.

Findings

Many respondents felt generally positive about vaccines and hoped that a COVID-19 vaccine would eventually be developed and approved. They felt susceptible to COVID-19 and were concerned to protect themselves. Barriers to the vaccine focused on safety concerns: short- and long-term side-effects, rushed vaccine development and regulatory approval, vaccinating the elderly and vulnerable first. Some participants had concerns about the likely effectiveness of the vaccine drawing parallels with the influenza vaccine, and with annual influenza deaths. Some participants cited political and financial motives for the rapid development of the vaccine, although others felt reassured by government and scientific advice. Generally, participants felt that the roll-out should prioritise those most exposed (front line workers), rather than those most at risk of complications (older adults, clinically vulnerable) and therefore were at odds with the UK government’s vaccine priority list.

Consequences

Understanding attitudes that underlie vaccine refusal or hesitancy is important for predicting vaccination behaviour and consequently for developing effective interventions or public health campaigns. Primary care staff involved in vaccinations should be aware of potential concerns of their patients and ensuring staff are properly prepared and supported for this role will be essential to the vaccination programme.