From vacillation to vaccination: resilience and its effect on vaccine sentiment in Asia

Vaccines are crucial interventions against infectious diseases, preventing an estimated 2.5 million deaths a year. While opposition to vaccination has always existed and an active refusal of vaccines is a minority position globally, concerns about reduced acceptance of vaccines in certain communities are growing. Particularly concerning are the public health fallouts that may result from rising negative sentiment towards vaccines such as the resurgence of measles in Europe and North America that has resulted partly from decreased population confidence in and reduced vaccination coverage with measles-mumps-rubella (MMR) vaccine. Other examples include concerns about the safety of dengue vaccine leading to reduced confidence in other vaccines in the Philippines and negative perceptions of human papillomavirus (HPV) vaccine in numerous countries.

Although often construed as an inherently personal attitude towards vaccines, vaccine sentiment results from a complex interplay between individual factors – including beliefs and experiences – and external factors – including media portrayals of vaccines, vaccination policies, and the ability of health systems to assure the efficacy and safety of vaccines. Other factors related to healthcare access, vaccination cues and trust in the wider health system may also influence vaccine sentiment.

Although several tools exist to measure public attitudes to vaccines and vaccination, these were mostly developed in high-income settings in Europe and North America, and little is known about vaccine sentiment in lower-income settings in Asia and Africa, how it varies across and within countries, and the determinants of vaccine sentiment.

This project, thus aims to measure population vaccine sentiment and to understand how public sentiment towards vaccines is influenced by both individual and contextual factors in five Association of Southeast Asia Nations (ASEAN) countries. Specific objectives of the study are:

1. To conduct a systematic review of medical and social science literature in order to identify the tools available at present to measure different aspects of vaccine sentiment and to present these results in the form of a summary.
2. To apply the results from the systematic review and develop a purpose-built survey tool to measure public vaccine sentiment in five ASEAN countries.
3. To understand the extent to which vaccine sentiment is influenced by individual factors (beliefs, attitudes, and experiences) in these five ASEAN countries.