What’s driving vaccine hesitancy and what can we do about it?

We explore trends and our own recent survey data to see where EU markets differ and converge on their trust of vaccine information

It’s been over a year since COVID-19 became a health crisis with global proportions.

Bringing our societies and economies to a screeching halt, the crisis demonstrated just how much our systems depend on public health. As we attempted adaptation to daily life in a global pandemic, all eyes turned to the scientists, researchers and healthcare professionals working around the clock to find an answer to the current crisis in vaccine-form.

And after what seemed like a lifetime’s worth of waiting, our protagonist arrived on the stage. Meetings occurred, announcements made, preliminary results delivered, efficacy proven, contracts signed, and market authorisations granted. Hope was glimmering ever so faintly that the tragedy would soon diminish.

However, even the best-laid plans can go awry.

Enter our antagonists: production delays, conflicting messaging, health concerns, and nationalistic tendencies. Not to mention the threat of misinformation looming at every turn to amplify doubts and fears in the public space.

These contenders have stoked the fire of vaccine hesitancy which had been smouldering across the EU in recent years. With many perceived uncertainties, one thing is certain: our efforts and investments in a vaccine will have been in vain if citizens refuse the jab.

While the threats anti-vax trends pose to public health are obvious, there is a secondary danger posed by an increasingly common pattern of behaviour: generalisation.

This happens as vaccine-related concerns are written off as anti-vax conspiracy, enforcing a potentially deadly division of “us” versus “them” as justifiable questions are not received with empathy and addressed with clear and concise information. Rather than nurturing a discussion which guides individuals to an informed position, rapid polarisation occurs based on emotions rather than evidence.  The positive news is evidence is on the side of vaccination efforts, we just need to learn how to communicate this as policy makers, health care professionals and active citizens.

Tailoring our vaccine communications approach

When we paint vaccine hesitancy with broad strokes, we neglect a decisive factor: the individual. Vaccination is an intensely personal experience; therefore, personal concerns must be treated with tact and empathy. According to Dr Heidi Larson, author of Stuck and founder of the Vaccine Confidence Project, statements which suggest an individual’s feelings or concerns about vaccines are “irrational” contribute to their sense of alienation and sometimes anger towards the system and scientific elites. Those of us who identify as pro-vaccine should remember that those who are against or hesitant of vaccines are not bad people, just concerned. We must not demonise but extend a hand to build bridges of understanding which will save countless lives.

Vaccine hesitancy is a spectrum, influenced by complex economic, political, and historical factors. This is particularly evident in the differences we see between EU member states. In a recent survey FH Brussels conducted in 4 European markets (France, Germany, Spain and Italy), trends appeared indicating commonalities (i.e. level of trust held for local doctors) and divergences (i.e. level of trust held for the European Union or National Governments) when it comes to trust in information sources related to COVID-19 vaccines. These trends in trust have in turn, impacted levels of confidence in vaccines.

These findings have led the team at FH Brussels to ask: what is giving birth to these national variations in vaccine confidence? More to this point, what is the hope of an EU-wide strategy to deploy doses which fails to consider the unique factors which have shaped the sentiment of citizens in each Member State? It’s clear the European Union needs not only a strong and unified plan, but also one which considers national nuances to circumvent dangerous trends.

To understand the common threads and stark differences, our team has partnered with FleishmanHillard’s in-house research and measurement group, TRUE Global Intelligence, to gather primary research from key markets to understand how a vaccination strategy can have EU-wide impact which is powered by national insights.

While our research is focused on the current health crisis, the lessons will outlast the progression of COVID-19 into a managed endemic. Vaccines are a crucial tool for public health which prevent and, in some cases, eradicate fatal diseases. As humanity is and will remain dependent on vaccination efforts, learning how to dispel myths and encourage uptake will remain an essential tool for public health.

Stay tuned as our team dives in!


  • Haven Hightower

    Haven is a policy and political outreach specialist who supports clients in health sectors by directing engagement with Brussels stakeholders. Prior to joining FleishmanHillard, she worked as head of office for a Member of the European Parliament on two committees: Environment, Public Health and Food...

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