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Vaccination policy should respond to the motivations of vaccine refusers

Research by Leiden University Medical Center (LUMC), The Hague University of Applied Sciences and Erasmus University Rotterdam shows that about 15 percent of Dutch people do not want to be vaccinated. If better use were made of the knowledge of local professionals such as GPs, it would be easier to reach vaccine refusers.

About 15 percent of the participants in a large-scale survey said they did not want to be vaccinated against COVID-19 for various reasons. They are described in detail in the Dutch research report The Societal Impact of COVID-19 (in Dutch), to which researchers Britt Kraaijeveld and Jet Bussemaker from the LUMC Campus The Hague contributed. According to the study, the main reasons for vaccine refusal are:

  1. Concern about short- or long-term side effects; not wanting to be used as a ‘guinea pig’.
  2. Confidence in one’s own body and immune system, so no vaccine is needed to protect against the virus.
  3. Mistrust in the government and other agencies involved in vaccination. There is diversity within this category: it is certainly not only limited to conspiracy theorists. People say that they are not crackpots, but they do have doubts about how the government is handling the coronavirus pandemic and how freedoms are increasingly curtailed. 
  4. Religious reasons: people do not want to be vaccinated because they trust in God and do not want to interfere with His plan.

In addition, this group is irritated by the fact that vaccine refusers and doubters are quickly dismissed as crackpots. This further fuels the respondents’ distrust because they feel that there is no room for nuanced dissent.

Practical obstacles to vaccination

Interviews with GPs in The Hague and Rotterdam show that many people also face practical obstacles to getting vaccinated. For example, the information provided about vaccination was too complicated for many people in vulnerable groups. It was also difficult for people from disadvantaged neighbourhoods to reach the vaccination locations.

The study shows that GPs are critical of the national policy, in which their experience was only belatedly used to contact hard-to-reach target groups. Residents generally have a lot of faith in their GP. Because of this, GPs can play an important role in providing information about the vaccines and thereby increasing the willingness to be vaccinated.

According to GPs, valuable time was lost because the vaccination campaign was aimed at the general public. GPs have had good experiences with targeted vaccination in which the injection site comes to people where they are, such as in mosques, at markets or in the local supermarket.

‘Acknowledge different perspectives’

The researchers advocate acknowledging the different perspectives on vaccination. In addition, they recommend engaging in unbiased discussion with vaccine refusers. By gaining more insight into the motives of different target groups, communication about vaccination can be better tailored to them.

It is essential to use available knowledge from the local community. GPs and other professionals such as district nurses and social workers are an indispensable link in reaching different target groups. It is therefore important that they are closely involved in the design and implementation of local vaccination policies.

Text: Leids Universitair Medisch Centrum

About this research

The research report No coronavirus vaccine for me’ (in Dutch) is part of the project The Societal Impact of COVID-19. This research was made possible by a grant from the ZonMw research programme COVID-19. More information on the study can be found at www.impactcorona.nl (in Dutch).

The research was carried out by:
Marianne van Bochove, Hasse van der Veen, Katja Rusinovic (The Hague University of Applied Sciences)
Btissame el Farisi (Erasmus University Rotterdam)
Britt Kraaijeveld, Jet Bussemaker (Leiden University Medical Center Campus The Hague)

In addition to the above-mentioned institutions, VU Amsterdam, Kieskompas, and the municipalities of The Hague and Rotterdam were part of this research project. 

An episode of the podcast Studio Corona (in Dutch) was also produced based on these findings. It can be found on Spotify and Apple Podcasts.  

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