In Australia, high vaccine hesitancy among most vulnerable to COVID-19

The cornerstone of COVID-19 pandemic management is vaccination. Countries around the world have developed strategies for prioritizing COVID-19 vaccinations. World Health Organization (WHO) guidelines indicate the optimal timing of vaccination among specific groups based on the probability of infection and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), e.g., health care workers providing direct care or acute disease and death (e.g., older people, organ transplant recipients).

But despite the health risks, new research published on the preprint server medRxiv* suggests many people in this group living in Australia are vaccine-hesitant.

Since Australia's vaccine rollout in early February, there have been over 13.7 million vaccine doses administered.

This study, led by Anne Kavanagh of The University of Melbourne, used data from 2,400 Australians who participated in a two-part survey in April and May 2021. The study reported that about 8.2% of respondents were vaccinated.

People with severe mental health conditions were most likely not to get the vaccine.

The researchers write:

"These findings demonstrate the urgent need for governments to enable easy access to vaccination for people in priority groups and to develop communication strategies to promote vaccination uptake, co-designed with the priority groups."

To date, Australia has had just over 37,000 cases and 941 deaths related to SARS-CoV-2.

Study details

Patient data were collected from the Taking the Pulse of the Nation survey taken every 2 weeks since April 2020 from the University of Melbourne. The survey was given via phone or online interview on Australians' feelings regarding the COVID-19 pandemic.

The study is based on survey information from April and May 2021, when people over 50 years old or considered priority groups were eligible to get the vaccine. Questions included a person's disability status, attitudes about the vaccines, and whether they were vaccinated.  People were considered to have vaccination coverage if they had at least one vaccine dose.


There was a total of 2,400 participants who completed the survey. Overall, about 8.2% of respondents reported being vaccinated and 35.6% were hesitant about getting the vaccine.

A total of 19.1% of survey respondents did not plan to get the vaccine at all.

Of all the respondents, about 27.5% reported having a disability, 10.8% had a severe mental health condition, 19.9% have a severe, long-term health condition, and 5.6% required constant outside assistance.

Low COVID-19 vaccination rates among people with mental health conditions

People with long-term health conditions had the highest rates of vaccinations with vaccination coverage at 13.4%, followed by people with disabilities at 8.4%. People with severe mental health conditions had the lowest vaccination coverage at 4.3%.

"Given that people in these priority groups were eligible to receive the vaccine at the time of the survey, the lack of difference in vaccination coverage between these groups and the overall sample is surprising and of concern," wrote the study authors.

Vaccine hesitancy polls high among survey respondents

While there was high overall vaccine hesitancy at 35.6%, vaccine hesitancy was lower for people with disabilities. People with disabilities reported about 30.3% vaccine hesitancy.

People who need frequent assistance (24.2%) and people with severe long-term health conditions (27.7%) had among the lowest vaccine hesitancy among all surveyed groups.

Age appeared to play a factor in vaccine hesitancy. Older people had the lowest vaccine hesitancy at 19.3%. Older adults in priority groups had even lower vaccine hesitancy.

Vaccine hesitancy was high across all groups, including priority groups, for people 18 to 64 years old.

Vaccine hesitancy was higher in women (39.9%) than men (31.1%). However, women falling into the priority group, including having a frequent need for outside assistance, having long-term health conditions, or having a disability, reported lower vaccine hesitancy.

"Further research is needed to understand the reasons underlying vaccine hesitancy in Australia, including among different subgroups of the population. Communication strategies to improve vaccination uptake need to be co-designed with the priority groups," conclude the researchers.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:
Jocelyn Solis-Moreira

Written by

Jocelyn Solis-Moreira

Jocelyn Solis-Moreira graduated with a Bachelor's in Integrative Neuroscience, where she then pursued graduate research looking at the long-term effects of adolescent binge drinking on the brain's neurochemistry in adulthood.


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