Understanding the depth of vaccine hesitancy, and the drivers behind the lack of take-up is critical to preventing further deaths, infections, and continuing harm to the economy.
The extraordinary Dunedin longitudinal study shows vaccine resistance can be laid down before high school age in response to childhood trauma or neglect. But better early education could help.
Many COVID-19 vaccination campaigns encourage doctors to serve as a trusted source of vaccine information. But certain vaccine-hesitant providers may stymie these efforts.
Some of the most persistent myths about COVID-19 vaccination have been false rumours that it can affect fertility in men or women. There has never been any evidence to support this misinformation.
Vaccine hesitancy is often met with one of two responses: Ridicule, or factual information. Both assume a failure of reason, but human behaviour is more complex than reason, so both responses fail.
The antagonism driven by political interference in COVID-19 vaccination is fuelling hesitancy. Mass vaccination campaigns require public buy-in via trusted health-care providers and community leaders.
Vaccine hesitancy may be a waiting game. Even those who said they would never get the COVID-19 vaccine if it were available immediately became more likely to do so when it was available in the future.
Instead of assuming that science skeptics are motivated by ignorance, or selfishness, we should listen to them and try to understand and address their actual concerns.
Some vaccine hesitancy is based on a fear of the nanoparticles used in mRNA vaccines. But humans have been interacting with nanoparticles for millennia, and we use nanotechnology-based devices every day.
We have moved beyond burning witches and lynching wrong-doers. So we should also stop shaming unvaccinated people. There are better ways to change behaviour.
Using trusted messengers, making sure that vaccine information is tailored to those being targeted, and greater flexibility over vaccination timing and venues could all increase uptake.
Paediatrician at the Royal Childrens Hospital and Associate Professor and Clinician Scientist, University of Melbourne and MCRI, Murdoch Children's Research Institute
Senior Scientist, Cochrane South Africa, South African Medical Research Council (SAMRC) and Honorary researcher, Division of Social & Behavioural Sciences, School of Public Health, UCT, South African Medical Research Council
Visiting Professor in Biomedical Ethics, Murdoch Children's Research Institute; Distinguished Visiting Professor in Law, University of Melbourne; Uehiro Chair in Practical Ethics, University of Oxford