Vaccine hesitancy will soon become the primary obstacle to global immunity
Global manufacturing capacity has been the primary rate limiter for Covid-19 vaccinations. Our vaccine manufacturing infrastructure was not designed to produce enough doses to cover 70% of the world’s population within a year (in addition to regular and routine vaccines) and, as expected, demand is outstripping supply. There has been good news on the manufacturing front, however, with several large pharma companies recently joining with rivals to ramp up production.
At the same time, data on vaccine hesitancy suggest that it may soon overtake manufacturing capacity as the primary obstacle to global coverage and reaching herd immunity. If this is the case, we will soon find that producing enough vaccines does not translate to enough vaccinations.
Covid-19 vaccine hesitancy is growing around the world. A survey of 15 countries found that willingness to get a Covid-19 vaccine dropped in nearly all of the countries between October and December 2024. France and Russia had the lowest rates of vaccine intent in the survey, below 50%. Another survey of 32 countries found that fewer than half of the population in Lebanon, France, Croatia, and Serbia intend to get vaccinated.
In Peru, vaccine hesitancy grew by 26 percentage points (from 22% to 48%) between August and December and the population is now evenly split between those willing and those not willing to receive the vaccine. Other data indicate some countries fall much lower: in the Philippines, fewer than a third are willing to have a Covid-19 vaccine.
Even in China, a country with historically high rates of vaccine take-up, intent to get a Covid-19 vaccine dropped in late 2024 (though at 80% China was still at the top of the chart). Negative coverage of western-developed vaccines in Chinese state media appears to be fueling mistrust of even Chinese-developed Covid-19 vaccines and slowing vaccination rates.
In both the US and UK, recent studies found that hesitancy rates are highest among younger adults, racial minorities, and people with lower education and income. A similar trend was noted this week in Israel, where vaccine take-up has slowed and is particularly low among minority communities and younger populations.
There was improvement in vaccine intent among Black and LatinX populations in the US between December and January; however, these groups are still most likely to say that they will “wait and see” rather than get the vaccine as soon as possible. Experts suggest that supply may outstrip demand in the US as early as April.
Public health leaders in countries around the world have pulled every lever they can to secure vaccine doses to protect their populations. Each dose is the result of unprecedented scientific and industry cooperation, complex negotiations, and a flat-out global effort. But the race to develop, manufacture, and distribute vaccines must result in vaccinations. We need to get ahead of vaccine hesitancy now, with strong outreach campaigns, before it becomes the rate limiter.
For more on this topic, register for the Duke Global Health Institute’s (virtual) conversation with experts addressing vaccine hesitancy later this month.