Vaccine confidence concerns the belief that vaccination – and by extension the providers and range of private sector and political entities behind it – serves the best health interests of the public and its constituents. The Oxford English Dictionary defines confidence as “the mental attitude of trusting in or relying on a person or thing”. In light of that, we are not examining the well-studied domain of supply and access barriers to vaccination, but rather what is typically called the “demand” side of immunisation. However, our focus on confidence takes the “demand” rubric a step further than the more traditional notion of building demand through increasing knowledge and awareness of vaccines and immunisation to understanding what else drives confidence in vaccines, and the willingness to accept a vaccine, when supply, access and information are available. In other words, understanding vaccine confidence means understanding the more difficult belief-based, emotional, ideological and contextual factors whose influences often live outside an immunisation or even health programme but affect both confidence in and acceptance of vaccines.
The purpose of the project is to monitor public confidence in immunisation programmes by building an information surveillance system for early detection of public concerns around vaccines; by applying a diagnostic tool to data collected to determine the risk level of public concerns in terms of their potential to disrupt vaccine programmes; and, finally, to provide analysis and guidance for early response and engagement with the public to ensure sustained confidence in vaccines and immunisation. This initiative also defines a Vaccine Confidence Index™ (VCI) as a tool for mapping confidence globally.
The VCI is a measure, based on a select number of factors identified from extensive analysis of areas of both low and high vaccine coverage. This index is useful for informing the design of immunisation programmes and strategies and understanding more explicitly where to target both human and financial resources, which will allow for more efficiency. The VCI is an important tool for routine immunisation as well as the introduction of new and underutilised vaccines. Further information is available on our research page.
Despite the historic success of immunisation in reducing the burden of childhood illness and death, episodes of public concerns and rumours around vaccines have occurred around the world, spreading quickly and sometimes seriously eroding public confidence in immunisation and ultimately leading to vaccine refusals and disease outbreaks.
Although reports of public concerns and questions around the safety and relevance of vaccines have been on the increase, aside from monitoring of adverse events following immunisation (AEFI), there is neither a systematic monitoring of broader public vaccine concerns nor a tool to assess risk levels of rumours and concerns to potential programme disruptions, vaccine refusals and potential disease outbreaks.
This project seeks to address these unmet needs and monitor public confidence in immunisation programs by listening for early signals of public distrust and questioning and providing risk analysis and guidance to engage the public early and pre-empting potential programme disruptions.