Global analysis of timely COVID-19 vaccinations: improving governance to reinforce response policies for pandemic crises

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Abstract

Purpose

The goal of this study is to analyze the relationship between public governance and COVID-19 vaccinations during early 2021 to assess the preparedness of countries to timely policy responses to cope with pandemic crises.

Design/methodology/approach

This global study elaborates descriptive statistics, correlations, regression analyses and Independent Samples T-Test on 112 countries, comparing those with high/low level of governance, to determine whether statistical evidence supports the hypothesis that good governance can improve the timely administration of vaccines.

Findings

Bivariate correlation reveals that doses of vaccines administered × 100 inhabitants have a high positive association with the General Index of Governance ( r = 0.58, p-value <0.01). The result is confirmed by partial correlation (controlling density of population per km ²): r = 0.584, p-value <0.001. The coefficient of regression in the models also indicates that an increase in the General Index of Governance improves the expected administration of doses of COVID-19 vaccines ( p-value <0.001).

Research limitations/implications

Although this study has provided interesting results that are, of course, tentative, it has several limitations. First, a limitation is the lack of data in several countries. Second, not all the possible confounding factors that affect the vaccination against COVID-19 are investigated, such as country-specific health investments and expenditures, and these aspects should be examined in the future development of this research. A third limit is related to the measurement of governance through the World Governance Indicators, which are based only on perceptions and can be biased by different socio-economic factors.

Practical implications

The identification of factors determining the timely vaccinations may help to design best practices of health policy for improving the resilience of countries to face pandemic crises.

Social implications

The improvement of preparedness of countries through good governance can foster a rapid rollout of vaccinations to cope with pandemic threats and the negative effects of their socio-economic impact.

Originality/value

This study presents a global analysis of the role of public governance for timely vaccinations to face pandemic crises in society.

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Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom

Jamie Murphy, Frédérique Vallières, Richard P. Bentall … (2021)

Identifying and understanding COVID-19 vaccine hesitancy within distinct populations may aid future public health messaging. Using nationally representative data from the general adult populations of Ireland (N = 1041) and the United Kingdom (UK; N = 2025), we found that vaccine hesitancy/resistance was evident for 35% and 31% of these populations respectively. Vaccine hesitant/resistant respondents in Ireland and the UK differed on a number of sociodemographic and health-related variables but were similar across a broad array of psychological constructs. In both populations, those resistant to a COVID-19 vaccine were less likely to obtain information about the pandemic from traditional and authoritative sources and had similar levels of mistrust in these sources compared to vaccine accepting respondents. Given the geographical proximity and socio-economic similarity of the populations studied, it is not possible to generalize findings to other populations, however, the methodology employed here may be useful to those wishing to understand COVID-19 vaccine hesitancy elsewhere.

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COVID-19 vaccine hesitancy in a representative working-age population in France: a survey experiment based on vaccine characteristics

Michaël Schwarzinger, Verity Watson, Pierre Arwidson … (2021)

Background Opinion polls on vaccination intentions suggest that COVID-19 vaccine hesitancy is increasing worldwide; however, the usefulness of opinion polls to prepare mass vaccination campaigns for specific new vaccines and to estimate acceptance in a country's population is limited. We therefore aimed to assess the effects of vaccine characteristics, information on herd immunity, and general practitioner (GP) recommendation on vaccine hesitancy in a representative working-age population in France. Methods In this survey experiment, adults aged 18–64 years residing in France, with no history of SARS-CoV-2 infection, were randomly selected from an online survey research panel in July, 2020, stratified by gender, age, education, household size, and region and area of residence to be representative of the French population. Participants completed an online questionnaire on their background and vaccination behaviour-related variables (including past vaccine compliance, risk factors for severe COVID-19, and COVID-19 perceptions and experience), and were then randomly assigned according to a full factorial design to one of three groups to receive differing information on herd immunity (>50% of adults aged 18–64 years must be immunised [either by vaccination or infection]; >50% of adults must be immunised [either by vaccination or infection]; or no information on herd immunity) and to one of two groups regarding GP recommendation of vaccination (GP recommends vaccination or expresses no opinion). Participants then completed a series of eight discrete choice tasks designed to assess vaccine acceptance or refusal based on hypothetical vaccine characteristics (efficacy [50%, 80%, 90%, or 100%], risk of serious side-effects [1 in 10 000 or 1 in 100 000], location of manufacture [EU, USA, or China], and place of administration [GP practice, local pharmacy, or mass vaccination centre]). Responses were analysed with a two-part model to disentangle outright vaccine refusal (irrespective of vaccine characteristics, defined as opting for no vaccination in all eight tasks) from vaccine hesitancy (acceptance depending on vaccine characteristics). Findings Survey responses were collected from 1942 working-age adults, of whom 560 (28·8%) opted for no vaccination in all eight tasks (outright vaccine refusal) and 1382 (71·2%) did not. In our model, outright vaccine refusal and vaccine hesitancy were both significantly associated with female gender, age (with an inverted U-shaped relationship), lower educational level, poor compliance with recommended vaccinations in the past, and no report of specified chronic conditions (ie, no hypertension [for vaccine hesitancy] or no chronic conditions other than hypertension [for outright vaccine refusal]). Outright vaccine refusal was also associated with a lower perceived severity of COVID-19, whereas vaccine hesitancy was lower when herd immunity benefits were communicated and in working versus non-working individuals, and those with experience of COVID-19 (had symptoms or knew someone with COVID-19). For a mass vaccination campaign involving mass vaccination centres and communication of herd immunity benefits, our model predicted outright vaccine refusal in 29·4% (95% CI 28·6–30·2) of the French working-age population. Predicted hesitancy was highest for vaccines manufactured in China with 50% efficacy and a 1 in 10 000 risk of serious side-effects (vaccine acceptance 27·4% [26·8–28·0]), and lowest for a vaccine manufactured in the EU with 90% efficacy and a 1 in 100 000 risk of serious side-effects (vaccine acceptance 61·3% [60·5–62·1]). Interpretation COVID-19 vaccine acceptance depends on the characteristics of new vaccines and the national vaccination strategy, among various other factors, in the working-age population in France. Funding French Public Health Agency (Santé Publique France).