"I have never had vaccine hesitancy before and am studying public health so know vaccination is an integral part of a public health response. However, because these are new types of vaccines, they have been produced faster than any other and I've heard stories of negative side effects, I am anxious about receiving it and whether it will negatively impact my chronic health conditions."

- AHP Panellist

For the February 2021 survey on Australia’s Health Panel we asked panellists about their views on the impending COVID-19 vaccine rollout. This was in response to some polling by Essential Research that had found mixed attitudes about the vaccine among Australians.

Demographics

For this survey, 196 panellists participated. They were mostly female (81%), mostly aged 46 or older (84%) and live in major cities of more than 250,000 people (63%). Panellists came from across every state and territory (see Figure 1). Panellists generally reported as healthy, with only 10% reporting they were in poor health. Additionally, 3% identified as Aboriginal or Torres Strait Islander, 6% as LGBTIAQ+, 7% as culturally and linguistically diverse and 18% as a person with a disability.

Fig 1: COVID Vaccine survey - graph

Pie chart: COVID vaccine survey - geographic distribution
Figure 1: State of residence of participating panellists
Attitudes towards the COVID-19 Vaccine

Panellists were generally very supportive of getting the vaccine, with 67% reporting they would get vaccinated as soon as possible and 30% would get vaccinated, but not straight away.

Among the panellists who wanted to get the vaccine as soon as possible, the most common reason was that they wanted to be protected from COVID-19 as soon as possible (68%). Sizeable minorities reported that they wanted current restrictions on things like travel to be relaxed as soon as possible (40%), or because they had a health condition that made them particularly vulnerable to COVID-19 (39%). Few panellists intended to get the vaccine ASAP because of their area of work or living arrangements. When given the opportunity to provide their own reasons, the two most overwhelmingly common reasons were that the panellist was in a vulnerable group based on their age, or that they felt it was simply ‘the right thing to do’.

"It's the right thing to do for the community as a whole. It's selfish not to."

AHP Panellist

Among the panellists who reported they would get vaccinated but not straight away, the most common reason given for the delay was that they were worried about the safety of the vaccine and possible side effects (66%). Large groups were also waiting to see if the vaccine would be effective against new strains of COVID-19 (47%), had concerns about the fast pace of development (42%) or were skeptical about the vaccine efficacy in general (41%). Minorities of patients had health conditions or other personal reasons (31%); had concerns about the quality of the vaccine manufacturing (29%) or were worried about supply chain issues and wanted to let others go first (29%). Few panellists were wanting to wait until the vaccine was a single dose e.g. due to a fear of needles or wanted to wait until a different type of vaccine that was currently being trialled became available. Regarding how long they intended to wait, the three most common responses were ‘until more data is published about the efficacy and/or side effects of the vaccine’ (49%), ‘Until I'm satisfied that people who need it more than me have been able to receive it’ (33%) and ‘I’m not sure’ (27%).

Overall, this suggests that to increase the likelihood of people taking the vaccine at levels sufficient to gain herd immunity, more information needs to be provided not only about the vaccine itself (to show it is safe and effective) but also information providing clarity around who is getting it and when, so that people don’t feel they are taking it from someone who needs it more.

"Supply and priority is my concern. I live rurally, retired, little social interaction. It’s more important for front-line medicos, people in aged care and then people like my husband and son with severe heart failure and the other severe physical disability should be supplied first and I'm not sure if the idea of doing the whole household at the same time is advised like it is with regular flu shots or childhood treatments."

AHP Panellist

Given the small number of panellists (n=5) who reported they would not take the vaccine at all, limited conclusions can be drawn. However the most common reasons given for refusal were: concern about the fast pace of vaccine development; the safety of the vaccine e.g. potential side effects; the quality of the vaccine e.g. if it will be manufactured to a high standard, and skepticism that the vaccine would work against new strains of COVID-19 that evolve. As such the identified  priorities around better provision of vaccine information and rollout information could help minimise outright vaccine refusal.

National COVID Vaccine Rollout Strategy attitudes

The vast majority of panellists supported the Federal Governments ‘COVID-19 Vaccine National Rollout Strategy’ that was release on January 7th 2021, with 38% strongly supporting and 40% supporting the strategy. While 14% neither supported or opposed the strategy, only 5% opposed it and 3% were unsure. Given this overwhelming support for the strategy as outlined in early January, the subsequent delays of, and confusion about, the rollout potentially will have had negative effects for consumer confidence about the competency of the government in distributing the vaccine and consumer trust in the vaccine being delivered at expected levels of safety, quality and efficacy.

Looking at what information panellists would like to be given in order to increase their likelihood of getting that vaccine and/or getting the vaccine earlier, there was a clear top 5 set of answers (see Figure 2). These were ‘clearer information showing it is sufficiently safe’ (51%), ‘clearer information about which strains of COVID the vaccine will protect against’ (49%), ‘clearer information showing the efficacy is sufficiently high’ (48%), ‘clearer information about what health conditions impact on eligibility to receive the vaccine’ (44%) and ‘clearer information about how the vaccine being offered compares to other vaccines’ (42%). Very few panellists wanted to see information about the type of vaccine being changed or the number of doses required being reduced.

Fig 2 Bar graph COVID vaccine survey

Fig 2: Bar graph COVID vaccine survey - responses to what sort of information?
Figure 2: Panellist responses to question "What sort of information would you want to be given that would increase your likelihood of getting a COVID vaccine and/or getting the COVID vaccine earlier?"

Regarding how detailed they wanted the above information to be when given to them, the panel was divided in three main groups (see Figure 3). The largest (34%) wanted to be given all available information including detailed scientific data about the safety and efficacy for the specific vaccine they are offered. Nearly as large was the second group (33%) who wished only for summary information that outlined the features of the vaccine and the reasons for its approval. The final group was a distant third at only 13%, who didn’t need any specific detailed information but just wanted a clear assurance that the vaccine had been reviewed through, and approved by, an independent and thorough process.

Fig 3 COVID vaccine survey - graph

Bar graph - panellist responses
Figure 3: Panellist responses to question ‘How much of the above information do you want to receive about the features of the different COVID vaccine(s) that will be available in Australia?’

Regarding where they would go to find this information, the clear preference was official websites of government or government agencies e.g. Healthdirect, TGA with 67% of panellists nominating those locations (see Figure 4). However sizeable minorities of consumers would also go to: their GP (47%); live press conferences being held by Premiers/Ministers and Chief Health Officers (34%); news media organisations including newspapers, radio and online (32%), and whatever specific health professional/clinic is offering them the vaccine (31%). Surprisingly, friend/family members would be used by only 4% of panellists.

Fig 4: COVID vaccine survey - graph

Bar graph - panellist responses
Figure 4: Panellist responses to question ‘Where would you go to find this information [about the COVID-19 vaccine]?’

When given the option to nominate other places they would go to get information, the two most overwhelmingly common were pharmacists and medical specialists who treated conditions the panellist already had e.g. oncologists for those who had or were undergoing cancer treatments.

Overall, this emphasises that there is no single location that is used and trusted as a source of information by all panellists, or at least a sufficient proportion to reach herd immunity levels, so the vaccine rollout will need to effectively engage with and leverage multiple communication channels to be successful.

Conclusions

This Australia’s Health Panel survey found that there is a strong level of support among the wider community for the COVID-19 vaccine, with most people wishing to get it for a broad array of reasons. However, it also found that a large proportion of people, while supportive of getting the vaccine, intended not to get it immediately but rather wait until a set of conditions had been met. In particular, clarity over the vaccines’ safety and efficacy levels, and clarity over the vaccines’ distribution to those who most need it. Similarly, while people were overwhelmingly supportive of the government’s announced rollout for the vaccine they were also strongly in favour of being provided with more information about the vaccine and the rollout and would use a broad array of sources to find that information.

While in some ways much has changed already in the month since this AHP survey was run, in other ways things are much the same. While the originally announced plan intended to have a significant portion of the Australian population already vaccinated by the end of May, the actuality of the rollout has been delayed and has encountered many problems, leading to a limited rollout program that is still in its infancy. As such CHF will use the results from this AHP survey to guide our advocacy on the COVID-19 vaccine rollout as it develops, to ensure that consumers are kept up to date with accurate information via the broad array of channels they use.

I am pro-vaccination. That however does not negate my need for information. Being informed gives me confidence and reinforces my trust in accepting health dept advice.  However, withholding information and relying on 'just trust me, I am an expert' alone, doesn't cut it. I want to know that the decisions being made are robust, transparent and explained. If they aren't explained, or cannot be explained, then I wonder 'why not?'

AHP Panellist

The Consumers Health Forum of Australia would like to thank all panellists for giving up their time to participate in this survey. Any questions about this survey and its findings can be directed to info@chf.org.au

Note: as each question in the AHP survey was optional, the number of responses for each question varies across the survey. As such the total ‘n’ for the set of answers of each question may not add up to the same overall number of survey participants.