Did the pandemic increase vaccine confidence?

COVID-19 may have rattled confidence in vaccines in parts of the world, but public health messaging that aligns with people’s values can ensure it isn’t lost.

  • 31 July 2025
  • 4 min read
  • by Priya Joi
A health worker preparing Covid-19 vaccination for a young girl who came for the vaccination in a government vaccination center in F9 Park Islamabad, Pakistan, this is the only facility in the country where people can ask to be administered a vaccine of their choice. Credit: Gavi/Asad Zaidi
A health worker preparing Covid-19 vaccination for a young girl who came for the vaccination in a government vaccination center in F9 Park Islamabad, Pakistan, this is the only facility in the country where people can ask to be administered a vaccine of their choice. Credit: Gavi/Asad Zaidi
 

 

Vaccine confidence rose in some parts of the world during the COVID-19 pandemic, according to a new global study published in Nature.

The research found that vaccine confidence increased between 2019 and 2022 in several regions – including low- and middle-income countries in Latin America and the Caribbean, where trust in vaccines had previously been in decline.

The percentage of people who agreed that vaccines are compatible with their personal or religious beliefs also rose during that period in Europe, Central Asia, Latin America and the Caribbean, according to the study.

These findings suggest that despite widespread misinformation and political tension during the pandemic, public health efforts and the clear link between the vaccine roll-out and a reduction in COVID-19 cases and deaths may have helped shift perceptions in a positive direction.

Nevertheless, overall vaccine confidence dipped in many parts of the world, the study found, indicating that global efforts are required to reverse this overall trend.

Vaccine bottles
Photograph of vaccination containers. Credit: Khasar Sandag / Gavi

Critical confidence

The team, led by researchers from Peking University and Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing, China, undertook the study to determine differences in vaccine confidence both by geographical location and age.

The team used data gathered by The Vaccine Confidence Project, founded in 2010 by the London School of Hygiene and Tropical Medicine, to address increasing global vaccine scepticism. It has tracked and assessed public confidence in vaccines globally through over 400 nationally representative surveys.

The researchers analysed data from more than 273,000 individuals across 90 countries, collected in 2015, 2019 and 2022. They assessed four measures of vaccine confidence: safety, effectiveness, importance for children and compatibility with beliefs.

Overall, while the study noted that vaccine confidence overall dipped between 2019 and 2022, high-income countries and those with higher levels of human development were more likely to report stable or higher confidence, particularly among older age groups.

Looking at the socioeconomic determinants of vaccine confidence among adults aged 65 and older, the researchers identified a positive correlation between education and income levels, and vaccine confidence.

The researchers found that people aged over 65 in high-income countries were more likely to agree on the safety, effectiveness and compatibility of vaccines with religious beliefs than those under 65 years.

The study team suggest that this is because in under-65s “vaccine confidence is more vulnerable to sociocultural influences, political dynamics and anti-vaccine movements.”

Falling confidence

One of the study’s key findings was that belief compatibility played an important role in vaccine attitudes.

In regions where compatibility with personal beliefs rose after 2019, such as Europe, Latin America and the Caribbean, vaccine confidence appeared more resilient.

For countries in Latin America and the Caribbean, the authors attribute the success of national immunisation programmes and public health messaging to higher vaccine confidence.

Dr Fuqiang Cui, Director of the Vaccine Research Center at Peking University, Beijing, and one of the lead authors, told VaccinesWork that another reason may be that Latin America and the Caribbean was one of the regions most severely impacted by the pandemic: some of its countries had among the highest per capita related deaths in the world.

“Vaccination represented a beacon of hope – a way to overcome the pandemic and reduce high mortality rates. This suggests that the strengthened perception of disease risk during the pandemic improved these populations’ opinions on vaccines,” he says.

The Middle East and North Africa (MENA) region reported the lowest levels of vaccine confidence in 2022, with only 17.45% of respondents expressing trust.

Diya Thapa Magar-12 receives the HPV vaccine in Timang, Nepal at Shree Gaurisankhar Basic School.
Diya Thapa Magar-12 receives the HPV vaccine in Timang, Nepal at Shree Gaurisankhar Basic School. Credit: Magnum / Nanna Heitmann

Increasing trust

The study concludes that while vaccine confidence was shaken in many parts of the world during COVID-19, recovery is possible. Regional variations show that targeted communication strategies – especially those that respect cultural and belief systems – can play a critical role in rebuilding trust.

The authors offer recommendations to counter misinformation and build public trust, including that governments must provide transparent, timely and accurate information about pandemics and vaccines.

“Future efforts to improve confidence should focus on how to guide and leverage the positive role of religion in vaccine promotion. This could be achieved by engaging religious leaders, given their strong influence over their followers,” says Dr Cui.

“Religious doctrines and arguments can provide strong support or resistance to vaccine promotion, a critical factor that future global efforts to improve vaccine confidence and uptake must consider.

“As scientists develop vaccines, strong partnerships can be forged with religious institutions through their leaders, while also enhancing the transparency of the ongoing vaccine development process,” he told VaccinesWork.

Regaining vaccine confidence once it has been lost is harder. The authors call on governments and health experts to ensure efforts are undertaken to maintain trust in vaccines as one of the most cost-effective and efficient ways of preventing disease and saving lives.