Pharma Focus Asia

Addressing Vaccine Hesitancy in Developing Countries: Survey and Experimental Evidence

Christopher Hoy, Terence Wood, Ellen Moscoe

Vaccine hesitancy is proving to be a significant impediment to COVID-19 vaccination campaigns in some developing countries. This study focuses on vaccine hesitancy and means of reducing it. Data come from a large, representative phone survey and online randomized survey experiment, both run in Papua New Guinea, a developing country with low vaccination rates. Less than 20% of relevant respondents to the phone survey were willing to be vaccinated, primarily because of fear of side effects and low trust in the vaccine.

High vaccination rates are an essential component in managing the COVID-19 pandemic. Initially, the limited supply of vaccines, especially in low- and middle-income countries, was a major constraint on vaccination programs. As vaccines started to become more readily available throughout 2021, it became clear that limited demand also posed a significant challenge in some developing countries, with people unwilling to be vaccinated against COVID-19 even when provided the opportunity.

Material and Methods:

Much of PNG is remote and parts of the country are prone to violence. Given these challenges, and the need to learn about vaccine hesitancy in a timely manner, with minimal in person contact, phone and online surveys were the most appropriate means of studying attitudes to COVID-19.

Phone survey
To collect information about levels of vaccine hesitancy and what factors might be contributing to it, a phone survey covering 2,533 households was conducted from May 26 to June 6, 2021. To address the potential concern that phone survey data would be un-representative we undertook three steps.

Vaccine hesitancy is proving to be a serious impediment to COVID-19 vaccination programs in some developing countries. Not only does this increase the health burdens these countries face, but–to the extent it increases global numbers of unvaccinated people–hesitancy in developing countries adds to the risk of new variants of the virus emerging and to the ongoing global challenge of the pandemic.

Citation: Hoy C, Wood T, Moscoe E (2022) Addressing vaccine hesitancy in developing countries: Survey and experimental evidence. PLoS ONE 17(11): e0277493.

Editor: Elizabeth S. Mayne, University of Cape Town Faculty of Science, SOUTH AFRICA

Received: April 22, 2022; Accepted: October 27, 2022; Published: November 17, 2022.

Copyright: © 2022 Hoy et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: If the manuscript is accepted for publication, we will promptly upload data files on the Harvard Dataverse (, and provide you with the DOIs for the files.

Funding: Funding for this study was provided by Gavi, the Vaccine Alliance; the Korea Trust Fund for Economic and Peace-Building Transitions; and The United States Agency for International Development (through the Papua New Guinea UNICEF office). The funders played no role in the the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

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