Table of contents
- Main points
- Main themes for concern about or unwillingness to receive a COVID-19 vaccine
- Main concerns about COVID-19 vaccines
- Perceived lack of risk
- Beliefs about vaccine contents
- Confusion over different types of COVID-19 vaccines
- Practical barriers among those who felt unable to receive COVID-19 vaccines
- Influences and motivations for receiving a COVID-19 vaccine
- Wider attitudes and beliefs about COVID-19 vaccines
- Glossary
- Measuring the data
- Strengths and limitations
- Related links
1. Main points
- Many participants who were unwilling or uncertain about receiving a coronavirus (COVID-19) vaccine expressed concerns about their safety; these included concerns about immediate side effects and longer-term impacts that participants felt could not yet be known.
- Fears about the safety of COVID-19 vaccines were often linked with how quickly they had been developed; participants perceived this as a sign that the COVID-19 vaccines could not be as safe as other vaccines that had been developed and used over several years.
- Some participants did not perceive catching COVID-19 as a significant risk; typically, this was because they were younger and felt they were unlikely to either catch or develop serious symptoms from catching COVID-19, or because they felt they were already taking adequate steps to avoid catching COVID-19.
- Those who were unable to receive a COVID-19 vaccine cited barriers including: not being able to find childcare to attend the vaccination appointment; not being able to travel to the vaccination centre; or having existing physical or mental health conditions that prevented them from receiving a COVID-19 vaccine.
- There was an appetite for more information about COVID-19 vaccines, particularly: side effects; contents; how they had been developed; and differences between, and safety of, the various COVID-19 vaccines.
- Some participants accessed information about COVID-19 vaccines from social media or unverified sources as well as, or instead of, mainstream media; this gave them cause for concern, for example, about the contents or side effects of COVID-19 vaccines.
2. Main themes for concern about or unwillingness to receive a COVID-19 vaccine
This bulletin contains summary findings from an in-depth qualitative study undertaken by IFF Research, which was commissioned by the Office for National Statistics (ONS). Its aim was to explore the attitudes of participants who were uncertain about receiving, or were unable or unwilling to receive a coronavirus (COVID-19) vaccine across the UK. The findings are based on 50 in-depth interviews conducted in February and March 2021.
Many participants cited more than one reason for not wanting a coronavirus (COVID-19) vaccine. However, they commonly gave one of two primary recurring reasons, which seemed to inform many participants’ uncertainty or unwillingness to receive a COVID-19 vaccine.
The most common primary concern was that participants did not trust that COVID-19 vaccines were safe. Participants often talked about the speed with which the COVID-19 vaccines had been developed, and the belief that not enough people had received COVID-19 vaccines over a long enough time period to know that there were no long-term side effects.
The second primary reason was that participants did not feel the COVID-19 vaccines were necessary. Participants who held this belief often felt that they could protect themselves against COVID-19 by maintaining their own health and a strong immune system, or by taking steps to avoid catching COVID-19 in the first place.
Back to table of contents3. Main concerns about COVID-19 vaccines
Many participants who were unwilling or uncertain about receiving a coronavirus (COVID-19) vaccine expressed concerns about the safety of the vaccines. This included concerns about immediate side effects and longer-term impacts that participants felt could not yet be known.
There's not been enough research on it and the thing that worries me is what could happen in a couple of months’ time with people that have already had it.
Because it's such a new virus and the world doesn't know enough about the virus itself...if you don't know enough about the virus itself how do you know enough about the vaccine and the long-term effects of it?
A prominent concern was whether COVID-19 vaccines affected fertility (both female and male), as well as the fertility of their children. For a few participants, the fear that COVID-19 vaccines would harm their fertility was the main reason for their uncertainty or refusal.
I would like to know how it affects fertility, as I'd like maybe one or two more children.
Fears about the safety of COVID-19 vaccines were often linked to how quickly they had been developed. Participants perceived this as a sign that the COVID-19 vaccines could not be as safe as other vaccines that had been developed and used over several years.
I feel like vaccines are something which take years to develop. I don't believe it could be effective in such a short amount of time. I feel like it's been a rushed vaccine which is why I don't trust it.
I feel like it’s too early. I don’t feel enough time or research has passed. I don’t know what the effects from the vaccine will be after five, 10 or 15 years from now.
4. Perceived lack of risk
Some participants who were unwilling or uncertain about receiving a coronavirus (COVID-19) vaccine felt that they were not necessary because they did not perceive catching COVID-19 as a significant risk. This was typically because they were younger and felt they were unlikely to either catch or develop serious symptoms from catching COVID-19, or because they felt they were already taking adequate steps to avoid catching COVID-19. Some participants preferred natural remedies, or to rely on their own immune system to protect them from developing COVID-19.
I feel like I'm young enough and healthy enough so I would probably fight it off myself.
I'm a naturalist. It's like statins. They wanted me to go on statins. [I] said I've a five per cent chance of a heart attack… I'd have to take them for the rest of my life. You give over your life to a dependency on these things.
5. Beliefs about vaccine contents
Some participants had heard that coronavirus (COVID-19) vaccines contained ingredients that they found alarming or concerning, and this raised religious or ethical concerns for some of them. A few had heard that they were developed using material from foetuses.
People just say stuff – what they think and what they have heard and what other people say – it is all second hand … I thought it was disgusting that they could use something like [foetus material] in that and put it into another person’s body … [I didn’t trust it] very much, it could be [lies] but then maybe not … it is human nature to have second thoughts; maybe they are not lying.
A few participants were concerned that COVID-19 vaccines contained animal products or were tested on animals, and this prevented them from accepting one because it conflicted with their beliefs. For example, one Muslim participant had heard that COVID-19 vaccines included animal content, which she did not think would be Halal.
Are there animal remnants in it? Halal and haram are a big issue [in my religion, Islam].
6. Confusion over different types of COVID-19 vaccines
A few participants were concerned about the different types of coronavirus (COVID-19) vaccines. They felt that because several different vaccines were available, with differing news stories about each in the media, it was difficult to know which were credible or safe.
You've got the [insert vaccine brand name] one, the [insert vaccine brand name] one. People are saying the [insert vaccine brand name] one doesn't work as well ... there is too much bad publicity about them …
7. Practical barriers among those who felt unable to receive COVID-19 vaccines
Those who were unable to receive a coronavirus (COVID-19) vaccine cited barriers including:
- not being able to find childcare to attend the vaccination appointment
- not being able to travel to the vaccination centre
- having existing physical or mental health conditions that prevented them from receiving a COVID-19 vaccine
If someone said to me, I had to have it [COVID-19 vaccines] I would be very fearful, I would be very frightened. Because once you start giving me that injection they don't know if I'm going to have an allergic reaction to it.
I find it so hard to keep any appointments, you can only take one child with you. Doctors get funny if you bring two ... going to dentist appointments have been difficult. I know they want to limit numbers, but some families will not be able to do it.
8. Influences and motivations for receiving a COVID-19 vaccine
There was an appetite for more information about coronavirus (COVID-19) vaccines, particularly:
- side effects
- contents
- how they had been developed
- differences between, and safety of, the various COVID-19 vaccines
Some said they would revisit their opinion on receiving a COVID-19 vaccine once there was more information available about side effects.
I would like to speak to my doctor about this before I say, ‘yes, I'm definitely going to take this’. I would like a definitive answer about the fertility side of it.
I am not saying that I will never ever have the coronavirus vaccine. It’s definitely a ‘now’ decision and it’s something I will re-evaluate on a regular basis.
9. Wider attitudes and beliefs about COVID-19 vaccines
Lack of trust in government and pharmaceutical companies among participants who were concerned or unwilling
Among some participants there was a lack of trust in the government and the government’s messaging around the coronavirus (COVID-19) and COVID-19 vaccines. Several participants believed that the government had exaggerated the number of COVID-19 cases to make the pandemic seem worse than it was. As a result, some participants felt that COVID-19 vaccines were not as necessary as government messaging suggested, which led to an unwillingness to accept COVID-19 vaccines.
A few participants also referenced news stories they had heard about other countries’ governments being more cautious about rolling out COVID-19 vaccines, for example, only deciding to offer it to people over 65 years old; this undermined the participants’ trust in the UK government’s decision to rollout COVID-19 vaccines so quickly.
A few participants mentioned stories that linked the COVID-19 vaccine rollout to increased deaths in care homes, conspiracy theories concerning population control, or that symptoms were actually being caused by 5G masts.
There are stories around the world of deaths and side effects. They're not telling us the full truth here.
A few participants also expressed a lack of trust in the pharmaceutical industry and referred to reports that one of the producers of a COVID-19 vaccine would have legal immunity. This concerned them because they felt it would reduce the company’s motivation to take their time to produce safer COVID-19 vaccines.
[Insert vaccine brand name] will not accept any liability if the vaccine messes you up, and the government has given them that leeway. That's a bit strange. To me that's like, ‘I'm going to put something in my body, and I don't know what's in it, and if it messes me up nobody is taking liability’.
Use of unverified news stories and information
Some participants accessed information about COVID-19 vaccines from social media or unverified sources as well as, or instead of, mainstream media. These participants commonly cited stories they heard through social media or unverified sources that gave them cause for concern, for example, about the contents or side effects of COVID-19 vaccines.
In real life I've heard it's working and it's fine. On the internet I've heard loads of people have died from the vaccine, so there's real life and online.
Attitudes to vaccinations in general
All participants had, to their knowledge, received their childhood vaccinations. Many participants had received vaccines in adulthood such as the flu jab, as well as those required for travel to certain countries, such as vaccinations against malaria and yellow fever.
Overall, participants did not have any hesitation about vaccines in general and were positive about their role in protecting against disease. During the interview, many participants stressed that while they were not currently accepting of COVID-19 vaccines, they were not “anti-vaxxers” and did not belong to an “anti-vax” movement.
More detailed findings are available on the IFF website.
Back to table of contents10. Glossary
Low-income workers
A low-income worker is defined for this research as someone with an annual household income last year of less than £18,000, after tax.
Low educational attainment
Low educational attainment is defined as having no educational or vocational qualifications.
Parent
A parent in this research refers to someone who is a parent or legal guardian of one or more children aged under 16 years.
Ethnic minority participants
Ethnic minority participants in this research refers to people who are from an ethnic minority group or background.
Clinically extremely vulnerable
People who are identified as clinically extremely vulnerable (CEV) are at very high risk of severe illness from the coronavirus (COVID-19). Up to 16 February 2021, CEV people were identified either because of a pre-existing condition or based on the clinical judgement of their clinician or GP that they are at higher risk of serious illness if they catch COVID-19.
From 16 February 2021, individuals can still be identified as CEV by these routes, but also by COVID-19 population risk assessment. The NHS identified approximately 2.2 million people as being CEV by clinical condition or clinician’s review. A further 1.5 million people were advised to shield through the COVID-19 risk assessment. More information can be found in Guidance on shielding and protecting people who are CEV from COVID-19.
Back to table of contents11. Measuring the data
The findings in this bulletin contains summary findings from an in-depth qualitative study that was completed by IFF Research and commissioned by the Office for National Statistics (ONS). Its aim was to explore the attitudes of groups who were uncertain about receiving, or were unable or unwilling to receive a coronavirus (COVID-19) vaccine across the UK.
The full set of findings are published on the IFF website. The findings are based on 50 participants who each took part in a 70-minute in-depth interview online or via telephone, between February and March 2021. The following groups took part in the study:
- parents
- those on lower incomes (defined as earning less than £18,000 a year after tax)
- those with lower educational attainment (defined as having no educational or vocational qualifications)
- those from ethnic minority backgrounds
- clinically extremely vulnerable people
These groups are not mutually exclusive. For more information, please refer to the COVID-19 vaccine refusal, UK QMI.
The analysis is not intended to be “representative” or measure the incidence of attitudes or behaviours, it is to understand them in depth and detail. When describing the results, terms such as “many”, “some” or “a few” are used to give a relative indication of the extent to which views were expressed or behaviours reported within the sample. The term “many” is used to mean that a view or behaviour is fairly widespread within a particular group of participants while “a few” indicates that the findings applied only to a small handful of participants. “Some” is used to indicate a middle ground between “many” and “a few”.
More quality and methodology information on strengths, limitations, appropriate uses, and how the data were gathered is available in the COVID-19 vaccine refusal, UK QMI.
Back to table of contents12. Strengths and limitations
The main strengths of the study include:
- it captures the personal circumstances of individual participants within the main demographic groups with varying reasons for uncertainty, unwillingness or lack of ability to receive a coronavirus (COVID-19) vaccine
- it is flexible, allowing the interview to be participant specific, with relevant prompts or probes to ensure important information is captured
- the interview guide was developed through expert consultation and met policy user needs
The main limitations of the study include:
- findings relate to certain circumstances that have since changed (for example, the extent of the vaccine rollout in the UK, or the information that was in the public domain at the time of interview) and therefore, attitudes or behaviours may have changed
- non-response bias: our participants may be different attitudinally and behaviourally than those who are not participants because of their willingness and ability to take part
- our findings are not statistically generalisable to other populations or the wider population because we have used a non-probabilistic sampling method – non-proportional quota sampling
There is more information in the COVID-19 vaccine refusal, UK QMI.
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