Beyond vaccine hesitancy: Australians’ attitudes and practices concerning COVID-19 vaccines in 2022

Background In Australia and many other countries, initial high uptake of COVID-19 vaccines in earlier years of the pandemic has not continued into later years, with a noticeable drop-off since 2021. Little in-depth research has identified the attitudes and social, epidemiological and political contexts behind this decline in the general Australian population. Objectives In-depth interviews were conducted with a diverse group of Australian adults to identify their attitudes and practices related to COVID vaccination. Methods A total of 40 online interviews were conducted in late 2022 and transcribed for analysis. The interviews were analysed using an inductive and deductive thematic approach to discern the stances adopted by participants in relation to vaccines. Results Five stances to the vaccines were identified: (i) vaccine confidence; (ii) vaccine pragmatism; (iii) vaccine hesitance; (iv) vaccine disillusionment; and (v) vaccine refusal. Findings go some way to demonstrating the impacts of the epidemiological, social and health policy contexts, nuance and range of attitudes and behaviours in response to the COVID vaccination program in the third pandemic year. Vaccine disillusionment is created through over-promising what the COVID vaccines can achieve. For the most part, participants demonstrated realistic viewpoints on both the possibility of side-effects and the efficacy of the COVID vaccines. Few people assumed that vaccination alone would protect them from COVID, understanding that their main value was in minimising the severity of the disease. Conclusions This study draws attention to the importance of going beyond assumptions about people’s lack of interest or unwillingness to accept COVID and other vaccines. It highlights people’s lived experiences of the pandemic over time in contributing to their vaccine-related attitudes and practices. Recommendations include improving accessibility and inclusion in vaccine education materials and service delivery, as well as continued efforts on the part of government and health authorities to educate the public about developments in vaccine science more broadly. Especially in a setting in which misinformation and disinformation about vaccine safety and effectiveness is rife, governments and health authorities need to communicate honestly with members of the public not only about their benefits, but also shortcomings.