Here’s why rich people are more accepting of vaccines than poor people

Vaccines help keep the planet safe. But they don’t work perfectly. People with vaccine hesitancy – whether for Indian measles or political extremism in Israel – see the shots as a risky invasion that leaves little room for choice.

In rich countries, people with vaccine hesitancy don’t get angry with vaccines – even when what’s in them makes them cringe. That’s according to new research in the journal Vaccine, which found that many are willing to take part in the vaccination against measles, mumps and rubella when the aid comes from another country. In poorer countries, poor people with vaccine hesitancy have a harder time agreeing to vaccines from other countries that in general are more difficult to access, or that contain more dangerous or irritating vaccines.

“To be fair, our findings show that there are four variants of vaccine hesitancy in rich countries,” wrote Uppsala University epidemiologist Eva Andersson in an email.

“On the other hand, we found that there are two different types of vaccine hesitancy in poorer countries. The first type we saw several times. In this case, many poor children had better positive views than their better-off counterparts in Sweden,” she added.

In the study, Andersson and co-author Philip Ling wanted to find out why some people are open to vaccines in high-income countries and in poorer ones. The researchers recruited 1356 healthy adults from Sweden and other rich countries to test their vaccine hesitancy.

Just 7 percent of those participants, whose average age was 28, said they were afraid of vaccines. Another 17 percent said they were unsure.

Then the study invited 600 of the participants to a hospital where they were given a choice between two vaccination – a measles, mumps and rubella vaccine and a DPP, a routine shot.

Half of the participants were also given a list of vaccine alternatives from an African country, but with a strange blank at the beginning of the list. The researchers asked the participants to guess why there wasn’t a real alternative.

Here’s the final result: people in richer countries said they were less likely to oppose the vaccine compared to those in poorer countries, when the vaccine was imported from another country.

“It is important to note that people with vaccine hesitancy globally are also willing to get vaccines from a high-income country when they are provided as aid, which again serves to emphasize the generous nature of global aid donations,” Andersson wrote.

The study analyzed people’s attitudes across eight disease categories: measles, mumps, rubella, chickenpox, polio, tetanus, tuberculosis and meningitis. People who had a more negative perception about how vaccines can affect people – or fear that the vaccine will make them sick – tended to be more accepting of vaccine imports.

Scientists have observed that vaccine hesitancy comes in many forms and that these form can vary across countries. In poor countries, there’s more vaccine hesitancy from poorer people, the study authors found. (Specifically, they were concerned that vaccine would only harm people in society already suffering from poverty and malnutrition.)

The Swedish researchers do point out that what they have found is only an initial detection. The study was conducted only in Sweden, so more work needs to be done across the world to learn why some people are more open to vaccines in rich countries but not in poor ones.

What’s clear is that the aim of promoting vaccination should be to find better ways to convince people in poorer countries to accept foreign vaccines, because existing methods aren’t working.

For instance, a popular vaccine hesitancy treatment involves losing your food money for two weeks so that people can see if they still want to have them. Researchers have found that people who have trouble accepting new information are much more receptive to losing money in the name of vaccinations than those who can view old family photos or colorful cooking on TV.

“Each attempt to change people’s behavior is crucial and to continue trying new ways and approaches is worthwhile,” Andersson wrote.

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