COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries.

Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs.

Americans' perceptions of privacy and surveillance in the COVID-19 pandemic.

OBJECTIVE: To study the U.S. public's attitudes toward surveillance measures aimed at curbing the spread of COVID-19, particularly smartphone applications (apps) that supplement traditional contact tracing. METHOD: We deployed a survey of approximately 2,000 American adults to measure support for nine COVID-19 surveillance measures. We assessed attitudes toward contact tracing apps by manipulating six different attributes of a hypothetical app through a conjoint analysis experiment. RESULTS: A smaller percentage of respondents support the government encouraging everyone to download and use contact tracing apps (42%) compared with other surveillance measures such as enforcing temperature checks (62%), expanding traditional contact tracing (57%), carrying out centralized quarantine (49%), deploying electronic device monitoring (44%), or implementing immunity passes (44%). Despite partisan differences on a range of surveillance measures, support for the government encouraging digital contact tracing is indistinguishable between Democrats (47%) and Republicans (46%), although more Republicans oppose the policy (39%) compared to Democrats (27%). Of the app features we tested in our conjoint analysis experiment, only one had statistically significant effects on the self-reported likelihood of downloading the app: decentralized data architecture increased the likelihood by 5.4 percentage points. CONCLUSION: Support for public health surveillance policies to curb the spread of COVID-19 is relatively low in the U.S. Contact tracing apps that use decentralized data storage, compared with those that use centralized data storage, are more accepted by the public. While respondents' support for expanding traditional contact tracing is greater than their support for the government encouraging the public to download and use contact tracing apps, there are smaller partisan differences in support for the latter policy.