Willingness to vaccinate against COVID-19 in Australia.

More than half of the world's population faces long-term restrictions as the new normal to prevent the spread of COVID-19. If a vaccine becomes available, it might be possible to develop herd immunity and protect those who are most vulnerable to serious consequences of COVID-19. The population coverage required to achieve herd immunity through vaccination varies across diseases and is dependent on the basic reproduction number (R 0). Modelling estimates R 0 to be around 2·5 for severe acute respiratory syndrome coronavirus 2 when no restrictions or physical distancing measures are in place, and R 0 reached almost 4·0 in Wuhan in early-mid January, 2020. Vaccination uptake for herd immunity would need to be at least 67% with an R 0 of 3·0. In their Comment, the COCONEL Group reported that 26% of French adults would not accept a COVID-19 vaccine. We similarly explored this question among a diverse sample of Australian adults.

We conducted an online survey of 4362 Australians aged 18 years and older during April 17–21, approximately 4 weeks after lockdown measures had been activated in Australia and at a time when potential deaths and health system capacity were still of great concern. We asked participants about actions or intentions toward the flu vaccine (“I have or I will get the flu vaccine this year”) and a potential COVID-19 vaccine (“If a COVID-19 vaccine becomes available, I will get it”).

In this sample, 630 (14·4%) participants said they would not get the flu vaccine this year, 394 (9·0%) were indifferent, and 3338 (76·5%) said they have or will get the flu vaccine this year. For a COVID-19 vaccine, 213 (4·9%) said they would not get the vaccine, 408 (9·4%) were indifferent, and 3741 (85·8%) said they would get the vaccine if it became available. Individuals who said they would not get a COVID-19 vaccine were more likely to believe the threat of COVID-19 has been exaggerated (43·7% [93/213]) than those who said they would get the vaccine if it became available (11·5% [429/3741]) and those who were indifferent (19·9% [81/408]). Inadequate health literacy and lower education level were significantly associated with a reluctance to be vaccinated against both influenza and COVID-19 (p<0·001; appendix). Notably, a high proportion overall were confident in the state (75·4% [3288/4362]) and federal (65·2% [2845/4362]) government's response.

In Australia, attitudes towards a COVID-19 vaccine appear to be more positive than reported in France in late March, which might in part reflect greater confidence in the government. However, our data show efforts are needed to target vaccine education to those with lower education and health literacy. It remains to be seen whether Australia's high intentions towards vaccine uptake will remain when restrictions are relaxed and the immediate perceived threat diminishes.