Trust in those developing, offering, and promoting vaccines plays a key role in decisions about the uptake of vaccines, says a new briefing note from the Nuffield Council on Bioethics.

As countries cope with COVID-19, vaccines have become integral to overcoming the pandemic and its devastating effects on individuals, communities, population health, and economies. As governments begin, and continue, their vaccine rollouts, this timely briefing note explores the factors which influence access to and uptake of vaccines, and what governments and healthcare professionals can do to encourage vaccine uptake.

The briefing note identifies trust as a key factor for people when deciding whether to take a vaccine. Trust can affect vaccine uptake in several respects, including who people receive their information from, and how they regard guidance they receive about vaccines, particularly if they have doubts about the motives and interests of, for example, governments and pharmaceutical companies. As we have seen in recent weeks, public trust can also be damaged where the safety profile of vaccines is called into question.

In addition to the difficulties of maintaining public trust, practical barriers to accessing the vaccine – such as timing, location, and availability of appointments and costs from having to take time off work – can also create significant issues, including lower uptake of vaccines in some communities.

Given the impact that the pandemic has had in many aspects of daily life, lower uptake of vaccines is not something we can ignore. The note concludes that governments must be proactive in addressing how uptake can be supported and improved, and mistrust addressed, so that communities – particularly those that are marginalised and have already been disproportionately affected by the pandemic – are not burdened by high rates of infection. The briefing note identifies several strategies to encourage vaccine uptake, including:

  • Clear, open, and accessible information from healthcare professionals and community support organisations to promote uptake of vaccines, especially in those communities where there is a lack of trust in local or national governments.
  • Exploring community engagement as a way of addressing distrust about vaccine development, and in overcoming practical barriers to vaccination. Talking to citizens can help reveal practical barriers to vaccine access, as well as quell misinformation.

Commenting on the briefing note, Hugh Whittall, Director of the Nuffield Council, said:

We are all relying on vaccine programmes to help us reach the other side of the pandemic. To do this effectively we need to consider the different factors that influence people’s vaccine decisions, and reflect on what we’ve done so far - what works, and what could work better. We can’t take vaccine uptake or acceptance for granted, and need to think about how public trust can be maintained as vaccination programmes gather pace worldwide.”


Sophia Griffiths
Acting Communications Manager
+44 (0) 20 7681 9622

Notes to editors

The Nuffield Council on Bioethics is an independent body that has been advising policymakers on ethical issues in bioscience and medicine for nearly 30 years. We are funded by the Nuffield Foundation, the Medical Research Council, and Wellcome.

This is the ninth in a series of bioethics briefing notes published by the Nuffield Council on Bioethics.