COVID-19 Vaccine Hesitancy in 53 Developing Countries : Levels, Trends, and Reasons for Hesitancy

This paper presents new evidence on the levels and trends of vaccine hesitancy in developingcountries based on harmonized high-frequency phone surveys from more than 120,000 respondents in 53 low- andmiddle-income countries. These countries represent a combined 30 percent of the population of low- andmiddle-income countries. On average across countries, one in five adults is hesitant about the COVID-19 vaccine, with themost cited reasons for hesitancy being concerns about the safety of the vaccine, followed by concerns about itsefficacy. Between late 2020 and the first half of 2021, there tended to be little change in levels of hesitancyexcept in Iraq, Malawi, and Uzbekistan, where hesitancy increased. COVID-19 vaccine hesitancy is higher amongfemale, young, less educated, and rural respondents, after controlling for selected observable characteristics. Countryestimates of vaccine hesitancy from the high-frequency phone surveys are correlated with but lower than those fromearlier studies, which often relied on less representative survey samples. The results suggest that vaccine hesitancyin developing countries, while less prevalent than previously thought, will be an important and enduringobstacle to recovery from the pandemic.