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Rapid response to:

Practice Practice Pointer

Covid-19 vaccination hesitancy

BMJ 2021; 373 doi: (Published 20 May 2021) Cite this as: BMJ 2021;373:n1138

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Rapid Response:

Vaccine hesitancy and Confirmation bias

Dear Editor

Vaccine hesitancy is not a new phenomenon.[1] [2]. The 19th century vaccine hesitancy is understandable because of poor access to information and most importantly, people were to yet to witness the extraordinary global success of vaccination.[1]. The paradoxical rise of 21st century vaccine hesitancy, in the face of easy access to high-quality information, could be explained by confirmation bias. [3].

Confirmation bias makes human beings seek information that confirms or strengthens their self-beliefs or values.[4]. Overcoming this bias requires open-minded rational analysis of all viewpoints but personalised internet search-engine results, influenced by users’ browsing history, curtail exposure to diversity of views.

Many people, who have a natural worry about long-term vaccine side effects, may be reassured by healthcare workers. But sceptics, whose vaccine hesitancy has been sculpted by endless loops of affirmation on social-media, are unlikely to be reassured by healthcare workers.[5].

1 Group BMJP. Anti-compulsory vaccination league. Br Med J 1867;1:264–73. doi:10.1136/bmj.1.323.264

2 Wolfe RM, Sharp LK. Anti-vaccinationists past and present. BMJ 2002;325:430–2. doi:10.1136/bmj.325.7361.430

3 Robinson E, Jones A, Lesser I, et al. International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples. Vaccine 2021;39:2024–34. doi:10.1016/j.vaccine.2021.02.005

4 McKee M, Stuckler D. How cognitive biases affect our interpretation of political messages. BMJ 2010;340:c2276. doi:10.1136/bmj.c2276

5 Razai MS, Chaudhry UAR, Doerholt K, et al. Covid-19 vaccination hesitancy. BMJ 2021;373:n1138. doi:10.1136/bmj.n1138

Competing interests: Unvaccinated distant family members have died of COVID-19

25 May 2021
Santhanam Sundar
Consultant Oncologist
Nottingham University Hospitals NHS Trust