Publication: Addressing Vaccine Hesitancy: Survey and Experimental Evidence from Papua New Guinea
Loading...
Published
2021-11
ISSN
Date
2021-11-12
Author(s)
Editor(s)
Abstract
This paper examines the drivers of COVID-19 vaccine hesitancy and tests various means of increasing people’s willingness to receive a COVID-19 vaccine. The study draws on data collected through a broadly representative phone survey with 2,533 respondents and an online randomized survey experiment with 2,392 participants in Papua New Guinea. Both surveys show that less than 20 percent of the respondents who were aware a vaccine existed were willing to be vaccinated. The main reason respondents stated for their hesitancy regarding the vaccine was concern about side effects; however, the majority also said health workers could change their mind, particularly if information was communicated in person. The phone survey illustrated that people’s level of trust in the vaccine and their beliefs about the behavior of others are strongly associated with their intention to get a COVID-19 vaccine. In contrast, people’s concern about COVID-19, most trusted source of information (including social media), and vaccination history were unrelated to their intention to get vaccinated. The online experiment showed that a message that emphasized the relative safety of the vaccine by highlighting that severe side effects are rare, while also emphasizing the dangers of COVID-19, increased intention to get vaccinated by around 50 percent. Collectively, these results suggest that policy makers would be well placed to direct their efforts to boosting the general population’s trust that getting vaccinated substantially reduces the risk of severe illness or death from COVID-19.
Link to Data Set
Citation
“Hoy, Christopher; Wood, Terence; Moscoe, Ellen. 2021. Addressing Vaccine Hesitancy: Survey and Experimental Evidence from Papua New Guinea. Policy Research Working Paper;No. 9837. © World Bank. http://hdl.handle.net/10986/36549 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Publication The Economic Value of Weather Forecasts: A Quantitative Systematic Literature Review(Washington, DC: World Bank, 2025-09-10)This study systematically reviews the literature that quantifies the economic benefits of weather observations and forecasts in four weather-dependent economic sectors: agriculture, energy, transport, and disaster-risk management. The review covers 175 peer-reviewed journal articles and 15 policy reports. Findings show that the literature is concentrated in high-income countries and most studies use theoretical models, followed by observational and then experimental research designs. Forecast horizons studied, meteorological variables and services, and monetization techniques vary markedly by sector. Estimated benefits even within specific subsectors span several orders of magnitude and broad uncertainty ranges. An econometric meta-analysis suggests that theoretical studies and studies in richer countries tend to report significantly larger values. Barriers that hinder value realization are identified on both the provider and user sides, with inadequate relevance, weak dissemination, and limited ability to act recurring across sectors. Policy reports rely heavily on back-of-the-envelope or recursive benefit-transfer estimates, rather than on the methods and results of the peer-reviewed literature, revealing a science-to-policy gap. These findings suggest substantial socioeconomic potential of hydrometeorological services around the world, but also knowledge gaps that require more valuation studies focusing on low- and middle-income countries, addressing provider- and user-side barriers and employing rigorous empirical valuation methods to complement and validate theoretical models.Publication The Macroeconomic Implications of Climate Change Impacts and Adaptation Options(Washington, DC: World Bank, 2025-05-29)Estimating the macroeconomic implications of climate change impacts and adaptation options is a topic of intense research. This paper presents a framework in the World Bank's macrostructural model to assess climate-related damages. This approach has been used in many Country Climate and Development Reports, a World Bank diagnostic that identifies priorities to ensure continued development in spite of climate change and climate policy objectives. The methodology captures a set of impact channels through which climate change affects the economy by (1) connecting a set of biophysical models to the macroeconomic model and (2) exploring a set of development and climate scenarios. The paper summarizes the results for five countries, highlighting the sources and magnitudes of their vulnerability --- with estimated gross domestic product losses in 2050 exceeding 10 percent of gross domestic product in some countries and scenarios, although only a small set of impact channels is included. The paper also presents estimates of the macroeconomic gains from sector-level adaptation interventions, considering their upfront costs and avoided climate impacts and finding significant net gross domestic product gains from adaptation opportunities identified in the Country Climate and Development Reports. Finally, the paper discusses the limits of current modeling approaches, and their complementarity with empirical approaches based on historical data series. The integrated modeling approach proposed in this paper can inform policymakers as they make proactive decisions on climate change adaptation and resilience.Publication Labor Demand in the Age of Generative AI: Early Evidence from the U.S. Job Posting Data(Washington, DC: World Bank, 2025-11-18)This paper examines the causal impact of generative artificial intelligence on U.S. labor demand using online job posting data. Exploiting ChatGPT’s release in November 2022 as an exogenous shock, the paper applies difference-in-differences and event study designs to estimate the job displacement effects of generative artificial intelligence. The identification strategy compares labor demand for occupations with high versus low artificial intelligence substitution vulnerability following ChatGPT’s launch, conditioning on similar generative artificial intelligence exposure levels to isolate substitution effects from complementary uses. The analysis uses 285 million job postings collected by Lightcast from the first quarter of 2018 to the second quarter of 2025Q2. The findings show that the number of postings for occupations with above-median artificial intelligence substitution scores fell by an average of 12 percent relative to those with below-median scores. The effect increased from 6 percent in the first year after the launch to 18 percent by the third year. Losses were particularly acute for entry-level positions that require neither advanced degrees (18 percent) nor extensive experience (20 percent), as well as those in administrative support (40 percent) and professional services (30 percent). Although generative artificial intelligence generates new occupations and enhances productivity, which may increase labor demand, early evidence suggests that some occupations may be less likely to be complemented by generative artificial intelligence than others.Publication The Lasting Effects of Working while in School(Washington, DC: World Bank, 2025-08-18)This paper provides the first experimental evidence on the long-term effects of work-study programs, leveraging a randomized lottery design from a national program in Uruguay. Participation leads to a persistent 11 percent increase in formal labor earnings, observable seven years after the program. Effects are stronger for youth who participate during pivotal educational transitions and are larger for vulnerable youth and men, while remaining positive for women and non-vulnerable youth. The program is highly cost-effective, with average impacts exceeding those of job training programs and comparable to early childhood investments.Publication It’s Not (Just) the Tariffs: Rethinking Non-Tariff Measures in a Fragmented Global Economy(Washington, DC: World Bank, 2025-10-22)As tariffs have declined, non-tariff measures (NTMs) have become central to trade policy, especially in high-income countries and regulated sectors like food and green technologies. Although NTMs may serve legitimate goals, they could also sort countries and firms into or out of markets based on compliance capacity and differences in product mix. Documenting recent advances in the estimation of ad valorem equivalents (AVEs), this paper uncovers new patterns of use and exposure of NTMs. High-income countries rely more heavily on NTMs relative to tariffs, while low- and middle-income countries face steeper AVEs on their exports. Firm-level evidence shows that NTMs disproportionately affect smaller firms, leading to market exit and concentration. Poorly designed NTMs can harm productivity and welfare, while coordinated, capacity-aware use can deliver inclusive outcomes. Policy design, transparency, and diagnostics must evolve to reflect the growing role—and risks—of NTMs in a fragmented global trade landscape.
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication COVID-19 Vaccine Hesitancy in 53 Developing Countries(World Bank, Washington, DC, 2022-09)This paper presents new evidence on the levels and trends of vaccine hesitancy in developing countries based on harmonized high-frequency phone surveys from more than 120,000 respondents in 53 low- and middle-income countries. These countries represent a combined 30 percent of the population of low- and middle-income countries. On average across countries, one in five adults is hesitant about the COVID-19 vaccine, with the most cited reasons for hesitancy being concerns about the safety of the vaccine, followed by concerns about its efficacy. Between late 2020 and the first half of 2021, there tended to be little change in levels of hesitancy except in Iraq, Malawi, and Uzbekistan, where hesitancy increased. COVID-19 vaccine hesitancy is higher among female, young, less educated, and rural respondents, after controlling for selected observable characteristics. Country estimates of vaccine hesitancy from the high-frequency phone surveys are correlated with but lower than those from earlier studies, which often relied on less representative survey samples. The results suggest that vaccine hesitancy in developing countries, while less prevalent than previously thought, will be an important and enduring obstacle to recovery from the pandemic.Publication COVID-19 Vaccine Inequities and Hesitancy in Iraq(Washington, DC, 2022)While Iraq continues to experience a surge in the number of coronavirus cases, the proportion of the country’s population that is vaccinated remains very low. For a more in-depth understanding of the state of vaccination in Iraq, this note presents findings on Coronavirus (Covid-19) vaccination disparities and hesitancy from the last three rounds of the Iraq High Frequency Phone Survey (IHFPS) conducted between June and August 2021. Findings from the survey suggest a low but increasing vaccination trend among adult Iraqis, however, resistance to the vaccine remain high. Fear and mistrust towards the Covid-19 vaccine risks to undermine the efficacy of the country’s vaccination campaign. Low vaccination rate and the important disparities that have emerged in vaccination and vaccine hesitancy highlight the need for a robust and more inclusive vaccination campaign.Publication Intra-Household Dynamics and Attitudes toward Vaccines(World Bank, Washington, DC, 2022-08)This paper explores how intra-household dynamics relate to attitudes toward vaccines in low-income countries, by drawing on three novel surveys from Zambia. The first is a nationally representative, in-person survey of over 10,000 households that asked all household members individually about their willingness to get a COVID-19 vaccine. The second and third surveys involved conducting randomized experiments with over 2,000 participants using Facebook and SMS messages. They tested how the impact of information about the benefits from receiving a COVID-19 vaccine on people’s willingness to get vaccinated varied based on intra-household dynamics. These data sources showed that people’s willingness (unwillingness) to get a COVID-19 vaccine was strongly associated with whether other household members were also willing (unwilling). Both experiments found that respondents who received information emphasizing either individual or household benefits from getting a COVID-19 vaccine were more willing to get vaccinated than those in the control group. This information was more potent among respondents who believed other members of their household would not get vaccinated but did not have a larger impact on respondents who were involved in household decision making. There was also some evidence of positive “second-round” effects whereby respondents who received the information treatments were more likely to encourage other household members to get a COVID-19 vaccine. An important implication that flows from this analysis is that although household members tend to have similar attitudes toward vaccines, communicating accurate information about the benefits of getting vaccinated can counter intra-household dynamics that undermine acceptance.Publication Reducing COVID-19 Vaccine Hesitancy with Social and Behavior Change Communication Strategies on Social Media(Washington, DC: World Bank, 2025-05-20)The COVID-19 pandemic significantly disrupted daily life and exacerbated global inequalities, leading policymakers to seek innovative, evidence-based solutions to mitigate its impacts. By March 2023, the pandemic had resulted in approximately 6.88 million reported deaths and 14.83 million excess deaths globally. The development and approval of COVID-19 vaccines changed the pandemic’s trajectory, but disparities in vaccine supply and demand led to persistent global vaccine coverage inequalities. Vaccine hesitancy, particularly in low- and middle-income countries (LMICs), was a major driver of these disparities. To address vaccine hesitancy, the Alliance for Health Online (AHO) and the World Bank’s Mind, Behavior, and Development (eMBeD) Unit within Development Impact (DIME) developed a global research program leveraging social media and behavioral science. This program aimed to diagnose barriers to vaccine uptake, identify effective behaviorally informed communications, and develop public goods to support while introducing innovative approaches such as chatbot functionality and fostering partnerships with the private sectorPublication The Evolution of COVID-19 Vaccine Hesitancy in Sub-Saharan Africa(World Bank, Washington, DC, 2023-01-12)COVID-19 vaccination rates in Sub-Saharan Africa lag behind other world regions, with just over 20 percent of the population in Sub-Saharan Africa fully vaccinated. To reach widespread coverage, high willingness to get vaccinated for COVID-19 among the population is considered an important prerequisite. Drawing on two years of panel survey data, this paper studies the dynamics of vaccine acceptance, its correlates, and reasons for hesitancy over time. The data come from multiple rounds of national High-Frequency Phone Surveys in five countries in East and West Africa (Burkina Faso, Ethiopia, Malawi, Nigeria, and Uganda), covering the period between 2020 and 2022. The surveys are cross-country comparable and draw their samples from nationally representative sampling frames. The paper finds that COVID-19 vaccine acceptance has been high throughout the study period (68 to 98 percent). However, acceptance levels were lower in 2022 than in 2020 in three countries (Burkina Faso, Malawi, and Nigeria) and higher in one country (Uganda). Moreover, individuals are observed to change their stated vaccine attitudes between survey rounds, to a limited extent in some countries (Ethiopia) and more frequently in others (Burkina Faso, Malawi, Nigeria, and Uganda). Vaccine hesitancy is higher in richer households and among those residing in urban areas, women, and the better educated. Conversely, hesitancy is lower in larger households and among heads of the household. The main reasons for hesitancy are concerns about side effects of the vaccine, its safety and efficacy, as well as assessments of COVID-19 risk, although these reasons fluctuate over time. The findings suggest that vaccine hesitancy is not the primary obstacle to reaching greater vaccine coverage in Sub-Saharan Africa. Instead, low coverage rates may be related to access and delivery barriers as well as supply shortages. Nevertheless, vaccine attitudes appear malleable so that continued efforts are needed to retain high levels of vaccine acceptance.
Users also downloaded
Showing related downloaded files
Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Lebanon Economic Monitor, Fall 2022(Washington, DC, 2022-11)The economy continues to contract, albeit at a somewhat slower pace. Public finances improved in 2021, but only because spending collapsed faster than revenue generation. Testament to the continued atrophy of Lebanon’s economy, the Lebanese Pound continues to depreciate sharply. The sharp deterioration in the currency continues to drive surging inflation, in triple digits since July 2020, impacting the poor and vulnerable the most. An unprecedented institutional vacuum will likely further delay any agreement on crisis resolution and much needed reforms; this includes prior actions as part of the April 2022 International Monetary Fund (IMF) staff-level agreement (SLA). Divergent views among key stakeholders on how to distribute the financial losses remains the main bottleneck for reaching an agreement on a comprehensive reform agenda. Lebanon needs to urgently adopt a domestic, equitable, and comprehensive solution that is predicated on: (i) addressing upfront the balance sheet impairments, (ii) restoring liquidity, and (iii) adhering to sound global practices of bail-in solutions based on a hierarchy of creditors (starting with banks’ shareholders) that protects small depositors.Publication World Development Report 2006(Washington, DC, 2005)This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication Argentina Country Climate and Development Report(World Bank, Washington, DC, 2022-11)The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.