COVID-19 vaccine hesitancy may be associated with traumatic events in childhood that undermine trust, including domestic violence, substance abuse in the home, or neglect, data published Tuesday suggest.
The
results are especially significant, the authors say, because of the prevalence
of adverse childhood experiences (ACEs) globally, with proportions of
people experiencing multiple traumas in some countries at 10% or more of the
population.
The authors write that hesitancy or refusal to get the vaccine increased with
the number of traumas reported.
For example, hesitancy was three times higher among people who had experienced four or more types of childhood trauma than those who did not report any traumatic events.
Bellis told Medscape Medical News that though their work suggests that higher levels of ACEs are linked with higher vaccine hesitancy, it is by no means the only reason people choose not to get vaccinated.
People with more ACEs were more likely to have low trust in National Health Service COVID-19 information.
"Other sociodemographics and a history of either chronic disease or COVID-19 infection were not significantly associated with low trust," the authors point out.
People reporting higher ACEs also were more likely to report that they felt they were unfairly restricted by the government. People with four or more ACEs were twice as likely than those with no ACEs to say they felt unfairly restricted and wanted rules such as mandatory masking to stop.
Additionally, people with four or more types of trauma were almost twice as likely to ignore the restrictions as those who hadn't experienced any — 38% vs 21% — to ignore the restrictions, even after accounting for associations with sociodemographic factors and previous COVID-19 infection or a history of long-term conditions.
"Clinicians can be a powerful voice to counter more alarmist or even conspiratorial messages that might otherwise resonate with those who find trust difficult," Bellis said.
He said that the effect of childhood adversity needs to be considered at all levels in health systems. Overarching public health strategists should include ways to earn trust to counter resistance in some of the most vulnerable communities where ACEs can be higher.
It will also be important in the short-term to "provide reassurance, build community champions, and understand the low base from which trust needs to be built," he said.
The researchers estimated the likely rates of vaccine hesitancy according to childhood trauma and age, and the numbers ranged from around 3.5% among those aged 70 and older with no experience of childhood adversity to 38% among 18- to 29-year-olds who had experienced four or more types of childhood trauma.
