COVID-19 vaccine hesitancy in rural India

Supported by a competitive grant awarded from the Sabin Vaccine Institute, CSBC worked to understand vaccine hesitancy in rural areas to develop evidence-led recommendations to encourage vaccine acceptance. In this project, we conducted an in-person survey in 32 districts of rural Uttar Pradesh (UP) and Bihar in March and April 2022 to generate insights.

Introduction

The COVID-19 vaccination campaign in India has been highly successful, with over 90% of the adult population vaccinated in just one year (March 2021 – March 2022). However, there is a surprising lack of empirical evidence of the prevalence of hesitancy or a comprehensive characterisation of barriers to vaccination among holdouts in the rural context. This project aims to bridge this gap by studying people in rural Uttar Pradesh and Bihar without up-to-date COVID vaccinations. It seeks to understand the reasons and beliefs that drive hesitancy in these populations. Additionally, we empirically estimate the demand for the COVID-19 vaccine for children.

Description and methodology

Our study used in-person computer-assisted surveys. We covered 20 districts in Uttar Pradesh and 12 districts in Bihar, sampling 6300 respondents. CSBC's field partner for this study was NYAS Research, which trained and managed a field team of 50+ enumerators to collect data.

Enumerator training

Our questions probed the unvaccinated for their barriers, and the vaccinated for the drivers of their decision to vaccinate. We also probed the attitudes around getting children vaccinated and any misconceptions parents may have about the same. Further, we tested two short video-based interventions and measured any change in parents' intentions to get their children vaccinated against COVID-19 after watching the videos.

In-person survey

Results and highlights

Through our study, we expect to understand barriers to vaccination amongst underserved populations better. The study also adds to the growing empirical literature on vaccine hesitancy in India and is particularly relevant since it focuses on rural settings that are otherwise not accessible through internet and phone-based surveys.

Research funders

The Sabin Vaccine Institute generously funded this study through their Social and Behavioral Research Grants Program.