Georgians remain hesitant about vaccinating kids

Note: This article first appeared on the Caucasus Data Blog, a joint effort of CRRC Georgia and OC Media. was written by Tsisana Khundadze, a Senior Researcher at CRRC Georgia, and Dustin Gilbreath, the Deputy Research Director at CRRC Georgia. The views expressed in this blog post reflect the views of the authors alone, and do not necessarily reflect the views of NDI or CRRC Georgia. 

Data from the CRRC Georgia and NDI December 2021 survey suggest that even fewer people in Georgia are willing to vaccinate their children than those who are willing to get vaccinated themselves.

A 9 November decision by Georgian authorities enabled children aged 12 or older to be vaccinated against COVID-19, so long as there was parental consent. 

In the December 2021 survey, 29% of Georgians reported already being vaccinated while 25% said they plan to get vaccinated, equivalent to 44% of the adult population in total. In contrast, 42% of Georgians said they would not get vaccinated against the coronavirus.  Two-thirds of those who are already vaccinated or willing to be said they would get a booster or already had. 

In contrast, only a quarter of people reported they would be willing to vaccinate, or had already had vaccinated, their children. The majority (59%) says they would not vaccinate their children.

The data indicates that there are a number of differences between those willing to and those not willing to vaccinate their children. 

Notably, people who do not have children under 12 in the household are 1.3 times more likely to say they would vaccinate them compared to people who have children under 12 in the household. 

People who say they are planning to get the vaccine or are already vaccinated themselves are 5 times more likely to say they would vaccinate their children.

People with higher education are 1.3 times more likely to report they would vaccinate their children than people with secondary or lower education. 

People who trust the healthcare system in Georgia are 1.2 times more likely to report the same compared with those who do not trust the healthcare system. 

Georgian Dream and opposition supporters are 1.2 times more likely to say they would vaccinate their children compared to people who did not name any party as closest to them. 

The wealthier a household is, the more likely a person is to say they would vaccinate their child. 

Older people are 1.5 times more likely to express willingness in vaccinating children than young people. 

Note: This chart was generated from a regression model. The additive index of ownership of different items is a common proxy for wealth.

With this data in mind, together with the late rollout of vaccines for children, perhaps it is unsurprising that as of 16 January, only 15,841 children were vaccinated with at least one dose in Georgia.

The data used in this article is available here.

Georgia has a vaccine inequality problem

Note: This article first appeared on the Caucasus Data Blog, a joint effort of OC Media and CRRC Georgia. It was written by David Sichinava, CRRC Georgia's Research Director. The views expressed in this article are those of the author’s alone and do not in any way reflect the views of CRRC Georgia, or any related entity.

A fast and timely rollout of COVID-19 vaccines is essential for keeping the pandemic at bay. While far-reaching immunisation helps save lives, it also helps with quickly reopening the economy. Nevertheless, not everyone has access to life-saving vaccines. Rich countries have been quick to hoard doses to vaccinate their own populations, leaving poorer states lagging behind. 

But unequal access to COVID-19 vaccines within countries also threatens the effective and timely mitigation of the pandemic. Notably, even in countries boasting high rates of vaccine rollout, such as the UK and Israel, COVID-19 vaccines are less accessible to vulnerable and disadvantaged populations. As recent CRRC/NDI data shows, Georgia is no exception.

Despite initial successes in curbing the COVID-19 pandemic, Georgia has done considerably worse in managing infection rates and vaccinations than its neighbours. In the first 10 days of August 2021, the country led global league tables in infection and death rates per 100,000 residents, while simultaneously lagging far behind in immunisation.

As of 25 July 2021, when the last interviews of the CRRC/NDI study were administered, about 7% of Georgians in the survey reported receiving at least one dose of the COVID-19 vaccine. The Georgian government initially prioritised vaccinating older people, so this group is slightly more likely to be inoculated (10%) than those younger than 35 (4%) and between 35 and 54 (8%). More Tbilisi residents (16%) received at least one shot than those from other urban areas (6%) and rural areas (2%).

Notably, a respondent’s socio-economic status predicted whether they had been vaccinated. About 16% of Georgians with a higher education had received at least one dose, as opposed to a mere 4% of those with no higher education. 

About a quarter of respondents with the highest socio-economic standing in the country (as measured by an asset ownership index) had received at least one dose, compared to 6% of those with the median number of assets, and 3% of Georgians within the lowest socioeconomic bracket.

A lack of information might contribute to low immunisation rates. The research indicates that those groups who were least likely to be vaccinated also claimed that they did not have enough information on the immunisation process. For instance, only 18% in the highest socio-economic status say that they did not have enough information on the vaccination process in Georgia, compared to almost half of those within the median (48%) and lowest standing on the socio-economic bracket (46%). 

Similarly, a larger share of Georgians with no higher education (47%) stated that they did not have enough information on vaccination, than those who had attained higher education (30%).

There was also geographic variation. For example, only one-third of Tbilisians reported not having enough information about Georgia’s immunisation process, compared with 43% in other urban areas and 47% in rural areas. 

Not surprisingly, in the days of the initial phase of vaccine rollout, available vaccination time slots in the capital and larger urban areas were filled almost instantaneously. Many Tbilisians even booked available places in vaccination centres outside the capital. This may be because they had better access to information and knowledge of the online booking system: CRRC/NDI data shows that 61% of Tbilisi residents knew how to access online booking system, as opposed to 45% of Georgians from other urban areas and only 27% of rural residents.

Those who reside outside the capital are not the only group put in a disadvantaged position. Other vulnerable groups such as older people, ethnic minorities, poorer Georgians, and those with no higher education were also less likely to have knowledge of how to use the online vaccination booking system. Few among those who claimed not to have enough information on the immunisation process knew how to use the online booking system.

While in the last few weeks, Georgia has accelerated its immunisation efforts, vaccinating more than 20,000 people daily, it is likely that the factors described in this article will continue to affect the timely and equitable access to life-saving vaccines. 

Considering the lack of pro-immunisation information provided by the government and the prevalence of anti-vaccine sentiment among many Georgians, it is crucial that information be disseminated explaining the process and benefits of immunisation. As the data above shows, it’s also critical that this is done in a manner that effectively reaches all Georgians.

Note: Differences were identified using two logistic regression model predicting (a) whether the respondent had a COVID-19 vaccine, (b) whether they reported not having enough information on the immunization process in Georgia, and (c) whether the respondent knew how to use online vaccine booking system. Predictors in each of the models included the following social and demographic variables: gender, age, education, settlement type, ethnicity, partisanship, and a durable goods index. A durable goods index is a common proxy measure of a household’s economic status, which counts the number of appliances present in the household. The lowest value corresponds to the score of 0. The median value corresponds to 6, and the highest value of the index is 10. The replication code is available here.

How Megi Bakradze’s death affected vaccine hesitancy in Georgia

[Note: This post first appeared on the Caucasus Data Blog, a joint production of CRRC Georgia and OC Media. It was written by Dustin Gilbreath, Deputy Research Director at CRRC Georgia. The views expressed in this article are those of the author’s alone and do not in any way reflect the views of the World Bank, CRRC Georgia, or any related entity.]

When Georgian nurse Megi Bakradze died following an allergic reaction to the AstraZeneca coronavirus vaccine in March, there were fears that vaccine hesitancy could grow. But how did her death really affect how people feel about vaccination?

According to previous data analysis, Georgia has among the largest vaccine hesitancy problems in the world. One incident which is widely seen to have exacerbated the issue was the death on 18 March of Megi Bakradze. Bakradze was a nurse who experienced an allergic reaction to the AstraZeneca vaccine and passed away just after having gone on television to support the vaccine rollout. Her death was later ruled to be due to negligence. The tragedy nonetheless sparked fears in Georgia around vaccination.

Newly released data from just a week after the tragedy suggests that while vaccine hesitancy shot up following her death, it recovered in the two weeks following. Forthcoming data suggests vaccine hesitancy has recovered to levels comparable to prior to the tragedy.

A February NDI and CRRC Georgia poll suggested that 35% of the public wanted to be vaccinated against COVID-19, 53% did not, and the remainder were uncertain or refused to answer. 

A World Bank survey which CRRC Georgia fielded from 24–30 March — after Bakradze’s death — suggested that only 24% of the public wanted a vaccine, 62% did not, and 14% were uncertain. 

While the questions on the surveys were slightly different, these differences were minimal suggesting that this large of a difference would not be explained by the question wording alone.

While vaccine hesitancy likely increased as a result of Bakradze’s death, the data suggests that as more time passed from the incident, vaccine hesitancy declined.

While on 24 March, only 16% of surveyed respondents wanted to be vaccinated, by 29 March, 28% did. At the start of the fieldwork, 69% answered that they did not want to be vaccinated, but by the end this number had declined to 57%.

The share responding ‘don’t know’ fluctuated by several points with no clear trend over the course of the fieldwork. 

This analysis is supported by a regression analysis, which suggests that controlling for the characteristics of respondents, there was a 1.5 percentage point increase per day in interest in getting vaccinated.

Note: Data for 30 March is not shown on the chart above as only six respondents were interviewed on this date. On prior days of fieldwork, between 256–403 respondents were interviewed.

More recent data from a forthcoming survey suggests that vaccine hesitancy has now returned to the level identified in the February CRRC and NDI survey.

While vaccine hesitancy appears to have declined to levels similar to before the Megi Bakradze tragedy, the data shows that it still has far to go until a large enough share of Georgia’s population is interested in a vaccine to protect the public.

Note: The analysis above is based on a logistic regression. The outcome variable is whether or not someone wants a COVID 19 vaccine. The regression controls for age (continuous), education level (Bachelor’s degree or higher versus no tertiary education), gender composition of the household (mixed, women only, men only), number of household members, date of interview, settlement type (Tbilisi, other urban, town, rural), and sex. 

The data used in this article is from the World Bank’s Poverty and Equity Global Practice COVID-19 High-Frequency Survey 2020-2021 Wave 1-3 (Ref. GEO_2020_HFS_v02_M) and is available here. 

Georgia among worst in the world for vaccine hesitancy

Note: This article first appeared on the Caucasus Data Blog, a joint OC Media and CRRC Georgia effort. The article was written by Dr. David Sichinava, Research Director at CRRC Georgia. The views presented in the article represent the views of the authors’ alone and do not represent the views of CRRC Georgia or any related entity. 

Scientists agree that global mass immunisation against COVID-19 is the only pathway to putting the virus under control. Yet, the World Health Organisation has argued that actually getting people to take vaccines is ‘an unprecedented challenge’, which might undermine mass immunisation efforts. 

New data suggests that the Georgian public is among the least interested in getting a vaccine globally, given available data. 

On the January 2021 Omnibus survey, CRRC Georgia asked respondents whether they wanted to be vaccinated against COVID-19 if a safe and effective vaccine was available tomorrow. While half the public (48%) said yes, half were against being vaccinated (40%) or uncertain (12%). 

Since this poll was conducted, the government has expanded those eligible to be vaccinated to include the general public over the age of 65, after take-up among medical workers was low. 

Vaccination efforts encountered a significant challenge when a nurse who was promoting vaccination passed away as a result of an allergic reaction to the vaccine itself. 

More recent polling from February, which was collected prior to the above described events, has shown an even lower share of the public wants to be vaccinated (35%). 

With this context in mind, how does Georgia fare globally in terms of vaccine acceptance? CRRC data puts the country near the bottom in the global league table of countries where polling data on vaccine hesitancy is available. 

Georgians are on par with the populations of the Philippines, France, and Russia regarding openness to getting vaccinated.

How do different groups of Georgians compare in terms of vaccine hesitancy? 

More women than men are hesitant about getting a COVID-19 jab. About half of Georgian men (52%) said that they would get vaccinated compared to 45% of women. Forty-three percent of women said they would not get inoculated, with only 37% of men saying they would not. 

Georgians with a higher education (53%) are eight percentage points more likely to want a vaccine than those without (46%). 

There is a notable partisan split when it comes to openness to vaccination. While most supporters of both the Georgian Dream and opposition parties want a vaccine, more Georgian Dream supporters (62%) said that they will vaccinate than opposition supporters (52%). Georgian Dream supporters were less likely to say that they would not vaccinate (27%) than supporters of other political parties (41%). Importantly, non-partisans were more likely to say that they would not vaccinate (46%) than vaccinate (41%).

Further analysis of the data shows that vaccine hesitancy is also related to other attitudes. For instance, more than half (54%) of those who believe that COVID-19 is a real threat (three-quarters of Georgians) would vaccinate. Those that think the danger of COVID-19 is exaggerated (19% of the total population) are more likely to refuse a vaccine. Only about 25% of such respondents would get a COVID-19 jab, while 66% would refuse to be inoculated.

How do those who refuse to be vaccinated or are uncertain explain their attitudes? Most (55%) respondents said that they do not trust vaccines. Seventeen percent said that they do not need a vaccine. About 10% were afraid of vaccination, and 5% said they are anxious about the vaccines’ potential side effects. Two percent named other reasons, while 11% were unsure. 

Notably, opposition supporters are almost twice as likely to say that they do not trust vaccines (72%) than those that identify with Georgian Dream (38%). While this finding should be taken with caution due to the small sample size, the differences are still suggestive.

Georgia’s vaccine hesitancy problem might partially stem from misinformation. An earlier analysis showed that almost the entire population believed in false facts about vaccines, such as jabs causing autism, that they negatively affect children’s development, or harm the human immune system.

Another reason for such hesitancy could be political. As vaccine reluctance in Georgia correlates to political feelings, further calls for division along partisan lines might well undermine the public’s trust in the process of mass immunisation. 

Instead, politicians should bear in mind an acute public health emergency, set aside political differences, and endorse a consensus about vaccination.

The data used in this article is available here. Replication code for the above analysis is available here.

The analysis above is based on series of multinomial regression models predicting vaccine hesitancy. Demographic controls include gender, age, settlement type, employment status, ethnicity, education, assets index, internet usage, experience of been infected by COVID-19, attendance of religious services and presence of children in the household. Attitudinal predictors control for party affiliation, trust in the government’s ability to deal with the COVID-19 situation, perception whether COVID-19 is a real threat, and optimism regarding COVID-19 situation.