Are you one of the rising number of people refusing the coronavirus vaccine?

Trust in vaccines is itself very variable and should not be taken for granted. The apparent decline in trust is enough to affect the effectiveness of the vaccine once it is delivered.

The international community is still struggling to contain the outbreak. Testing and tracing measures have struggled to be enforced, and some countries -- particularly in Europe -- are entering a new round of lockdowns and increasingly struggling to cope with the outbreak.

Yet another force -- resistance to getting a coronavirus vaccine -- appears to be growing.

Many pharmaceutical companies are conducting vaccine trials, while organizations including the World Health Organization (WHO), Gavi, and CEPI are working to provide possible future help to those WHO need it most.

The efforts of the past few months have brought us closer to releasing a vaccine. According to news in early November, doctors in the UK are ready to deliver the vaccine by Christmas.

A decline in trust

According to a survey of 15 countries, 73% of adults strongly agree or somewhat agree with the statement: "If a COVID-19 vaccine were available, I would take it." Three months earlier, the figure was 77 percent.

At the time, it was clear that there was a lack of confidence in the vaccine and that the outbreak was still not over.

Why do people hesitate?

There are different reasons why people don't want to get vaccinated.

Globally, 34 percent were concerned about side effects and another 33 percent worried that clinical trials were moving too fast.

Among those who did not take the vaccine, the Japanese were most concerned about side effects (62 percent), while Brazilians and Spaniards were most concerned about the pace of clinical trials (48 percent in both countries).

In 15 countries, about a quarter of adults (24%) believe the chance of contracting COVID-19 is so low that there is no need for a vaccine. Adults in India were most likely to agree with the statement (52 percent), followed by the United States (31 percent), despite the distance between the two countries, while Canadians were least likely to agree with the statement at 16 percent.

When do people want to get vaccinated?

The survey also looked at how often people choose to get vaccinated. Half of the world's adults (52%) said they would get the vaccine within three months of it being fully available.

When asked how soon they thought the first COVID-19 vaccines would be widely available, an average of only 45% of adults in the 15 countries thought it would be within the next six months. Among them, 16 percent thought the vaccine would be widely available within the next three months.

However, 55 percent said it would take nine months or more, including 18 percent who said it would take at least 18 months.

If people refuse to vaccinate

Apart from the challenges of producing large quantities of vaccine and ensuring fair distribution, one of the biggest stumbling blocks is trust in the vaccine itself, according to the survey.

Another study, which plotted trends in trust in vaccines in 149 countries from 2015 to 2019, found that doubts about vaccine safety have grown as political instability and religious extremism have increased. Trust in vaccines is inherently so variable that one cannot take it for granted.

Experts estimate that at least 70 percent of the population needs to be immune to the virus to curb community spread. This requires a high level of public confidence in vaccines, and the current confidence gap is enough to limit their effectiveness.

The World Health Organization listed public vaccine hesitancy as one of the top 10 threats to global health in 2019. It affects not only public health, but also business and economics.

While the data in this latest study suggest that overall confidence in COVID-19 vaccines is greater than none, the growing hesitancy is real and a reminder that vaccination won't work if people refuse to take it.