Reluctance or refusal to get vaccinated against Coronavirus infection (vaccine hesitancy), may be linked to the experience of traumatic events in childhood, such as neglect, domestic violence or substance misuse in the family home, suggests research funded by Public Health Wales and published in the BMJ Open.
Research conducted with adults in Wales identified that vaccine hesitancy was three times higher among people who had experienced four or more types of childhood trauma than it was among those who hadn’t experienced any.
Childhood adversity has been shown to be linked to poorer mental well-being, with some studies suggesting it may lead to reduced trust in health and other public services. To explore this further, the research aimed to find out whether childhood trauma might be linked to levels of trust in NHS COVID-19 information; support for, and compliance with, Coronavirus restrictions (such as mandatory face coverings and social distancing); and intention to get vaccinated against the infection.
But the researchers point out that people who have experienced childhood trauma are “known to have greater health risks across the life-course. Results here suggest such individuals may have more difficulty with compliance with public health control measures and consequently require additional support.”
This is important not only for the current pandemic but for other future public health emergencies, they suggest.
Understandably individuals who have suffered abuse, neglect or other forms of adversity as children may find it more difficult to develop trust in state systems provided for their protection and help. Here we have demonstrated how adults with a history of adverse childhood experiences are less likely to trust advice from health services and are subsequently less likely to either follow COVID-related restrictions or accept and act on information on the benefits of being vaccinated.
Systems need to help ensure that children have safe and nurturing childhoods
Professor Karen Hughes (Public Health Wales, Bangor University) added:
“If we want more people to trust our public systems then these systems need to help ensure that children have safe and nurturing childhoods. For those that have suffered adversity in childhood we should consider other ways of communicating critical health messages, for example using individuals, communities, or other institutions in which there may be established trust. Simply repeating the same message through public sources that some people may have already rejected is unlikely to result in such individuals changing their minds.”
Doctor Kat Ford, of Bangor University’s School of Medical & Health Sciences said:
“Some individuals risk being excluded from population health interventions and therefore have higher risks of infection and ill health. We need to better understand how to engage such individuals, improve their trust in health systems and enable increased compliance with health guidance.”
The survey asked about nine types of adverse childhood experiences (ACEs; childhood trauma) before the age of 18: physical, verbal, and sexual abuse; parental separation; exposure to domestic violence; and living with a household member with mental illness, alcohol and/or drug misuse, or who was in prison.
Respondents who expressed little or no trust in NHS Coronavirus information and who felt unfairly restricted by government COVID-19 restrictions were more likely to favour the immediate ending of regulations on social distancing and mandatory face coverings. They were also more likely to say they had flouted the regulations occasionally and to profess reluctance or refusal to get vaccinated.
Data were collected between December 2020 and March 2021 over the telephone with a sample of 2,285 adults living in Wales.
The full study ‘Associations between adverse childhood experiences, attitudes towards COVID-19 restrictions and vaccine hesitancy: a cross-sectional study.’ is freely available here:
https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2021-053915
