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Will vaccination refusal prolong the war on SARS-CoV-2?
  1. Robert Marcec1,
  2. Matea Majta1,
  3. Robert Likic2
  1. 1 University of Zagreb School of Medicine, Zagreb, Croatia
  2. 2 Department of Internal Medicine, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb, Croatia
  1. Correspondence to Robert Likic, Department of Internal Medicine Unit of Clinical Pharmacology, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10000, Croatia; robert.likic{at}; rlikic{at}


Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that appeared in Wuhan, China in January 2020 and caused a global pandemic drastically changing everyday life. Currently, there are vaccine candidates in clinical trials and development, so it is only a matter of time before one is authorised for human use.

Materials and methods We collected public opinion survey results about attitudes towards SARS-CoV-2 vaccination conducted in 2020 in 26 European countries.

Results The pooled surveys were conducted on a total of 24 970 participants; on average only 58% (n=14 365/24 970) of responders across Europe were willing to get a SARS-CoV-2 vaccine once it becomes available, 16% (n=3998/24 970) were neutral, and 26% (n=6607/24 970) were not planning to vaccinate against SARS-CoV-2. Such a low vaccination response could make it exceedingly difficult to reach the herd immunity threshold for SARS-CoV-2 through vaccination.

Conclusion It is very important to start conducting educational public health activities on the topic of vaccination as soon as possible, before a vaccine becomes available, in order to improve attitudes towards SARS-CoV-2 vaccination. Only by educating the general public about the benefits, safety and efficacy of vaccines can we hope to avoid the unnecessary prolongation of the COVID-19 pandemic.

  • Infectious diseases
  • Infection control
  • Public health
  • Public health
  • Clinical pharmacology

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  • Contributors RM and MM collected and pooled the surveys’ results; RM wrote the first draft while MM performed literature search. RL designed the study and critically reviewed and revised the draft. All authors contributed equally to the second revision of the manuscript and approved the final version of the article prior to its submission to the journal.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Map disclaimer The depiction of boundaries on the map(s) in this article does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. All data relevant to the study are included in the article or uploaded as supplemental information.

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