Social amplification of risk and “probable vaccine damage”:A typology of vaccination beliefs in 28 European countries

Background: Despite lacking scientific support, vaccine hesitancy is widespread. While serious vaccine damage as a scientific fact is real yet statistically highly uncommon, emerging social and technological forces have amplified perceptions of risk for “probable vaccine damage”, making it a widely shared intersubjective reality. Methods: Using the Eurobarometer 91.2 survey on a statistically representative EU27-UK sample interviewed in March 2019, we documented perceptions of vaccine risks and identified three belief configurations regarding vaccine effectiveness, safety, and usefulness, through exploratory cluster analysis. Results: The public beliefs in significant vaccine risks are frequent. Approximatively one-tenth of the EU27-UK population consider that vaccines are not rigorously tested before authorization, one-third believe that vaccines can overload or weaken the immune system and that they can cause the disease against which they protect, and almost one-half believe that vaccines can cause serious side effects. We identified three belief configurations: hesitant, confident, and trade-off clusters. The hesitant type (approx. 11% of EU27-UK respondents) is defined by the perception that vaccines are rather ineffective, affected by risks of probable vaccine damage, not well-tested, and useless; the confident type (approx. 59%) is defined by beliefs that vaccines are effective, safe, well-tested, and useful; and the trade-off type (approx. 29%) combines beliefs that vaccines are effective, well-tested and useful, with perceptions of probable vaccine damage. The vaccine-confident and the trade-off types have similar vaccination histories, indicating the significant role of other factors besides beliefs in inducing behavior. Conclusions: The high proportion of varying public beliefs in significant vaccine risks and the presence of a trade-off type of vaccination assessment indicate the social normality of beliefs in probable vaccine damage. Communication campaigns should take into account the social normality of the perceived risk of “probable vaccine damage” across various social types, and patterns of concomitant trust and mistrust in vaccination.