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Vaccination is generally considered the most direct way to restoring normal life after the outbreak of COVID-19, but the available COVID-19 vaccines are simultaneously embraced and dismissed. Mapping factors for vaccine hesitancy may help the roll-out of COVID-19 vaccines and provide valuable insights for future pandemics. We investigate how characteristics of a COVID-19 vaccine affect the preferences of adult citizens in the Netherlands to take the vaccine directly, to refuse it outright, or to wait a few months and first look at the experiences of others. An online sample of 895 respondents participated between November 4th and November 10th, 2020 in a discrete choice experiment including the attributes: percentage of vaccinated individuals protected against COVID-19, month in which the vaccine would become available and the number of cases of mild and severe side effects. The data was analysed by means of panel mixed logit models. Respondents found it important that a safe and effective COVID-19 vaccine becomes available as soon as possible. However, the majority did not want to be the first in line and would rather wait for the experiences of others. The predicted uptake of a vaccine with the optimal combination of attributes was 87%, of whom 55% preferred to take the vaccine after a waiting period. This latter group tends to be lower-educated. Older respondents gave more weight to vaccine effectiveness than younger respondents. The willingness to take a COVID-19 vaccine is high among adults in the Netherlands, but a considerable proportion prefers to delay their decision to vaccinate until experiences of others are known. Offering this wait-and-see group the opportunity to accept the invitation at a later moment may stimulate vaccination uptake. Our results further suggest that vaccination campaigns targeted at older citizens should focus on the effectiveness of the vaccine. • We conducted a choice experiment on vaccination preferences among Dutch citizens. • 87% accepts a safe and effective COVID-19 vaccine that is available swiftly. • 55% of this group prefers to delay their decision to learn from others' experiences. • Respondents who preferred to wait tend to be lower-educated. • The vaccine's effectiveness is important for older respondents who prefer to wait. [ABSTRACT FROM AUTHOR]

Abstract: Among all public health provisions national immunization programs (NIPs) are beyond doubt one of the most effective in reducing mortality, morbidity, and costs associated with major infectious diseases. To maintain their success, NIPs have to modernize in response to many new and old demands regarding efficacy, safety, availability of new vaccines, emerging and evolving pathogens, waning immunity, altered epidemiological situations, and the public''s trust in the program. In this paper we present an evaluation model in the form of a checklist that may help in collecting relevant scientific information that is necessary for evaluation and decision making when considering changes in a NIP. Such a checklist points to relevant information on the vaccine-preventable disease, the pathogen causing it, the vaccine, and the cost-effectiveness ratio of the vaccine. However, the final judgment on a potential change in the NIP cannot be based on a simple algorithm, as the relevant information reflects factors of a very different kind and magnitude, to which different value judgements may be added, and which may have certain degrees of uncertainty. Because any change in the NIP may be accompanied by more or less unforeseen changes in the vaccine''s efficacy, evolutionary consequences, including the antigenic composition of the pathogen, and the vaccine''s safety profile, an intensive surveillance program should accompany any NIP. Elements thereof include clinical–epidemiological surveillance, surveillance of vaccination coverage, immune surveillance, surveillance of microbial population dynamics, and surveillance of adverse events and safety issues. We emphasize that the decision to introduce a vaccine in the NIP should be taken as seriously, both scientifically and ethically, as the decision to withhold a vaccine from the NIP. In the latter case one might be responsible for vaccine-preventable disease and mortality. [Copyright &y& Elsevier]