Wellcome Global Monitor 2018

"Improved understanding of how different people feel and think about science and its relation to health is essential to encourage debate, address disparities and foster greater public engagement, with the ultimate goal of improving health for everyone."

This report shares the results of nationally representative surveys conducted by the Wellcome Trust to query 140,000 people aged 15 years or older in 140 countries regarding their trust in science, scientists, health professionals, and vaccines. The report explores how attitudes vary by characteristics such as nationality, gender, income, and education. It may be of interest to researchers, policymakers, science communicators, public engagement practitioners, funders, and anyone working to increase trust and engagement between scientists and society.

The Global Monitor adopted the Vaccine Confidence Project's Vaccine Confidence Index to measure confidence in vaccine importance, safety, and effectiveness. Collected from April through December 2018, selected data about vaccines and related issues are outlined below.

Attitudes to vaccines (Click here to go directly to Chapter 5: Attitudes to Vaccines):

• 92% of parents worldwide said their children had received a vaccine, while 6% said they had not, and 2% said they did not know. The highest percentage of parents who said their children did not receive a vaccine were Southern Africa (9%) and East Asia and Southeast Asia (8%).
• When asked if they believed vaccines are effective, 84% either strongly or somewhat agree, 5% either strongly or somewhat disagree, and 12% neither agreed nor disagreed.
• 79% of those surveyed either strongly or somewhat agree that vaccines are safe, while 7% strongly or somewhat disagree. Another 11% neither agree nor disagree, and 3% said they don't know.
• Only 72% of people in Northern America and 73% in Northern Europe agree that vaccines are safe. In Western Europe, this figure is lower, at 59%, and in Eastern Europe, the figure is only 50%. In France - a country among several European ones now experiencing outbreaks of measles - 1 in 3 people disagree that vaccines are safe. People in France were also among the most likely to disagree that vaccines were effective, at 19%, and to disagree that vaccines were important for children to have, at 10%.
• Most people in lower-income areas agreed vaccines were safe. The highest number was in South Asia, where 95% of people agreed, followed by Eastern Africa, where the figure was 92%. Bangladesh and Rwanda had nearly universal agreement about the safety and effectiveness and have achieved very high immunisation rates despite many challenges in physically getting vaccines to people. Rwanda became the world's first low-income country to provide young women with universal access to the human papillomavirus (HPV) vaccine.
• In most regions, people who have high trust in doctors and nurses are very likely to consider that vaccines are safe. (This is less true in Western and Eastern Europe.) Conversely, those who had sought information about science, medicine, or health recently appeared to be less likely to agree.
• There is a positive relationship between overall trust in scientists and attitudes towards vaccines, though the relationship is strongest in high-income countries.

Trust in science and health professionals:

• Globally, 18% of people have a 'high' level of trust in scientists, while 54% have a 'medium' level of trust, 14% have 'low' trust, and 13% 'don't know'. This ranges from one-third of people having 'high' trust in Australia and New Zealand, Northern Europe, and Central Asia, to around 1 in 10 in Central and South America.
• Factors that significantly relate positively to trust in scientists include: learning science at school or college, confidence in key national institutions (such as the government, the military, and the judiciary), living in a rural location, the extent to which people feel it is difficult to get by on their income, higher levels of income inequality in a country, and lack of access to mobile phones and the internet.
• 73% of people say they would trust a doctor or a nurse more than other sources of health advice, including family, friends, religious leaders, or famous people. This figure ranges from a low of 65% in East Asia and the Middle East, to a high of about 90% in parts of Europe, Northern America, and Australia and New Zealand.
• 84% say they trust medical and health advice from medical workers (such as doctors and nurses), but that decreases to 76% for trust in that same advice from the government.
• People in high-income countries are about as likely to have confidence in hospitals and health clinics in their country as lower-middle-income countries (78% and 82%, respectively).

Understanding of and interest in science and health:

• Over half (57%) of the world's population don't think they know much, if anything, about science.
• The basic concepts of 'science' and 'scientists' are not universally understood across all countries, even in high-income nations. In Central Africa, 32% said they understood none of the definitions presented to them or said they didn't know; in Northern America and most of Europe, this figure drops as low as 2%.
• 62% say they are interested in learning more about science, particularly people living in low-income countries, 72%.
• Globally, 28% of people say they recently sought information about science, and 41% have recently sought information about medicine, disease, or health.
• Globally, 49% of men worldwide say they know 'some' or 'a lot' about science, compared with 38% of women. Almost everywhere, men are more likely to claim greater science knowledge than women. This gap exists even when men and women report equal levels of science attainment.
• Worldwide, more than half the people aged 15-29 (53%) say they know 'some' or 'a lot' about science, compared to 40% of those aged 30-49 and 34% of those aged 50 and older.

Science and society:

• About 7 in 10 people feel that science benefits them, but only around 4 in 10 think it benefits most people in their country. South America has the highest proportion of people who believe that science neither benefits them personally nor society as a whole, about a quarter of people. About a third of people in North and Southern Africa and Central and South America feel excluded from the benefits of science.
• People in France are most likely to see science and technology as a threat to the local employment prospects. Regionally, the people of Western Europe and Eastern Europe are the most pessimistic regions about the impact of science and technology on jobs in their countries.
• Among people with a religious affiliation, 55% would agree with their religious teachings in a disagreement between science and their religion, 29% would agree with science, and 13% say it depends on the issue. "Religion and science are sometimes depicted as being in opposition, but Wellcome Global Monitor challenges this stereotype by finding that most people in the world do not see a conflict between their religious beliefs and science."

The results from this first Wellcome Global Monitor will provide a baseline of evidence to assess how attitudes change over time; the survey will be re-run in the future.