Public mistrust of vaccines is causing the outbreak of diseases like measles, according to researchers.
Scientists from the London School of Hygiene and Tropical Medicine, Imperial College London and the Saw Swee Hock School of Public Health in Singapore questioned 66,000 people across 67 countries to discover their views on whether vaccines are important, safe, effective and compatible with their religious beliefs.
People in southeast Asia showed the highest level of confidence in vaccines, with Africa second.
The survey comes as a major yellow fever vaccination program is under way in the Democratic Republic of Congo and Angola.
An outbreak of the disease has killed hundreds of people. The World Health Organization aims to vaccinate more than 15 million people in both countries.
"If everyone agrees to be vaccinated, we can eradicate yellow fever from our country," said Mosala Mireille, one of the head doctors overseeing the program in Kinshasa.
Europe showed the lowest level of confidence, driven largely by France where 41 percent of the population questions the safety of vaccines.
Scares dent public confidence
Doctor Heidi Larson from the London School of Hygiene and Tropical Medicine says recent high-profile press coverage in France of vaccine scares has dented public confidence.
"Anxieties about links between Hepatitis B [vaccines] and multiple sclerosis several years ago, scientifically deemed unlinked, but still caused anxiety,” Larson said. “There still is today concerns about side effects related to the HPV vaccine, again not scientifically confirmed."
Mistrust in France was also driven by the response to the H1N1 flu outbreak fears in 2009, when the government spent $1.4 billion on 94 million doses of the vaccine. The majority were sold off or destroyed.
Larson fears the consequences of that mistrust.
"We will get some combination of influenza strains that will be very fatal,” Larson said. “And if we have such poor compliance with a pandemic vaccine in the future, I would be very worried about that."
Researchers warn that decreases in confidence can lead to people refusing vaccines, which in turn can trigger disease outbreaks. But the study found a high level of global support for vaccinating children against disease.