Health policy (Amsterdam, Netherlands) · 2026
Vaccine hesitancy in conflict-affected Ukraine: An agent-based analysis of survey data.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Naeem Amna, Sikder Iftikhar U, Pangallo Marco, Pavlova Iuliia, Lapii Fedir, Zarubina Valeriia, Rahman M Sohel, Haque Ubydul
Аннотация
BACKGROUND: In conflict-afflicted regions like Ukraine, disrupted health services, displacement, and logistical disturbances have compromised immunization and trust, underscoring the need to understand behavioral, access, and conflict dynamics for resilient strategies.
OBJECTIVE: To simulate the interaction between behavioral, structural, and social variables in predicting changes in vaccination beliefs and uptake in war-impacted Ukraine.
METHODS: We conducted a geographically diverse cross-sectional survey across 557 Ukrainian hromadas (local communities) during the ongoing war to assess vaccine confidence and behavioral determinants using an integrated psychological-computational framework. Empirical data were analyzed through k-means clustering and agent-based modeling (ABM) to simulate vaccination dynamics under conflict conditions. This survey-informed ABM examines how social contagion, healthcare access disruption, and conflict exposure may jointly shape vaccination behavior in a conflict-affected setting. To our knowledge, it represents one of the first behavioral simulation frameworks informed by survey data collected during the ongoing war in Ukraine.
RESULTS: Our agent-based modeling suggested that vaccination uptake in Ukraine is governed by a dynamic interplay between structural access and peer influence. Belief transitions reached 88%, whereas vaccination uptake increased 3%-15% due to access barriers. Conversely, peer dynamics increased vaccination coverage to 69%-89%, leading to a smoother coverage distribution. Sensitivity analyses indicated that peer conformity was the dominant driver, suggesting a collective mechanism linking social contagion and health behavior adoption.
CONCLUSION: Our findings suggest that structural access and peer influence jointly drive vaccine uptake during conflict, introducing a survey-based agent-based framework that links belief dynamics to behavior. These insights provide actionable pathways for equitable immunization policies in fragile and conflict-affected settings.
OBJECTIVE: To simulate the interaction between behavioral, structural, and social variables in predicting changes in vaccination beliefs and uptake in war-impacted Ukraine.
METHODS: We conducted a geographically diverse cross-sectional survey across 557 Ukrainian hromadas (local communities) during the ongoing war to assess vaccine confidence and behavioral determinants using an integrated psychological-computational framework. Empirical data were analyzed through k-means clustering and agent-based modeling (ABM) to simulate vaccination dynamics under conflict conditions. This survey-informed ABM examines how social contagion, healthcare access disruption, and conflict exposure may jointly shape vaccination behavior in a conflict-affected setting. To our knowledge, it represents one of the first behavioral simulation frameworks informed by survey data collected during the ongoing war in Ukraine.
RESULTS: Our agent-based modeling suggested that vaccination uptake in Ukraine is governed by a dynamic interplay between structural access and peer influence. Belief transitions reached 88%, whereas vaccination uptake increased 3%-15% due to access barriers. Conversely, peer dynamics increased vaccination coverage to 69%-89%, leading to a smoother coverage distribution. Sensitivity analyses indicated that peer conformity was the dominant driver, suggesting a collective mechanism linking social contagion and health behavior adoption.
CONCLUSION: Our findings suggest that structural access and peer influence jointly drive vaccine uptake during conflict, introducing a survey-based agent-based framework that links belief dynamics to behavior. These insights provide actionable pathways for equitable immunization policies in fragile and conflict-affected settings.