Hesitancy Against COVID Vaccine: Is It a Pattern Across Nations?

Timely awareness programmes about COVID-19 vaccines could have easily contained false claims against the vaccines.

(Photo: iStock)

A timely awareness programs about the vaccines could have easily contained false claims against COVID-19 vaccine. Image used for representational purposes. 

What Are Vaccines? How Helpful Are They?

When we fall sick due to an infection, our immune system generates biochemicals called ‘antibodies’ that neutralises the pathogens (disease-causing microbes). Specific cells called Memory-B cells retain the memory about these antibodies that would neutralise a particular pathogen. The moment our immune system encounters the same pathogen in future, memory-B cells provide information (like a blueprint) to another group of cells to produce antibodies.

With time, scientists found out that the memory-B cells can be generated through vaccination, without actually getting infected.

Vaccines, basically, help immune system to develop and retain Memory-B cells against a pathogen, without the need of contracting any life-threatening disease. Sometimes more than one dose of a vaccine may be required to develop a long-lasting immunity.

That is why we needed several booster doses for polio. Vaccines have come a long way. While inactivated pathogens were used during the early vaccines, the modern vaccines use just the genetic sequences for any specific part of the pathogen (epitope), which is good enough to generate antibodies and Memory-B cells.

Thus, the actual pathogen or its fragment is not used even indirectly. The world is free of diseases like smallpox and polio primarily due to vaccines.

As per World Health Organization (WHO), 20-30 lakh deaths a year are prevented because of vaccination, and additional 15 lakh deaths can be circumvented with improved global vaccinations. India was able to control polio through pulse polio programme that was one of the world’s largest vaccination drive.

Is There a Vaccine Hesitancy for COVID-19 Vaccines?

Vaccine hesitancy is not a new phenomenon. At different times and places, people have avoided vaccines due to personal reasons and beliefs, misinformation, and socio-political issues, including anti-vaccination campaigns.

The additional hesitancy for COVID-19 vaccines is also due to suspicions arising from the fact that they have been prepared in very less time and we are yet to fully understand the disease itself. While social media ensures spread of information to everyone, it especially amplifies any side effects and enhances hesitancy.

Is Vaccine Hesitancy More in Developing Countries?

It is a common assumption that undereducated and undeveloped regions would be more suspicious about the vaccines. However, vaccine hesitancy exists even in the developed western world. In fact, the public in developed nations are much more hesitant to vaccinations than countries in South and South East Asia.

Is There a Pattern of General Vaccine Hesitancy Across Nations?

In a study reported by Wellcome Global Monitor on attitudes to vaccines, high-income regions appeared to be least certain regarding vaccine safety.

Only 59% in Western Europe and 50% responders in Eastern Europe were sure about vaccine safety. But, when it came to lower-income areas such as South Asia and Africa, a majority agreed that vaccines are safe (South Asia-95%, Eastern Africa-92%).

In case of India, 95% agreed that vaccines are safe and effective and 98% agreed that vaccines are important for children.

Data of Perceived Safety of Vaccine by Region.(Photo Courtesy: Wellcome.org)

Hesitancy About COVID Vaccines

Last year, a survey on 13,426 randomly selected individuals from 19 countries was published in the respected Nature Medicine journal on potential acceptance of COVID-19 vaccine.

71.5% respondents said that that they would take a shot if the vaccines were proven safe and effective, and were available, they would get the vaccine.

The numbers above the bars represent percentage of people who responded positively.(Photo Courtesy: Screengrab from Nation Public Health Emergency Collection)

People who reported COVID-19 sickness among family members didn’t have a higher chance of taking the vaccine than respondents without any case in the family. Older respondents were more likely to take a vaccine than younger people.

Recent Factors That Increased the Hesitancy for COVID-19 Vaccines

COVID-19 vaccines were produced in a record time, thanks to the overall developments in science and biotechnology. However, this rapid turnout is also a cause of concern to the public.

Data related to side effects, toxicity, effects on seniors, children, pregnant, and lactating mothers can only be acquired after large-scale clinical trials; naturally, it takes time.

Science and research are dynamic fields that update us as new data emerge. However, this sowed uncertainty in the minds of many who considered these updates as distrustful and indicators of non-certainty.

Irresponsible comments by religious and political leaders increased hesitancy. Moreover, unfortunate deaths (of vaccinated people) and the news on blood clots formation after AstraZeneca-vaccine further damaged credibility of vaccines.

In all, the health agencies couldn’t address these issues swiftly and their complacency allowed the spread of misinformation and conspiracy theories.

Some of these false claims, like COVID-19 vaccine causes sterility, could have been easily contained through proactive measures. There should have been timely awareness programmes about the vaccines when the vaccines were first announced.

How to Increase Vaccine Acceptance?

1. Merely stating that vaccines are safe is not enough. Vaccination programmes should consider the social and psychological factors among different populations that drive vaccine acceptance.

2. Along with health professionals, videos of political, religious/spiritual leaders, and celebrities taking vaccines and sharing their experiences can positively influence people.

3. People trust the experiences of their relatives, neighbours, and local leaders when it comes to medications/treatment. Especially in the rural regions, the block level officers, panchayat members, mukhiyas, and sarpanch should be trained to talk about the vaccines.

4. Informative memes though WhatsApp, social media, and TV should be used to spread awareness as well as quash rumours. YouTube advertisements at the beginning of each video and collaborations with affluent YouTubers can be considered.

5. People need to be told about the side effects as well so that they don’t panic while experiencing them. There should be a 24-hour helpline for vaccinated people.

6. Provide incentives for getting vaccinated. The current aim is to get people vaccinated as soon as possible to prevent further waves.

7. Immediately blacklist and penalise people who spread misinformation, especially those with large following.

(Dr Piyush Kumar is a Postdoctoral Fellow at Icahn School of Medicine at Mount Sinai, New York. This is an opinion piece. The views expressed above are the author’s own. The Quint neither endorses nor is responsible for them.)