COVID-19 vaccine hesitancy and what to do about it?

Positive Minds | Positive Stories | Edition 024

I had my first injection of the AstraZeneca vaccine against COVID-19, and I am fine.

It was 3.30 pm yesterday, Friday 2 April 2021, when I entered the COVID-19 vaccination compound set up by the Senegalese government for the United Nations and international organisations staff and their families.

Do you have an ID card? What is your date of birth? Where do you live? What is your phone number? Do you have any co-morbidities such as hypertension, heart failure, kidney failure, diabetes, or cancer?

These were the routine questions the nurse asked me before filling in my COVID-19 vaccination card and directing me to the person in charge of the vaccination.

"Sit down and roll up the left sleeve of your shirt", the lady said to me. Within 5 seconds, I had received my first dose of AstraZeneca vaccine,

Then the lady showed me an area that had been set up for the purpose and said, "Sit there for 15 minutes to make sure you are responding to the vaccine". I joined 3 other people who were waiting for their 15 minutes to run out.

By 3.50 pm, it was all over. I walked away with my COVID-19 vaccination card with the date to take the second dose. When I got home, I was interrogated by my wife, a vaccine sceptic. She had tons of questions for me. The first one was: "are you well ?". “As you can see”, I answered. Then she goes on with other questions.

My wife is not the only vaccine sceptic. Millions of people around the world are sceptical. Their scepticism grew when several countries, notably in Europe, suspended the AstraZeneca vaccination. Since then, WHO experts and other scientific experts have confirmed that the Swedish-British company's vaccine is safe and effective.

But why do my wife and so many other people continue to be sceptical about the vaccine?

A recent poll from P-NORC poll found that about 1 in 3 Americans say they definitely or probably won’t get the COVID-19 vaccine. The lack of trust mainly drives their scepticism: lack of trust in the COVID-19 vaccines, lack of trust in the government, and lack of trust in pharmaceuticals. People also worry about side effects or feel that the vaccine is not safe because it has been rushed. Conspiracy theories, usually fed by rumours spread on social media, have also contributed to anti-vaccine sentiment in many countries, particularly in Africa. Past scandals such as the deaths of 11 Nigerian children in 1996 after Pfizer gave them the experimental anti-meningitis drug called Trovan were all to blame.

The risk of “vaccine hesitancy” is so high that WHO listed it as one of  Ten threats to global health in 2019, before COVID-19 was declared a global pandemic.

How can we address COVID-19 vaccine hesitancy?

If you Google “Vaccine hesitancy” or “vaccine scepticism", you will find many great articles and reports about the topic, a sign that it is not a new topic. My preferred report is a report of the WHO's Strategic Advisory Group of Experts on Immunization (SAGE) working group published in October 2014, long before COVID-19 hits the world. According to this report, vaccine hesitancy is influenced by three factors known as the “3Cs”: complacency, convenience and confidence.

• Confidence is the trust in 1) the effectiveness and safety of vaccines; 2) the system that delivers them; and 3) the motivations of the policymakers who decide on the needed vaccines.

• Complacency exists where perceived risks of vaccine-preventable diseases are low, and vaccination is not deemed a necessary preventive action.

• Convenience is measured by the extent to which physical availability, affordability and willingness-to-pay, geographical accessibility, ability to understand (language and health literacy) and appeal of immunisation services affect uptake.

To effectively address vaccine hesitancy, governments and organisations must address the “3Cs” simultaneously. However, depending on the context, time, place, program and vaccine-specific, each “C” will have a different weight and influence on the issue.

But to me, the bigger risk is the exponential growth in the use of social media (such as Facebook, WhatsApp or Twitter) to spread vaccine misinformation like wildfire and therefore fuel vaccine hesitancy. To mitigate this risk, a Vaccines Misinformation Management Guide was commissioned by UNICEF and produced in partnership with First Draft, Yale Institute for Global Health and The Public Good Projects (PGP). It is a free downloadable resource in 6 languages: English, French, Spanish, Italian, Arabic and Turkish. The guide aims to help organisations address the global infodemic by developing strategic and well-coordinated national action plans to rapidly counter vaccine misinformation and build demand for vaccination informed by social listening.

Are these enough to address COVID-19 vaccine hesitancy? I can't say. However, data and evidence show that vaccine works. According to WHO, vaccination is one of the most cost-effective ways of avoiding disease – it currently prevents 2-3 million deaths a year. A further 1.5 million could be avoided if global coverage of vaccinations improved. Thanks to vaccinations, once, common illnesses such as polio, measles, diphtheria and rubella have been all but eradicated. COVID-19 is no exception.

That's why I got my COVID-19 vaccine. If you are among the vaccine sceptics, I ask you to use the WHO website or scientific websites and journals to get timely and accurate information. Like me, you will soon be convinced that vaccination against COVID-19 works. There is no such thing as zero risk, but as WHO considers, the benefits of the AstraZeneca COVID-19 vaccine outweigh its risks. It recommends that vaccinations continue.