After a year of unprecedented changes, chaos and panic, COVID-19 vaccines are the most awaited products of 2021. But though mass vaccination drives have begun, the response has been lukewarm despite the availability, affordability, and accessibility of the jabs to healthcare, sanitation, and frontline workers.
To date, two vaccines have been approved for inoculation in India: Pune-based Serum Institute’s Covishield and Hyderabad-based Bharat Biotech’s Covaxin. While Covishield has completed phase 3 trials, the latter has been rolled out with its phase 3 trials still ongoing. In fact, Bharat Biotech had announced recently that the vaccine may not be suitable for those with a history of allergies, bleeding disorders, pregnant/lactating women, and even for people on blood thinners and other immunity-based medication. Similar information is found in the Covishield fact sheet.
An adequate supply of vaccines is in place at least for the first phase, but procurement is just half the battle won — the trickier part is to persuade the population to roll up their sleeves for the two jabs. Social media has seen a rising number of self-proclaimed experts who have been decoding the ingredients and efficacy of the vaccines through unsubstantiated claims.
Refusal to vaccinate
According to the World Health Organization, vaccine hesitancy is defined as a reluctance or refusal to vaccinate despite the availability of vaccine services. Like Western nations, vaccine hesitancy has been a cause of concern in the past in India as well. For instance, U.P. witnessed a sudden dip in the uptake of oral polio vaccines when the Muslim community was struck by misconceptions that the vaccine led to illness and infertility. Similar hesitancy was witnessed in Tamil Nadu and Karnataka, which are otherwise familiar with the concept of vaccines. Hesitancy for the MMR (measles, mumps, and rubella) vaccine was sufficiently high in the Malappuram district of Kerala to render community immunisation a challenging goal.
Vaccine hesitancy is as old as the concept of vaccination itself. However, in times of uncertainty, people are particularly susceptible to misinformation due to an intricate combination of cognitive, social and algorithmic biases i.e., information overload and limited attention spans.
The debates around hesitancy for COVID-19 vaccines include concerns over safety, efficacy, and side effects due to the record-breaking timelines of the vaccines, competition among several companies, misinformation, and religious taboos. According to a survey conducted by LocalCircles in December, a community social media platform, about 69% of the respondents said they will not rush to vaccinate themselves against the pandemic. Another survey indicates that 55% of healthcare professionals are hesitant to take the vaccine; 64% prefer to do an antibody test before vaccination. Despite negligibly low cases of adverse effects reported so far, such notions have silently wormed into our vaccination efforts.
People can choose to not be inoculated, but to break the chain of transmission, it is imperative to have the right strategy in place. Hence, it is suggested that we adopt the idea of libertarian paternalism, a concept of behavioural science, which says it is possible and legitimate to steer people’s behaviour towards vaccination while still respecting their freedom of choice. Vaccine hesitancy has a different manifestation in India, unlike in the West. According to the World Economic Forum/Ipsos global survey, COVID-19 vaccination intent in India, at 87%, exceeds the global 15-country average of 73%.
The way forward
Instead of anti-vaxxers, the target audience must be the swing population i.e., people who are sceptical but can be persuaded through scientific facts and proper communication. The second measure is to pause before you share any ‘news’ from social media. It becomes crucial to inculcate the habit of inquisitive temper to fact-check any news related to COVID-19 vaccines.
The third measure is to use the celebrity effect — the ability of prominent personalities to influence others to take vaccines. Studies suggest that celebrities can serve as agents of positive social change, erasing scepticism associated with vaccine adoption and prompting information-seeking and preventative behaviours. We can start with politicians and government officials who are next in line for vaccination. Celebrities can add glamour and an element of credibility to mass vaccinations both on the ground and on social media. The infodemic around vaccines can be tackled only by actively debunking myths, misinformation and fake news on COVID-19 vaccines.
Rakesh Dubbudu is the founder of the fact-checking initiative Factly and Nanditha Kalidoss is Health Fellow (Misinformation) at Factly
