India has found its footing in its campaign to vaccinate citizens against COVID-19. About 78% of the adult population has received one dose and more than 36% has received both doses. This is great news as vaccination, together with face masks and social distancing, is a powerful tool for returning to normalcy.
Recent evidence indicates that acceptance of COVID-19 vaccines in India is among the highest in the world. This is a testament to those who have been working tirelessly for months within communities. However, even small pockets of unvaccinated individuals can threaten the success of an immunisation campaign. This is especially true for a highly transmissible virus like the Delta variant of SARS-CoV-2. Misinformation about vaccines, in particular, can erode vaccine confidence. In 2017-2019, false rumours about the measles-rubella vaccine spread through social media and led to a spike in vaccine refusals in some areas. Also, with daily confirmed cases as low as they are now, enthusiasm to get vaccinated could wane. This is why we need to solidify vaccine confidence now.
Power of trust
Vaccine confidence exists on a spectrum. There are some who are against all vaccines. But there are also many who remain on the fence. Perhaps they have concerns about the speed with which the vaccines were developed or they received a message from a trusted family member or friend about the ingredients of the vaccine. The COVID-19 vaccines used in India are safe and effective, especially in preventing severe outcomes. And so, many of us may feel the urge to refute each and every one of these concerns. For those who remain sceptical, however, such arguments may feel patronising and could backfire. Conversations around vaccination, rather, should stem from a place of respect, empathy and understanding and should avoid disparaging language. This helps build trust — the key to vaccine confidence. In addition, when speaking with peers about misinformation, it helps to acknowledge that it is sometimes difficult in the current context to know what is true and what is not. Providing data from a trusted source, like government agencies or academic institutions, can also help correct misperceptions about vaccines.
Framing vaccination as the default normative behaviour can help encourage those who have doubts. Many of us have already been doing this when we ask our friends and family, “ Teeka lagwaya, na? ” or “You’ve been vaccinated, right?” By asking this simple question, we are setting expectations for those around us. Vaccination is the norm. We are asked the question and we in turn ask others too.
The messenger is also important for building trust. Individuals are more likely to listen to someone from their own background or area. In many villages, all the eligible individuals have been vaccinated. In some cases, someone within the community — a sarpanch or a highly respected individual — got vaccinated and encouraged others to do so as well. Doctors and health workers are also often trusted sources of information about health decisions. Actors and sportspersons are also powerful spokespersons.
A campaign that appeals to people
The COVID-19 immunisation campaign it is not the first large-scale vaccination effort in India. In 2014, India was declared polio free. This achievement could not have been possible without the simple campaign, ‘ Do boond zindagi ki ‘ or ‘Two drops of life’. The message was hopeful and appealed to Indians. A strong endorsement from celebrities and the engagement of community leaders propelled the message. The ongoing campaign to vaccinate India requires similar energy.
Editorial | Gearing up: On vaccines and public trust
An effective response to any health emergency requires a multidisciplinary approach. And so, creatives and public health experts must work closely together to bolster vaccine confidence. Bollywood is uniquely positioned to tap into the Indian psyche through effective storytelling. This is important because not everyone connects in the same way with facts and figures. We recently launched a campaign with creative support provided by the leading marketing agency Wieden+Kennedy, Delhi, centered around the question everyone is already asking: “ Teeka lagwaya, na? ” We hope to see more campaigns in the future. Vaccines bring the hope of returning to normalcy. Normalcy is not just survival, but also about fearless living, of bringing joy back into our lives and caring for others. These are essential considerations for effective, narrative-based communication around vaccines.
Brian Wahl is an epidemiologist and assistant scientist at the Johns Hopkins Bloomberg School of Public Health; Madhu Gupta is Professor at the Postgraduate Institute Medical Education and Research; and Neeraj Ghaywan is a National Film Award-winning movie director