India is seeing a second wave of COVID-19 cases. However, this time we have diagnostic tools to tackle the infection, our healthcare workers are better equipped and more informed about the virus, and we have vaccines to counter the pandemic.
Benefits of vaccines
Yet I get several calls a day from concerned friends and relatives on which vaccine is better or if they should take the vaccine at all. My answer to most of them is simple — a resounding yes! Vaccines are one of the most important public health tools we have to mitigate the impact of infectious diseases. While some vaccines prevent infections from gaining a foothold in our body, others reduce the severity of illnesses. Currently available COVID-19 vaccines belong to the second category: they are disease modifying vaccines.
It’s important to understand that a vaccinated individual can contract SARS-CoV-2, and without getting noticeably ill, can pass it on to other susceptible individuals. That is why face masks should be worn even after one receives the COVID-19 vaccine. While at individual and community levels, COVID-19 vaccines can save lives, replacement of non-COVID-19 healthcare services at government and private facilities due to rising demand for COVID-19 care can also be avoided through rapid vaccination drives.
Yet, despite such direct and indirect benefits of COVID-19 vaccines, many are still hesitant to accept these life-saving scientific interventions. This phenomenon, vaccine hesitancy, is defined by the World Health Organization as a reluctance or refusal to be vaccinated and is one of the top threats to global health. It is a complex phenomenon for which there are no easy answers — hesitancy is often extremely localised to region and sociocultural contexts.
This is not new. Reluctance to vaccinate has had detrimental impacts on public health in the past. Hesitancy was observed in Britain around vaccination against whooping cough in the 1970s and 1980s, and against measles in 1990. Hesitancy around the HPV vaccine in Japan and tetanus toxoid in Kenya has also been recorded. In India, too, there was hesitancy during the polio vaccination campaign. But mothers of the polio-affected children acted as agents for social change and paved the way for India reaching polio-free status.
But today’s digital age has given vaccine hesitancy new momentum. In this age of surplus information, outbreaks of misinformation, spread through social and digital media channels, have the potential to significantly impact public health. India is particularly vulnerable to this challenge because we are increasingly moving towards consumption of news and information online and through social channels. This kind of misinformation, when directed towards public health programmes such as immunisation, can adversely impact public trust, especially through an ‘echo chamber’ effect.
Some solutions
There cannot be a one-size-fits-all approach to vaccine hesitancy, but some things have worked in the past. Key among them is building public trust through clear and transparent communication. We need to equip ourselves as well as healthcare professionals and frontline workers with the information needed to counter misinformation. The messenger is also as important as the message. Garnering the support of trusted local and community voices can build credibility and address region- and community-specific needs and remove hesitancy. Seeding positive messages proactively in the community and on social platforms and demonstrating positive behaviour change, instead of countering rumours once they circulate, have also been shown to combat hesitancy. Above all, we need to understand and address our community’s concerns with empathy, because this is not just about the COVID-19 pandemic; it is about public trust in vaccines as a whole. Only when we as a community trust that vaccines work can we mobilise, protect those who cannot be vaccinated and take a giant step towards a healthier world.
Samiran Panda is Head, Epidemiology and Communicable Diseases, ICMR
