The Vaccine Hesitancy Conundrum

This Wednesday at 8 am, I got chatty with the garbage collector. On completion of the task of waste disposal, I asked him – Have you got vaccinated against COVID? And pat came the answer – “Yes sir, both doses, all eligible members of my family are vaccinated as well.” I had to know more, and so asked him “Why?” And pat came the answer again – “because it will develop my natural immunity to fight against the evil COVID virus.” He continued, “I also know that it’s not enough that I get vaccinated but so should my immediate family to prevent transmission and increase collective protection against the evil COVID virus.” To understand his education, I asked him “have you finished schooling?” and pat came the answer, “only 7th standard sir, but whatever information I need, I get that from the correct sources.” I thanked him for his service and time.

By 11 am I was talking to a client with a healthcare background, and the question associated with vaccination came up. I asked him if he was vaccinated and he said “No. I am unsure that I will get vaccinated as there is just too many mixed information that is coming out in the research papers and the press.” The rest of the discussion was business as usual.

Got me thinking – a well-read scientist has a block towards the vaccines that are available, while a street smart simpleton who just processes information that he needs is very clear about the need for vaccination and has supported getting multiple people vaccinated. What was more daunting was that he did not seem to connect to the fact that the COVID vaccine would ensure that even if he gets affected post-vaccination, the chances for it to cause morbidity and mortality is minimised.

“Vaccine hesitancy” is a reality globally and it’s not a stranger in India either!

The term “vaccine hesitancy” received much limelight recently from the media, who use it to refer to groups that are reluctant or refuse to take the COVID-19 vaccines that have been made available to them. It’s supported certain mischievous groups that provide misinterpretations of reality – regarding development and testing of the vaccine, misconstrued religious beliefs and disinformation against the vaccine, geopolitical vaccine wars that showcase one countries vaccine better than the other, etc.

The World Health Organisation (WHO) suggests BeSD (behavioural and social drivers) vaccination model, which tends to use “Motivation”, as the key driver for vaccination. In certain developed countries, vaccination drives were incentivised by the respective governments to ensure that more public gets vaccinated in the shortest possible time. However, this may not be the best model for developing countries with a much larger population than the developed countries.

India chose the route of information dissemination through the government and private on-ground resources to bust vaccine hesitancy. While this has been well received by larger sections of society backed up by strong vaccine availability and accessibility in a phased manner across the country, it’s not without its challenges.

India is a diverse land of many cultures, traditions and habits that vary across the 28 states and 8 union territories. Based on WHO’s guidelines the government chose to tackle the behavioural and social drivers of society by pushing the agenda of COVID appropriate behaviour over the whole year that started from March 2020 by building on “Trust”. By November-December 2020, the news associated with two vaccines manufactured in India for the world - Covishield by Serum Institute of India’s (SII) and Covaxin by Bharat Biotech’s – after due regulatory approvals, started communicating their safety, efficacy, study designs, production plans, etc. By January 16, 2021 India’s mass Covid-19 vaccination drive was initiated with two vaccines. As on 12th July 2021, around 38 crore Indians have received at least one dose of the vaccine. At this pace, it will take more than a year to get the whole country vaccinated. This may tend to fracture the initial gains that we could garner by timely research, approvals, production of the vaccine and inoculation drive. Vaccine hesitancy is being tackled continuously by government officials, society leaders, healthcare workers, etc. Many private companies are doing multiple vaccination education drives across their organisations and the societies nearby to ensure that they are able to get through to the people and break the associated myths about the vaccine. Many private companies have started inoculating all their employees and their families to increase the speed of vaccination across the country. However, there is a larger population in rural India that feels that COVID is more rampant in cities and may not affect them as much as they are simple peasants and farmers who are much more physically fit than their city cousins.

As time goes by, more and more people are getting convinced that they will have to get vaccinated if they would like to get back to their normal lives. Experience over the last two years shows that the virus does not care for “vaccine hesitancy”, and is ready to do its bit towards the third wave of the infection in India.

The choice is yours – face the virus with the vaccine or without. What do you have to lose?