VACCINE HESITANCY: What does it mean?

A vaccine is a biological agent created to elicit the immune system's recognition, defense, and immunization against a particular infectious disease. Typically, weakened or inactivated versions of a pathogen (such as a virus or bacteria), fragments of the pathogen, or proteins produced by the pathogen make up vaccines. Vaccines are delivered to induce an immune response without actually spreading the disease. Immune memory is formed as the immune system "learns" to identify the infection, create antibodies, and do so.

The main objective of vaccination is to get the body ready to fight the virus as soon as it is exposed to it in the future, allowing the person to do so promptly and successfully. This means that when a person who has received the vaccine comes in contact with the actual virus, their immune system will be able to react quickly, preventing or lessening the severity of the infection.

The smallpox vaccination was the first one to be developed. Smallpox was a fatal condition. In the past century, it claimed the lives of 300 million to 500 million people worldwide. The disease was eventually eradicated after the vaccination was administered to humans. It is the only illness that has been entirely eradicated [1].

What is vaccine hesitancy?

Despite the availability of vaccination services, vaccine hesitancy refers to a delay in accepting or refusing immunization. Vaccine reluctance varies across time, region, and vaccines and is complicated and context-dependent [2]. Vaccine hesitancy occurs as a result of some factors such as:

• Vaccine complacency

Vaccine complacency: develops when the perceived risk of diseases that can be prevented by vaccination is low and when the perceived risk of diseases that can be prevented by vaccination is low and vaccination is not seen as a required preventive measure. Numerous circumstances, such as other obligations in one's life or in one's health that can be deemed to be more significant at the time, can affect one's level of complacency about a specific vaccine or about vaccination in general. Success in immunization programs may paradoxically lead to complacency and, in the end, reticence as people assess the risks of receiving a certain vaccine against the chances of contracting the disease it protects, even though that disease is no longer widespread. The extent to which complacency dictates reluctance is also influenced by self-efficacy (the self-perceived or actual ability of an individual to take action to be immunized). [2]

Vaccine convenience: This occurs when physical accessibility, price and desire to pay, geographic accessibility, understanding (language and health literacy), and attraction of immunization services affect adoption, vaccination convenience is a crucial component. The degree to which vaccination services are provided at a time, place, and in a cultural environment that is convenient and pleasant also affect the decision to be vaccinated and may cause vaccine hesitancy. These factors may be real or perceived quality of the service.

Vaccine confidence: is described as confidence in the following three areas: the efficacy and safety of vaccines; the system that administers them, including the dependability and expertise of the health services and health professionals; and the goals of policymakers who choose the necessary vaccines. [2]

Poor communication: Although not a determinant, sometimes poor communication can contribute to vaccine hesitancy. For instance, the ability to combat false information about vaccinations and win community support for vaccination campaigns is constrained in low- and middle-income countries. Lackluster or ineffective immunization campaign messaging can cause vaccine reluctance and outright refusal in high income nations with well-resourced vaccination programs. In 1999, the rationale for the USA's decision to reduce the amount of thimerosal used as a preservative in some vaccines was insufficiently explained. This resulted in the public's confidence in vaccinations being weakened, which caused vaccine hesitation and refusal [3].

Some points to consider when addressing Vaccine hesitancy therefore includes:

• Any vaccination program should include a communication strategy in its design from the beginning. The effectiveness of the communication, the vaccination intervention, and its effects are all compromised by hurried communication planning. Lack of communication from the onset can cause major issues with program execution and opens the door for communication from parties with vested anti-vaccine or religious interests. In the European region, it was acknowledged that countering false information and anti-vaccination actions required a planned and aggressive communication strategy [4].
• Second, communication involves both parties. It involves both listening and telling in equal measure. As vital as the information experts seek to convey is understanding the viewpoints of the people for whom immunization programs are meant and their involvement with the issue. In order to support polio eradication efforts in endemic areas, mobilizing communities through their religious and community leaders has shown to be an efficient communication method [5].

There are numerous tools for communicating. They consist of service-based communication, social mobilization, mobile technology, print media, digital media, and mass electronic media. Target groups can be interacted with through the creative combination of these technologies. Online and offline mass communication initiatives may be more successful in preserving societal norms surrounding revaccination or in gaining support for vaccination programs. They might potentially backfire on groups that are vehemently opposed to immunization [6].One of the most efficient and economical public health interventions in history, vaccinations have prevented countless infections and fatalities while helping to manage or eradicate a number of severe diseases. Measles, polio, smallpox, influenza, and many other diseases are examples of those that can be prevented with vaccination. In order to protect people and communities from the spread of infectious illnesses, vaccination is a vital part of public health measures.

One of the most important issues facing public health is vaccination reluctance. Among the tactics used to overcome vaccination reluctance are:

• Education and Communication: It is crucial to provide accurate and understandable information regarding vaccines, their importance, and their safety.
• Establishing Trust: When it comes to developing trust with patients, healthcare professionals are essential. They are able to allay worries and offer comfort.
• Community Engagement: Adapting vaccination promotion initiatives can be aided by interacting with local communities and learning about their unique concerns.
• Law and Policy: In order to promote greater vaccination rates, several areas have put in place laws requiring vaccinations or vaccination passports.
• Fighting Misinformation: It's important to make an effort to refute false information and misinformation about vaccines. Fact-checking groups, social media sites, and public health campaigns can all be used in this process.
• Peer Influence: Motivating immunized people to talk about their experiences and advocate for vaccination can influence others.