India should build COVID-19 vaccine confidence, identify ‘hesitancy hotspots’: Immunisation expert Heidi Larson

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November 9, 2020 4:56 PM

India should identify COVID-19 vaccine hesitancy hotspots, pockets where people may be unwilling to receive immunisation for varied reasons, and then build vaccine confidence, says anthropologist and international immunisation expert Heidi J Larson.

In India, the survey found that vaccination intent has remained unchanged at 87 per cent since August, although 34 per cent respondents were worried about side effects while 16 per cent were concerned about fast-moving trials.

India should identify COVID-19 vaccine hesitancy hotspots, pockets where people may be unwilling to receive immunisation for varied reasons, and then build vaccine confidence, says anthropologist and international immunisation expert Heidi J Larson. Several global surveys are being conducted about public willingness to take a vaccine, said the professor of Anthropology, Risk and Decision Science at the London School of Hygiene and Tropical Medicine. “… India must identify hesitancy hotspots and then conduct a vaccine confidence survey, Larson, who is also founder-director of the Vaccine Confidence Project research group in London, told PTI in an email interview.

With many vaccine candidates globally in the final phase of human trials, a safe and effective COVID-19 preventive is expected to be approved for production, distribution and acceptance sometime next year. According to a recent global survey, people in 10 out of 15 countries showed growing reluctance about getting vaccinated. However, Indians are the keenest on getting vaccinated whenever a COVID-19 vaccine is available. In the World Economic Forum/Ipsos survey of 18,526 adults from 15 countries, 73 per cent said they would get a COVID-19 vaccine if available, down from 77 per cent in August.

In India, the survey found that vaccination intent has remained unchanged at 87 per cent since August, although 34 per cent respondents were worried about side effects while 16 per cent were concerned about fast-moving trials. According to Larson, there is generalised vaccine hesitancy primarily because of the lack of proper information on the safety and efficacy of any of the possible COVID-19 vaccines. This is due to distrust of governments as well as motives of pharmaceutical companies as they are trying to come out with a vaccine faster than normally done so, she reasoned.

“Some of these concerns are understandable as we currently do not have any final information on the safety and efficacy profiles of whichever vaccine may be approved. Other fears are due to distrust of government more broadly or the motives of vaccine companies to produce vaccines more quickly than normal. “But these vaccines have been able to be developed and tested more quickly because of new technologies. These are not old processes that have been short-cut, they are new processes,” she noted.

According to the anthropologist, certain communities such as the Muslims also have issues due to the presence of gelatine, which is derived from pork. “There are religious issues. Such as some Muslims concerned that some vaccines are not halal because they have gelatine which is derived from pork. Although most Muslims agree that vaccines are important to save lives and if there is no alternative, they will accept the very a small amount of gelatine in some vaccines,” she said.

On what could be the solution to clear such hesitation, she said, “The most important thing is to understand why people refuse vaccines, only then can you know what the issue is and how to address it.” Larson, who earlier headed the Global Immunisation Communication at UNICEF, noted that political polarisation, religious extremism and misinformation on the internet and through other media such as radio, newspapers and person-to-person discussions are a problem for vaccine confidence.

It is important to get accurate information out to the public, but some of these issues are not about information, they are about emotions and beliefs which are much more difficult to change,” she said. Larson described the COVID-19 pandemic as a “global health crisis” which can “cause long term problems for individuals”. Asked whether the invention of a COVID vaccine will be able to eradicate the disease, Larson said, “We are unlikely to eradicate COVID-19 for a very long time, if at all.”

However, she is hopeful that everyone will be vaccinated by the end of 2021 and suggests that healthcare professionals and frontline workers should be immunised first as they are most at risk. They are also at risk of spreading it to others, she added. “As there are likely not to be enough vaccines for everyone in the world at the same time, there will need to be a decision on who gets the vaccines first, Larson said.

After healthcare workers, older people should be administered the new vaccine for COVID-19. India’s Union Health Minister Dr Harsh Vardhan had in early October stated the Centre is planning to vaccinate about 25 crore people against novel coronavirus by July next year. Vardhan had also said priority would be given to health workers engaged in COVID-19 management in getting inoculated and asserted the Centre would ensure fair and equitable distribution of vaccines, once they are ready.

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