A vaccine is only effective if people are willing to receive it. It will help with prevention and immunization, but the biggest hurdle is the hesitancy surrounding it. Vaccine hesitancy is as old as the hills. It is not unique to Covid-19 and there is an unfortunate history attached to it, which we will present in the following paragraphs. This challenging conversation about vaccines is a necessity to be carried out, as equally as the vaccination itself.
We must understand the reasons behind the hesitancy in order to help individuals to come to the most informed conclusion. Take the example of buying products on a day to day basis. No matter how often we do this activity, there is a natural instinct to check the expiration date on the product itself. In the end, there is no correlation between how often we do something and the trust that comes with it because there is always room for mistrust. Even though vaccines are the safest and sure way to build herd immunity since the time it was developed in 1798, the factor of complete trust is still absent. When the pandemic began, the light at the end of the tunnel was a vaccine and when we reached the light, people were asking why and how did we reach it this quickly. People are skeptical about the Covid-19 vaccine due to the time duration within which it was built. According to the Wellcome Trust, a charitable foundation focused on health research, it takes 10-15 years to fully develop a vaccine from which the first 5 years consist only of research and development. If this is the case, then according to Our World in Data, how are 265 crore people fully vaccinated in the world, within 2 years of this pandemic? The answer was provided by Dr. Eric J. Yager, an associate professor of microbiology at Albany College of Pharmacy and Health Sciences, who explained that scientists had been studying Coronaviruses for over 50 years, with data regarding the structure, genome and life cycle of this type of virus already existing. There was also a worldwide collaboration to tackle this pandemic from day one. The massive strides in science and technology over the years helped fast track research and clinical trials as well.
In addition to this, the roots of mistrust stem from the legacy of systematic racism and disenfranchisement. Black communities have disproportionately experienced clinical neglect and abuse from the health care system. From 1932 to 1972, the United States Public Health Service and the Centers for Disease Control and Prevention conducted the Tuskegee Study on African American males. For 40 years, human experiments were carried out. The subjects were told they were receiving treatment for bad blood, but in reality, were involved in a study to observe the natural history of untreated Syphilis. Even after Penicillin was discovered as a reliable cure for Syphilis, the majority of the men did not receive it and died in the process. Pharmaceutical companies have been stained with their questionable and unethical practices for years to come. Even the CIA’s campaign to find Osama Bin Laden involved a fake Hepatitis B vaccination project, which subsequently undermined the public trust in global health and programmes in Pakistan. It led to the development of a cognitive bias called frequency illusion, where Pakistanis began to abstain from the long-standing vaccination drives for Polio too. They heard about this incident and began to “see it” everywhere. Instances like these understandably erode trust, when pillars of law and health conduct themselves in such ways.
In January 2021, Johns Hopkins Centre for Communication Programs reported that across 23 countries only 63% of respondents will accept the vaccine. This is much below the 75% minimum estimate recommended by public health experts for a population to reach herd immunity. With a low public acceptance of the Covid-19 vaccine, misinformation has cluttered the social media world, worsening the situation. While social media can be an extremely positive and handy tool, it has also been a vehicle for false claims regarding the vaccine along the lines of altering people’s DNA, causing infertility and creating new variants of the virus. On Wednesday, September 29, 2021, YouTube announced an immediate ban on false claims and baseless speculations surrounding not only the Covid-19 vaccine but also the vaccines that have been approved years ago, such as the one for Measles. This is a step towards decreasing the fear, doubt and anxiety that comes with one simple click.
Personal beliefs and irrational fears also play a role in hesitancy. The former includes a general belief in natural immunity being stronger than vaccines. The difference between getting a vaccine and encountering a disease or virus naturally is that vaccines can provide us with the protection we need, with lesser quantities of the respective virus or bacteria and there is a control on scheduling the exposure. We have to weigh the risks of naturally developing immunity (waiting to be infected with Covid-19 and recovering from it with no guarantee) against getting vaccinated for the prevention of this threatening virus. We leave you to ponder upon this a little further. Along with this, Trypanophobia, the extreme fear of needles, is also a contributing factor. An Oxford University survey of more than 15,000 adults in the UK suggested that needle phobia accounts for about 10% of Covid vaccine hesitancy since the Covid-19 vaccines are currently needle-based. Adam, a 23-year-old from Gainsborough, England, who is troubled with Trypanophobia, shares that it is not the pain he is afraid of but the thought of the injection itself, piercing his skin which makes him feel like and I quote – “The world is ending at that moment.” He really wants to get vaccinated against Covid-19, but an extreme fear of needles is holding him back (https://youtu.be/i2wnAW0JMxo). Individuals experiencing the milder end of this phobia could benefit from relaxation strategies like breathing, muscle relaxation and visualization strategies to cope with the discomfort to at least get immunized. Seeking therapy could be the best way possible to work through the moderate to severe end of the phobia.
Vaccine hesitancy is as complex as the Coronavirus family. This uncertainty is connected to the perception of this vaccine being too experimental, mistrust in our systems of law and health, the prevalence of misinformation from the media, personal beliefs and phobias. Dr. Sam Sun, the director of inDemic Foundation, an NGO that provides information about Covid-19 explains that transparency throughout the vaccine process will be key to debunking misinformation and building the public’s trust. We agree with this view and would like to add that it has to be a persistent effort, especially focusing on reaching out to the more disadvantaged groups of society. We feel that no one should be dismissive of people who are hesitant to get the vaccine, it is clearly not as easy as ABC. Vaccine hesitancy should be tackled with insight and not criticism.
– Urveez Kakalia and Ferangiz Hozdar.