Vaccine hesitancy: an uphill battle

A sizeable number of individuals have not gotten the Covid-19 vaccine even when it is being offered for free

The third COVID-19 wave is on the wane in Pakistan with the National Command and Operation Centre reporting a 2.54% test-positive rate on 9^th June, the lowest in almost 2 months. However, it is clear by now that the most effective way to defeat this pandemic is through mass-vaccination rather than continuing restrictions. As of June 10^th, Pakistan has vaccinated just over 10 million individuals (including both the completely and partially vaccinated), enough to cover only 10% of the target adult population of 100 million. The country aims to vaccinate 70% of the adult population (70 million adults) by the end of the year, which would require a daily vaccination rate of around 293,000 people. While there has been criticism levelled at the government for its lagging vaccination rate, there is another major and unaddressed problem: vaccine hesitancy.

While the government could have taken steps to commence its vaccination campaign earlier and administer vaccines at a faster rate, it can’t do much by way of convincing the large and intransigent anti-vaccine portion of the population. It is clear from the pattern of vaccine eligibility by age-group that a sizeable number of individuals have not gotten the vaccine even when it is being offered for free. As of today, all of Pakistan’s adult population is eligible for vaccination and there is certainly not enough vaccine supply in the country to vaccinate 90 million people had everyone registered. The fact that vaccine registrations have opened up for 18 to 29 year-olds shows that much of the eligible population has not opted to get the vaccine.

One of the reasons why polio continues to persist in Pakistan is vaccine hesitancy, so there is no surprise to see similar, if not higher, apprehension for the coronavirus vaccine. Given the lack of emphasis and underdevelopment of the reservoir of public health knowledge, misinformation regarding the coronavirus is potent.

Theories circulating range from complete denial of the virus to speculating that it is a product of the incumbent PTI government. With fast connectivity through WhatsApp and Facebook, outlandish conspiracy theories and misconceptions spread like wildfire, accumulating thousands of interactions within hours. I still remember viewing a video at the onset of the pandemic in which a gentleman read the label of bottle of Dettol which included the word “coronavirus” in the list of pathogens it protected against. This was, in the man’s view, evidence for how this novel coronavirus is a manufactured crisis since the “coronavirus” is an old virus. Such content damages any governmental efforts to educate the public regarding the virus.

This trove of misinformation has now found its way into the vaccination campaign. Reports of vaccine side-effects and vaccine related deaths have been sensationalized on social media which have created an overblown apprehension for COVID-19 vaccines. A majority of the population is also unaware of how vaccines work, not understanding that vaccines significantly reduce the chance of death or suffering severe illness from COVID-19 rather than preventing the disease. Soon after Prime Minister Imran Khan was given his first shot of the vaccine, he tested positive for COVID-19. This prompted a slew of misinformation which pointed out the ineffectiveness of the vaccine since the PM contracted the virus even after getting the vaccine. Clarifying comments followed from the Government but the vaccination numbers still reflect the stark truth of vaccine hesitancy. An Ipsos survey from 9^Th March 2021 shows that about 40% of Pakistanis were against getting vaccinated.

Some possible solutions that could significantly lower vaccine hesitancy are public health education campaigns and incentives to get the vaccine. Education campaigns could use social media to publish content that corrects misinformation. Guidance on interpreting vaccine data such as efficacy in preventing symptomatic illness and vaccine side effects is crucial to garner greater acceptance for the vaccine. Local community involvement is important. If people see members of their own communities getting the vaccine with no hazardous effects, they will be encouraged to follow. Leveraging the power of community interaction is key to convince the larger population of the benefits of the vaccine.

Incentivization is another useful method of countering vaccine hesitancy: allowing vaccinated people to attend in-door events, gyms and cinemas etc. Vaccination will become attractive if it provides a path back into normal life.

The pandemic is still far from over in Pakistan. The battle against the pandemic will be very difficult to win unless headway is made against vaccine hesitancy. This is neither the time for complacency nor declaring a premature victory.

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