In rural India, concerns about COVID-19 vaccines are now increasingly commonplace.
Vaccination dilemma these days
- People voice their concern about what will happen to them if they get vaccinated and have doubts that the government is sending inferior quality vaccines to them.
- Vaccination sessions in local health centers often see very few or no takers.
- In contrast, urban vaccination sites face increased demand, especially in the 18-45 age group, and vaccine shortage is a major issue.
- From a public health and equity perspective, this is a cause for worry.
Why this failure?
- The fear of vaccines and rural communities not only resisting but also outright rejecting vaccination is a reality.
- Efforts by local health authorities to create awareness and convince people are of little avail.
- There are contrasting dimensions to the COVID-19 vaccine rollout: one where people are enthusiastically accepting it and the other of resistance.
- There are many diverse factors at play in this, which may go beyond the health concerns and have more to do with socio-anthropological aspects of health-seeking behavior.
Vaccine hesitancy
- Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite the availability of vaccine services.
- It is complex and context-specific varying across time, place, and vaccines.
- It is influenced by factors such as complacency, convenience, and confidence.
Its scope
- Vaccine hesitancy is not a recent phenomenon. It is neither limited to a particular community or country nor have we seen it only in the context of COVID-19.
- We have also seen vaccine hesitancy among the urban and the more educated or ‘aware’ populations, with pockets of populations of socio-economically well-off communities refusing to get their kids vaccinated.
- While vaccine hesitancy can lead to a firm rejection of vaccines, there’s also a possibility of people changing their perceptions over time.
Socio-cultural context behind
- Most of our fears and apprehensions stem from a deep impact of something adverse or unfavorable that we have personally experienced or our social circles have experienced.
- Over time these become our beliefs, our innate guards.
- In the context of the concerns described at the beginning of this article, we must look at vaccine hesitancy from a distinct lens of fear and not necessarily skepticism for new vaccines.
- Rather, they seem to indicate deep-seated fears and belief in conspiracies, the fear of perhaps being discriminated and deceived, and of being omitted (from societal benefits).
Building trust
- Communities might not see the impact of a vaccine instantly, as it’s usually preventive in nature rather than curative.
- People are used to taking medications or intravenous fluids when they are unwell or in pain, and they may feel better almost immediately, but that’s not the case with vaccines.
- On the contrary, vaccines administered to a healthy person may lead to occasional side effects like fever, body aches, etc.
- Add to those rumors about deaths post-vaccination, and it may not be so easy for people to get convinced about the vaccines.
Way ahead
- Addressing vaccine hesitancy in rural India would first of all require health systems to be honest and transparent.
- Create awareness, let people know how vaccines work, how they help prevent disease, what are the probable side effects and how they can be managed.
- Health authorities need to be comfortable about people raising questions while providing the answers as best as possible.
- Being cognizant of local cultural sensitivities and working with trusted intermediaries is important in this effort.
- Sustained and meaningful efforts need to be made to build trust, gain the confidence of communities and meet their expectations.
- Even more crucial is to engage communities in planning, execution, and monitoring of health care services at all levels.
