Coronavirus – Health and Governance Issues

Tackling vaccine hesitancy challenge in rural India


From UPSC perspective, the following things are important :

Prelims level: Not much

Mains level: Vaccine hesitancy

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.

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