Ignorance and misinformation have dangerous consequences, more so amid a global health crisis.
Recently, a retired professor’s aired interview from the Philippines went viral after he deliberately stated that the vaccines are “unsafe” and “more dangerous” than the virus itself. This was slammed by the Department of Health (DOH), stating that it is “irresponsible” to give a platform to such falsehoods especially during the onslaught of the COVID 19 pandemic.
Health authorities utilize the media to put out accurate information regarding COVID-19 vaccines as reflected in the communication efforts done by the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF) and the DOH. However, conspiracies and false information threaten these information campaigns – the dire consequence is most apparent with the wavering of the Filipinos' confidence in the vaccines.
This budding hesitancy hinders the success of the COVID-19 vaccination program in the country. As Philippine Foundation for Vaccination (PFV) head Dr. Lulu Bravo remarked during the Vaccine Solidarity Movement, "misinformation and disinformation" kill the confidence of the people towards the vaccine.
From the strings of misinformation that lurk in the media domain, the challenge is finding a way to effectively debunk these vaccine myths; boost vaccine confidence, and encourage people to get vaccinated. However, it is also imperative that beyond telling people to get vaccinated, is to ensure that the vaccines are safe and accessible to every Filipino. In addition, this requires ensuring that there is a reliable healthcare system that the people can turn to as most of the fears and concerns stem from its possible collapse due to the rising cases.
Addressing the Fears
Several factors can be attributed to being the cause of people’s fear and hesitance towards COVID-19 vaccines. To understand where the Filipino’s vaccine hesitancy stems from, one must zoom in on the sociological context from which the country operates and the experiences and background of the people themselves.
The World Health Organization (WHO) describe vaccine hesitancy as complex and context-specific; varying across time and setting; and influenced by factors such as complacency, convenience, and confidence. In the Philippines, several scholars and experts pointed to the Dengvaxia controversy back in 2018 as one of the main factors that contributed to the sudden rise of vaccine hesitancy. The Dengvaxia health scare was caused when the dengue vaccine Dengvaxia was found to have heightened the risk of disease severity for some people who have taken it. Several reported deaths allegedly linked to Dengvaxia fed widespread media coverage of allegations that the vaccine was to blame, even as many scientific assessments questioned these claims.
The study conducted by the Vaccine Confidence Project which aimed to measure the confidence level of the Filipinos towards vaccines found that vaccine confidence plummeted from 93% (strongly agreeing that vaccines are important) to a mere 32% after the Dengvaxia controversy occurred.
Aside from the controversy, a myriad of fake news and misinformation also flooded social media which led to even more panic and distrust from the public. CNN reported that 32 individuals have already been arrested due to the proliferation of fake COVID-19 news online. Consequently, this made the information campaign even more challenging for the health authorities.
On the other hand, vaccine preference is also listed as one of the determining factors as to whether a person would get vaccinated or not. Filipinos tend to shy away from China-made vaccines as shown in numerous surveys, with more preference towards Western-made vaccines such as Pfizer. Raymond John Vergara in his article published in Oxford’s Public Health journal cited that the Filipinos remain to have a ‘negative trust rating’ on China because of the maritime issues with the West Philippine Sea. Filipinos, he explained, are suspicious of “the alleged goodwill of the Chinese government in providing assistance to the Philippine Government’s procurement of vaccines”. He also pointed out the existing prejudice among the Filipinos with regards to the quality of Chinese products. This geopolitical conflict intensified the hesitance of the public, mainly towards Chinese-made vaccines.
However, it is also important to note that people are very much aware of the risk of catching the virus. Their fears are not entirely founded on rumors, false information, or prejudices. While these factors contributed to vaccine hesitance, safety concerns on the vaccine remain the most cited reason for vaccine refusal.
According to a Pulse Asia survey, ninety-four percent of the 2400 respondents they have interviewed, are afraid and anxious that they or their families could contact COVID-19. Despite this, the majority of the respondents do not necessarily view vaccines as the solution to this conundrum. 84 percent of those who refuse to get vaccinated cited the “safety factor” on why they resist vaccination. Similarly, the fear of negative vaccine side effects outweighs the vaccines' promise of protection even as endorsed by health authorities.
Thus, with the inoculation of the vaccine currently underway, addressing the public’s fears and safety concerns is a must to build vaccine trust. After all, the success of the vaccination as a public health intervention is dependent upon individual action. With the vaccination efforts being a collective undertaking, it will only be as strong as its weakest link – and so each of their fears counts.
Dr. Ryan Buendia, a cardiologist of St.Luke's Medical Center Taguig, receives a Sinovac vaccine jab. Front-line healthcare workers were the first to be inoculated against COVID 19 in March. (Photo by Joey Razon - PNA)
Outweighing the Risks
As of September 14, 2021, only 22,14 % of the target vaccines or roughly 17M Filipinos have been fully vaccinated. While this number might seem enormous in its own right, the country is still far from achieving herd immunity with its population being over 109 million. This is still a far cry from the needed 80% rate to achieve herd immunity. More than three quarters of the population have not gotten their shots yet – and large number of people from these remaining millions outright refuse vaccination.
Dr. Gianne Eduard Ulanday, a virologist from the University of the Philippines noted that time is of the essence especially in this dire circumstance. While the hesitancy and fear linger, the virus will continue its course without exception. It is exactly within this reason that the administering of thevaccine must be swift – and therefore an undue delay due to hesitancy is a huge hurdle.
As cited in previous section of this article, most of the people’s hesitance stem from safety concerns, mentioning reasons such as the vaccines being ‘rushed’ and fear of vaccine side effects. These fears are not entirely unfounded. Indeed, the COVID vaccines have been delivered to the public in a much faster pace than the other vaccines that are currently available for public use. However, this doesn’t mean that the vaccines were rushed or compromised.
Dr. Jose Valquez, a professor of infectious diseases at Augusta University Medical Center explained that the Food and Drug administration was evaluating in real-time and the drug companies are also evaluating in real-time as subjects were taken into the study. “Everything was real-time data, instead of looking at the data later on,” Dr. Valquez added.
The scientists still followed the normal procedures, but without the usual bureaucratic constraints or funding issues. Without these limitations, the usual gap between the phases of the trial are shortened, saving time in the process. Because scientists normally do not have the resources to conduct all three trial phases at the same time, they are usually done one at a time. Instead, with the help of volunteers and sufficient funding, all three phases were completed at the same time. This means that the final data and safety checks for COVID-19 vaccines are identical to the other vaccines.
On the other hand, the vaccine is not entirely a silver bullet to end this pandemic. It is, however, a powerful weapon to which we can utilize in order to pacify the current situation. Certainly, there are risks of getting side effects but the dangers of contracting COVID-19 are even more serious and long-lasting. According to health authorities, each of the 15 approved COVI-19 vaccines can cause side effects, but these are usually mild and wear off within a few days of getting the vaccine. In this case, it is easy to gauge that the benefit outweighs the risk.
Shifting the Narrative
While it is essential to understand and address the vaccine hesitancy in the county, any campaign will be doomed to failure without are flected action to substantiate it. Understanding the roots of the public’s fears and the context to which vaccine hesitancy thrives in the country are crucial but so is a concrete plan of action to address these concerns.
Gideon Lasco and Joshua San Pedro in their column published for the Inquirer criticized the undue emphasis on vaccine hesitancy as a contributing factor to the failure of the vaccination program. As though people's beliefs of vaccines are the only predictor of vaccine hesitation, they wrote that the vaccine hesitancy narrative lays unwarranted responsibility and blame on individuals.
Indeed, centering the narrative on vaccine hesitancy might divert attention away from other fundamental reasons why the country’s vaccination program remained slow and insufficient: inaccessibility of vaccines in the remote areas in the country, shortage of vaccine supply, lack of trust between the people and the authorities, and many others.
As much as health organizations try to instill vaccine trust with media and information campaigns, they fall short in dispelling people’s anxieties and misgivings because the health system itself is barely able to cope with the pandemic's demands, let alone vaccination attempts. With thousands of new confirmed cases each day, the healthcare system is barelycoping.
Thus, one can’t simply blame vaccine hesitancy on the people. The government, health authorities, and the broader systemic response are also equally accountable to this issue. It is critical to assure the public, but action should speak louder than words.
Building Trust
Establishing trust in an already wary audience is challenging. Disinformation and false narratives only serve to exacerbate these fears. As a result, a constant media campaign and effort to counter these myths should be in place. However, there is a limit to how far these campaigns cango.
Vaccine hesitancy is a highly nuanced issue, and future solutions must reflect and address these intricacies in both their design and evaluation. To provide a well-informed intervention, health authorities and implementers must first accurately identify the target population and fully comprehend the genuine nature of their specific vaccine or vaccination concerns. But this doesn’t mean that the emphasis should only be on the individual level, the administration should also ease the people’s concerns by providing a healthcare system that Filipinos can rely on and trust. It's critical to look at the big picture and disentangle the threads at both the individual and systemic levels – and this entails shifting the narrative and zooming in vaccine hesitancy as an issue beyond fear.