Vaccine Hesitancy? Let’s Learn From The Polio Lesson

On March 27, 2014 the World Health Organization (WHO) declared India—as part of its South-East Asia Region--polio-free, a major public health achievement for the country. Seven years later, even as we continue to celebrate our polio-free status, the country is battling yet another deadly virus. So now, we must look to our past and apply what we’ve learned to help combat the coronavirus.

Specifically, we must also look again to the power of vaccines given the important role they play as a public health tool in curbing the spread of disease. Thanks to the polio vaccine and the efforts of Rotary and its Global Polio Eradication Initiative (GPEI) partners, over 19 million people—who would have otherwise been paralyzed-- are walking, and 1.5 million childhood deaths have been averted.

Yet, despite the proven success and safety of vaccines, we continue to face the challenge of vaccine hesitancy with Covid-19, just as we did in our fight against polio.

What is Vaccine Hesitancy?

A successful immunization programme depends on widespread public acceptance and adoption. Named a top global health threat by WHO in 2019, vaccine hesitancy (or refusal) poses a major barrier to an immunization programme’s success.

Some common misconceptions held by individuals refusing the vaccine stem from a lack of information, misinformation or religious-based objections. For example, in India, some worry that multiple vaccines administered at once may harm a child’s immunity. The fallacy of ‘vaccine overload’ has been difficult to overcome, despite multiple studies demonstrating that the recommended vaccines are no more likely to cause adverse effects when given in combination than when they are administered separately.

To compound the issue, individuals with anti-vaccination beliefs often fall victim to confirmation bias and become further entrenched in their positions when issues related to vaccines make headlines.

Covid-19 Vaccine Rollout Challenges

Even as India began mass Covid-19 vaccinations in January 2021, turnout was as low as 22 percent in some states, and a recent survey of nearly 17,000 citizens across India revealed that 60 percent of those polled were hesitant to take a coronavirus vaccine immediately.

Concerns regarding side effects and the efficacy of the vaccines themselves are largely behind this data as Covaxin (one of the vaccines currently being administered) has not yet cleared phase III clinical trials.

Beyond concern over the coronavirus vaccines, citizens have a number of reasons for holding vaccine-hesitant attitudes, ranging from the false belief that India is reaching herd immunity so vaccination is unnecessary, to individual concerns regarding personal health.\

Overcoming Vaccine Hesitancy: Strategies and Tactics

For each misconception related to vaccines, we will support the work of public health officials by:

1. Sharing fact-based information from trusted experts: As frontline and healthcare workers become educated about COVID-19 vaccines, they can disseminate information to the general public on all aspects of immunization, from potential side effects, to necessary precautions and more. For instance, Dr. Pavithra Venkatagopalan, a leading coronavirus researcher and Rotarian has been debunking myths on social media around the Covid-19 vaccines through awareness videos.

2. Effectively using social media and engaging community leaders: Celebrities, public health professionals, and esteemed community influencers can all help encourage vaccine acceptance and promote lifesaving health and hygiene practices. Notably, this tactic was used during India’s battle with polio as Ashok Mahajan, Chairman, Rotary’s Covid Task Force in India, engaged the Muslim community through the formation of the Muslim Ulema Committee. The body advocated for polio immunizations and helped India to eradicate the disease earlier than expected. More recently, in response to the Covid-19 pandemic, the same body encouraged the Muslim community to follow government restrictions and practice social distancing and mask-wearing.

3. Making vaccines more accessible: By setting up vaccination booth sites in remote and hard-to-reach areas – as we did to end polio--and by providing immunizations free of cost or at subsidized rates, we can help the public to feel more confident and receptive to vaccination programmes.

The Road Ahead

Vaccine hesitancy has been in play for decades, even as the underlying concerns may have shifted over the years. Ultimately, the government—in partnership with civil society, nonprofits, and the private sector—must drive public sentiment in favour of Covid-19 immunizations.

As trusted members of their communities, Rotary and its GPEI partners are working alongside the government to support all aspects of vaccine introduction and delivery, equitable distribution of Covid-19 vaccines, and to help overcome vaccine hesitancy.

This is not an impossible task. In fact, the Rotary Club of Madras has already partnered with the state government of Tamil Nadu to support that region’s Covid-19 vaccination rollout, and additional such collaborations are expected.

Ultimately, if all stakeholders work together to address the myriad concerns underlying vaccine hesitancy, India will be able to stop coronavirus infections just as we officially stopped polio seven years ago.

(The author is Rotary’s National PolioPlus Chair for India and member of the India Expert Advisory Group (IEAG) on vaccines. Views expressed are personal, and do not necessarily reflect those of Outlook Magazine)