Experts’ Opinions| Vaccine hesitancy on the rise: a generation risk?

ByCatalina Russu

Experts’ Opinions| Vaccine hesitancy on the rise: a generation risk?

Vaccine hesitancy, which is defined by WHO as a “delay in acceptance or refusal of vaccines despite the availability of vaccination services”, has been reported in more than 90% of countries worldwide. It has increased globally leading to a subsequent decrease in vaccination rates and an increase in outbreaks of vaccine-preventable diseases (i.e. measles, poliomyelitis, and pertussis). Why is this happening and what are the further consequences? We asked several international health experts for their opinion.  

What are the main reasons for vaccine hesitancy?

Emmanuel Mugisha, public-health specialist

“An individual may lack confidence in vaccinations which may arise from a mistrust of the vaccine(s) or a mistrust of the healthcare provider. This is usually exacerbated by limited information about the vaccine(s) as well as the ever-growing anti-vaccine groups. For example, individuals have questioned the need for so many vaccines when they themselves received fewer vaccines in the past. There are certain religions where they don’t believe in any modern medicines. Poor information and the management of adverse events following immunization (AEFIs) have also increased complacency. Poor accessibility, especially in developing countries, is a major factor where many inconveniences are encountered in the effort to go to receive a vaccine.”

 

 

Patrick Musyoka, Public Health Specialist

“Lack of proper health education/awareness. Most communities do not know about the importance of vaccines for children so it becomes hard to impart this information during immunization sessions. Also, there is a lack of political goodwill. There are also traditional beliefs and culture where most of the communities rely on old beliefs about medicine. Among other reasons are perceived risks of the vaccines; lack of trust and also vaccine safety concerns; too many vaccines given to the children which create a lot of fears; the community lack confidence to the health workers.”

 

 

 

 

Clare Ashaba, MPH. HSS Specialist

“Diminished trust in public health systems. As abstract as this may sound, there’s a significant proportion of the population that believes that vaccines are a ploy to inflict harm on their reproductive health as seen in cases of hesitancy towards the HPV vaccine. In this era of social media, such false information spreads easily and can negatively influence parents’ decisions regarding the vaccination of their children.”

 

 

 

Hadiza Umara, public health expert

“Vaccine hesitancy can be attributed to the spread of misinformation (media, particularly social media) that vaccines are detrimental to health, lack of confidence and trust in healthcare, and low vaccination knowledge among parents. While a community may have access to the required vaccinations, unexpected circumstances can obscure their ability to take advantage of this. There may be limitations about the cost of transportation to the primary health center and lengthy waiting times at the health center. These challenges can result in uncertainty about pursuing future vaccinations for their children, particularly in developing countries like Nigeria.”

 

 

Dereje Assefa, senior public health expert

“As the prevalence of the vaccine-preventable disease has decreased, people have paid more attention to the rare Adverse Event Following Immunizations (AEFIs) and new research on this subject has also been published rumors arising from politicians include “polio campaigns are used to access wanted criminals.”

 

 

 

What are the main consequences of these vaccine boycotts?

Victoria Shoyombo, health specialist

“The main consequence of vaccine boycott is disease outbreaks, even in a population that had previously achieved herd immunity. For a population to be completely protected from disease, a minimum proportion of that population needs to be immunized. Anyone that boycotts a vaccine is intentionally putting others in the community at risk of falling ill. Vaccine boycott will also raise health service costs for countries. Prevention health services are far cheaper than treatment which also takes up human resource time that could be dedicated to groundbreaking discoveries that will further improve population health.”

 

 

Racheal Najjemba, student

“This leads to an increased burden of disease in terms of incidence and prevalence. This then leads to increased morbidity and mortality which in turn makes the government lose in terms of human resources since the younger generation who would contribute to the future workforce is left to die and we shall have very few people living longer. The health services of such a country will be rated as poor and the country will be classified as having low or middle-income status whereas countries offering immunization coverage will have better health services. There will be low productivity since most of the time communities and individuals are hospitalized due to diseases that can be prevented by immunization which is an effective intervention.”

 

 

John Bawa, development planner

„Some of the main consequences are: re-emergence of certain diseases (polio, measles in the USA in 2019, Africa, Asia) with dire consequences; drug resistance and mutation of the causative agents prolonging efforts towards eradication and treatment costs; resurgence of morbidity and mortality of children and other vulnerable populations; increase pressure on existing health resources and infrastructure.”

 

What can the international community do about vaccine hesitancy?

 

Gonzo Manyasi, clinical biologist

“Tweak the more acceptable routine vaccine programs. If blanket vaccine coverage is the idea, let the health systems include the ‘last mile’ factor in their immunization campaigns so that no child is left out. For Kenya, this would entail the resumption of the training of a cadre that was known as Community Nurses rather than just having a few units of community nursing in the regular nursing training program. The obvious solution would be to educate the target populations adequately before launching any such campaigns and to ensure the message reaches the grassroots, namely each household, and not just seminars and workshops here and there!”

 

 

Rose Aguolu, public health expert

“Measures to be taken by the local community to address this global health issue include advocacy to and engagement of key community influential stakeholders – traditional rulers, religious leaders, political leaders; scale-up public awareness about the importance of vaccinations and their processes, side effects and frequency and the consequences of vaccine boycott which may be through mass media, in local languages, film shows, in schools and social meetings and the recruitment and training of local-based/community members to be involved in providing vaccinations in the communities. Also, the international community should look at the feasibility of producing vaccines which could be highly potent and effective even at single dosing (probably long-acting) with fewer side effects, the integration of some immunization into other public health programs to encourage adherence and a reduction in the cost of vaccines.”

 

 

Clare Ashaba, MPH. HSS Specialist

“The international community should support governments to design and implement innovative strategies to optimize immunization programs to reach target populations. They should use online and virtual platforms to communicate effectively. Also, they should leverage social media – collaborating with social media influencers who have large followings to engage the target population. One more thing would be to strengthen public-private partnerships.”

 

 

 

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