Despite the recent progress with the rollout of Covid-19 vaccination programmes, many mistruths circulating online have, in turn, had an impact on willingness to receive the vaccine. Unfortunately, this does not come as a big surprise. The ‘anti vax’ movement has been causing havoc for years by standing in opposition to vaccinating against disease, calling into question the safety of vaccines and circulating conspiracy theories surrounding the practice of vaccination itself. Although this kind of ideology has been around as long as vaccination itself, the accessibility of the internet coupled with the rise in use of social media in recent years provides the perfect breeding ground for such material. Vaccine hesitancy, a term which describes rejection or slow acceptance of vaccination, in relation to Covid-19 may not come as a surprise, but it is an issue worthy of attention as vaccination is our ticket out of the pandemic.
Several years prior to the pandemic arising, Professor Heidi Larson of the London School of Hygiene and Tropical Medicine (and founding director of The Vaccine Confidence Project) warned of the dangers of the spread of ‘viral misinformation’,the distrust in vaccinations that seemed to be worsening and the threat this poses to global health. In a similar vein, the World Health Organisation (WHO) named vaccine hesitancy in its top 10 threats to health in 2019. The rollout of Covid-19 vaccinations have demonstrated that these long-standing worries around vaccine hesitancy are not without basis- all manner of misinformation has surfaced online since the first vaccines were approved, along with more generalised and widespread concern that the vaccines have been ‘rushed’.
Although official information has been released in attempts to correct mistruths and alleviate concerns, claims about the vaccine inevitably spread faster and reach more people through social media than via official channels. Although regulating posts on social media is something sites such as Facebook have improved upon recently, there is arguably further to go with this and the problem may now lie more so with subtle posts influencing people’s opinions as opposed to blatant anti-vaxxers, which is much more difficult to police. In addition to social media sites like Facebook and Twitter, WhatsApp is another hotbed for misinformation- which can spread rapidly between different groups without regulation as encryption has now been put in place with concerns regarding safety being brought to light. This is especially problematic as individuals are arguably more likely to believe something forwarded directly to them by a friend. Importantly though, it is those actively spreading and endorsing misinformation we should be frustrated at, not those who have been taken in by it.
Increasingly, documentation is showing that those belonging to ethnic minority groups are less likely to take up the Covid-19 vaccine when offered it. In December, the Royal Society for Public Health conducted a poll which showed that willingness to have the Covid-19 vaccine amongst individuals from Black, Asian and minority ethnic backgrounds was only 57%, compared to 76% of the UK population as a whole. This is not a simple issue of ‘not wanting the vaccine’, but is understandably born from a longstanding lack of trust in officials and structural inequalities that minority groups are constantly faced with. Importantly, it has been pointed out that it is easy to blame those who are hesitant to receive the vaccine, rather than addressing the important systemic issues underlying this.
Different approaches to overcoming Covid-19 vaccine hesitancy have involved strategies such as using WhatsApp groups to spread the word in dispelling mistruths about the vaccine via ‘trusted community voices’ such as local Imam’s and GPs. The NHS Race & Health Observatory have produced a useful infographic setting out ways of increasing covid vaccine uptake amongst ethnic minority people. Proposals largely centre around building trust, and some suggestions include embedding vaccine hubs into local places of worship to make vaccination more accessible to all, among others. Indeed, pop up vaccination centres set up in mosques certainly seem to have been well received so far.
As the UK’s vaccination programme has progressed, a form of vaccine hesitancy between the different vaccines available has been emerging. With different levels of ‘effectiveness’ being cited in the news, anecdotal reports from the vaccination front line suggest some members of the public are demanding to pick which vaccine they receive based on this. However, the recent news of several major EU countries halting use of the Oxford AstraZeneca vaccine over ‘safety fears’ could be a mortal blow. Although the vaccine has since been declared safe to continue using by the Medicines and Healthcare products Regulatory Agency (MHRA), the European Medicines Agency and the WHO, and despite the fact that these EU vaccination programmes have now largely resumed, it will undoubtedly have repercussions in terms of (already delicate) public trust.
It is thought that Covid-19 vaccination programmes globally will need an uptake rate of somewhere between 55-85% to be successful in conferring herd immunity to the virus. In December an Ipsos World Economic Forum survey revealed that 77% of UK adults expressed intent to have the vaccine, but perhaps more worrying were the results for South Africa (53%), Russia (43%), and France (40%). It isn’t enough just to worry about ourselves. A global pandemic requires global vaccine coverage to reduce the chances of further variants emerging and thus to save lives.
Continued promotion of scientifically correct and user-friendly information, in addition to firmer action against anti vax material found online, is key to achieving and maintaining a high uptake in vaccination. We are reliant on accurate information being made widely accessible and visible to the public, but also on local efforts to engage with groups who may be more at risk of low-uptake. Additionally, vaccinators themselves may be integral in dispelling myths and encouraging uptake on a very local scale.
By Eleanor Pace
Eleanor is a final year graduate medical student and member of the working group for the Global Health Policy Centre, with an active interest in global health and health policy. She has particular interests in vaccine hesitancy and communicable diseases.
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