How important are the determinants of health in modifying trust in vaccines?

This article was exclusively written for The European Sting by Mr. Francesco Rosiello who deals with CBRN emergencies, disaster medicine, healthy cities, medical intelligence, health simulations and Health Technology Assessment, International Humanitarian Law and Disasters one. He is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Vaccine hesitancy, as defined by the WHO SAGE Working Group, is a behavioral phenomenon, which “refers to delay in acceptance or refusal of vaccination despite availability of vaccination services”

A multinational study(1) showed that in 10 countries in Asia, Africa, and South America vaccine hesitancy is significantly higher in females, those who identified themselves as Muslim, those living in rural areas, working in non-healthcare related sectors, and those who have not received a flu vaccination during the past 12 months..

The relationship between vaccine acceptance or hesitancy and gender is considered complex. Overall, women play an important role in vaccination decisions for children and the decisions can influence others within the same household. Given limited information from initial clinical trials about safety and effectiveness of vaccines in pregnant women.

Vaccine hesitancy will be comparatively lower in healthcare professionals due to their in-depth understanding of vaccines and their efficacy. Healthcare professionals are considered the most trusted advisor, having a direct influence on the vaccination decisions of the public. The lack of knowledge and understanding about the mechanism, risk, and safety of vaccines partly explains the reason for higher vaccine hesitancy in a population with a non-healthcare-related job.

Therefore, strategies have to be formulated to increase knowledge and awareness of the benefits of vaccination using audiovisual aids by targeting individuals with a non healthcare-related job. In addition, the individuals not receiving a flu vaccination during the past 12 months also exhibited vaccine hesitancy, indicating a negative perception about vaccinations in general.

Over the years, the spread of incorrect information on vaccines and vaccination by the anti vaccination movement has significantly contributed to the high rate of vaccine hesitancy and to increase economic cost of healthcare(2). High vaccine hesitancy might be the result of conspiracy theories sprouting through social media. Some studies showed that religious teachings prioritize prayers over medicine and this might result in vaccination hesitancy among devotees.

Efforts to increase vaccine coverage must target figures that highly influence vaccine uptake, particularly caregivers, religious leaders, and healthcare providers. The participation of religious leaders in promoting vaccination has been reported as an important strategy to overcome contradictions between religious beliefs and vaccination.

In the context COVID-19, the religious elements might be addressed by involving enlightened Islamic scholars in health promotion and awareness regarding COVID-19 and this might facilitate appropriate COVID19 control efforts in Islamic countries. In the context of COVID-19, vaccination not only protects individuals’ health but also plays a critical role in protecting vulnerable populations by achieving herd immunity.

There is a need to establish effective COVID-19 vaccine communication strategies to improve vaccine trust, thereby enhancing vaccine acceptance. Such measures should focus on vaccine-hesitant groups to obtain the maximum result. These groups could be targets of vaccination campaigns for both routine childhood vaccination and COVID-19 vaccination.

A multisectoral approach involving the collaborative effort of various stakeholders, such as the government, private companies, and religious groups, should be formulated to create a longstanding public trust in vaccinations.

References

1.      Harapan H, Anwar S, Yufika A, Sharun K, Gachabayov M, Fahriani M, et al. Vaccine hesitancy among communities in ten countries in Asia, Africa, and South America during the COVID-19 pandemic. Pathog Glob Health. 2021 Dec 20;1–8.

2.      Rosiello F, D’Oca E. Vaccinations and the movement of antivaccers. Eur J Public Health [Internet]. 2020 Sep 1 [cited 2021 Jan 3];30(Supplement_5). Available from: https://academic.oup.com/eurpub/article/doi/10.1093/eurpub/ckaa166.700/5916042

About the author

Francesco Rosiello deals with CBRN emergencies, disaster medicine, healthy cities, medical intelligence, health simulations and Health Technology Assessment, International Humanitarian Law and Disasters one. During his studies, he has won 5 scholarships on disaster medicine and clinical trials and 5 university collaboration grants. He has presented work in all the International Workshops on CBRNe from 2013 to today, at the 1st international congress on CBRNe and in numerous conferences, some of which for medical students. He is a member of numerous Italian and international scientific societies.