13,773 Vaccine Hesitancy in the Polio Context, The Drum Beat 769, January 23, 2019

The Drum BeatVaccine Hesitancy in the Polio Context – The Drum Beat 769
January 23, 2019
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Understanding vaccine hesitancy (VH), leading in some cases to refusal, is vital to the success of Global Polio Eradication Initiative (GPEI), as well as to further expansion of routine immunisation. GPEI partner the World Health Organization (WHO), via its Strategic Advisory Group of Experts (SAGE) on Immunization, has called for improved monitoring of vaccine confidence. The top 3 reasons for VH across all WHO regions, 2014-2016, were: risk-benefit (scientific evidence); lack of knowledge and awareness of vaccination and its importance; and religion, culture, gender, and socioeconomic issues. Clearly, communication is at the heart of any effort to understand and address VH – a complex and context-specific phenomenon – which is reflected in the nearly 200 summaries on The CI’s polio theme site on the topic. This Drum Beat offers just a small fraction of what we have to offer, with a focus on hesitancy around the oral polio vaccine (OPV).
From The Communication Initiative Network – where communication and media are central to social and economic development.
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  • 5.Public Trust in Vaccination: An Analytical Framework
    by Vijayaprasad Gopichandran
    With a focus on the Indian context, this paper develops an analytical framework to assess trust in vaccination and addresses specific issues pertaining to mistrust in vaccination. “In certain districts of Uttar Pradesh and Bihar, there was serious resistance to the polio vaccination due to widespread misinformation among the minority communities that it was a western ploy to sterilise the minority populations and thus reduce their numbers….A deeper analysis…revealed that…the community was tired of the repeated rounds of the pulse polio campaign, which had led to suspicions, and the minority community was even less amenable to vaccination because the complete apathy of the mainstream health system towards their other healthcare needs had left them feeling marginalised and oppressed….This highlights how trust in vaccination is strongly influenced by trust in the health system and the social, historical and political context.” It is argued that active communit! y engagement with respect to vaccination policies is one of the key measures for ensuring that the vaccination policy and health system are viewed as trustworthy. [April-June 2017]
  • 6.Science and Politics in the Polio Vaccination Debate on Facebook: A Mixed-Methods Approach to Public Engagement in a Science-Based Dialogue
    by Daniela Orr
    In the context of this study on public engagement with the 2013 polio crisis in Israel in a social media environment, the researchers point out that the vast majority of the public are not biologists or epidemiologists, and they thus need to trust the sources that deliver the information to them and act upon guidance from these sources. This opens the door to political considerations and evaluations of the sources who deliver the information. The researchers consider “political” anything that involves power relations, including dialogue and public engagement in the scientific realm. They characterise mainstream media and social media as “among the most important and powerful agents that mediate between science and the public”. [Mar 2018]
  • 7.Media Representation of Vaccine Side Effects and Its Impact on Utilization of Vaccination Services in Vietnam
    by Bach Xuan Tran, Victoria L Boggiano, Long Hoang Nguyen, Carl A Latkin, Huong Lan Thi Nguyen, Tung Thanh Tran, Huong Thi Le, Thuc Thi Minh Vu, Cyrus SH Ho and Roger CM Ho
    Vietnam’s vaccine-related milestones include becoming polio free in 2000. However, there have been examples in which reports in the media of adverse effects following immunisations (AEFIs) have threatened these successes. For instance, in 2013, a few AEFIs were reported after infants received the Quinvaxem vaccine, which triggered controversies in many print and internet-based Vietnamese newspapers. A total of 68.2% of subjects hesitated to receive vaccines after hearing about AEFIs in the media, and 12.4% subjects would refuse vaccination altogether after hearing about AEFIs. Receiving information from community health workers and their relatives, colleagues, and friends was negatively associated with VH, but facilitated vaccine refusal after reading about AEFIs in the media. [Sep 2018]
  • See also:
    * Sentiment, Contents, and Retweets: A Study of Two Vaccine-Related Twitter Datasets
    * Misinformation Lingers in Memory: Failure of Three Pro-Vaccination Strategies
    * Silent refusals and distrust of vaccines is a big challenge for vaccination teams
    * Vaccine Hesitancy: Towards a Better Understanding of Drivers and Barriers to Awareness, Acceptance and Activation

  • 8.Vaccine Hesitancy among Mobile Pastoralists in Chad: A Qualitative Study
    by Mahamat Fayiz Abakar, Djimet Seli, Filippo Lechthaler, Esther Schelling, Nhan Tran, Jakob Zinsstag and Daniel Cobos Muñoz
    The types of demand-side barriers reported most frequently among the mobile pastoralists in Chad studied were mistrust of the Expanded Programme on Immunization (EPI) and polio vaccination outreach services, followed by health system issues and concerns related to potential harm of vaccines. In addition to the language barrier between health professionals and nomadic communities, health workers seemed to ignore the basic cultural and religious norms in the camps, and there were few Muslim health workers. [Nov 2018]
  • 9.Polio Vaccine Hesitancy in the Networks and Neighborhoods of Malegaon, India
    by Jukka-Pekka Onnela, Bruce E. Landon, Anna-Lea Kahn, Danish Ahmed, Harish Verma, A. James O’Malley, Sunil Bahl, Roland W. Sutter and Nicholas A. Christakis
    To learn about social network factors associated with polio VH, the researchers investigated social and spatial clustering of households by their vaccine acceptance status in Malegaon, India, an area known for vaccine refusal and repeated detection of polio cases. In short, there was both social and geographic clustering. “[T]aking into account people’s social network position can enhance the effectiveness and efficiency of public health messaging and interventions.” [Feb 2016]
  • 10.Successful Polio Supplementary Immunisation Activities in a Security Compromised Zone – Experiences from the Southwest Region of Cameroon
    by Eposi C. Haddison, Dorine Ngono, Gael T. Kouamen and Benjamin M. Kagina
    According to the authors, the 2018 polio supplementary immunisation activity (SIA) in the Southwest region of Cameroon was successful due to: political will, optimal planning and co-ordination, support from partners, widespread sensitisation and mobilisation of the members of the community before and during the SIA, and dedication by the teams involved. Several challenges were faced that were either resolved or circumvented. For example, misunderstanding of the objectives of immunisation and fear that vaccines might transmit diseases or be used as a weapon by the authorities during times of conflict may lead to VH. To prevent such mistrust, the WHO and UNICEF were portrayed as the main organisers. This strategy permitted vaccination in certain districts where the population was suspicious of the government. [Oct 2018]
  • 11.Understanding vaccine hesitancy in polio eradication in northern Nigeria
    by Taylor S, Khan M, Muhammad A, Akpala O, van Strien M, Morry CFeek W and Ogden E
    This study is based on a purposive sampling survey of 1,653 households in high- and low-performing (relative to VH) rural, semiurban, and urban areas of 3 high-risk states of northern Nigeria in 2013-14 (Sokoto, Kano, and Bauchi). One finding: Women in very low-risk settlements were considerably more likely to have participated in community meetings, regardless of type of meeting. The results suggest that strategies to address the micro-political dimension of vaccination – expanding community-level engagement, strengthening the role of local government in public health, and enhancing public participation of women – should be pursued to reduce non-compliance as a set of strategies complementary to conventional didactic/educational approaches and working through religious and traditional “influencers”. [Oct 2017]
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  • See also:
    * Vaccine Hesitancy Prevalence and Correlates in Riyadh, Saudi Arabia
    * The Impact of Access to Immunization Information on Vaccine Acceptance in Three Countries [Botswana, the Dominican Republic (DR), and Greece]
    * State of Vaccine Confidence in the EU: 2018
    * Vaccine Acceptance, Hesitancy and Refusal in Canada: Challenges and Potential Approaches


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This issue of The Drum Beat was written by Kier Olsen DeVries.
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