Vaccine hesitancy is listed among the top 10 threats to global health, according to World Health Organization. When it comes to COVID-19 vaccines, acceptance is of utmost importance along with effective and equitable distribution. Review across 10 low- and middle-income countries shows concerns about side-effects of COVID-19 vaccination as a reason for hesitancy.
Possible harmful side-effects to the foetus have been observed as the top reason for vaccine hesitancy in a 16-country survey on COVID-19 vaccine acceptance among pregnant women and mothers of young children. Pregnant women expressed concern over the harmful effects of COVID-19 vaccine on their baby and lack of information about safety of vaccines during pregnancy as reasons for vaccine hesitancy.
Vaccine misinformation and hesitancy need to be addressed to increase confidence and acceptance of COVID-19 vaccines by pregnant women. A multinational cohort study indicates a consistent association between pregnant women with COVID-19 and higher maternal morbidity and mortality and likelihood of stillbirth. A review recommends prioritizing pregnant women for COVID-19 vaccination, especially in countries with high under-five and maternal mortality.
CDC data in the US indicates only 11.1 per cent pregnant women are fully vaccinated for COVID-19 as of May 8, 2021, owing to vaccine hesitancy. Evidence indicates doubt/distrust regarding the safety and efficacy of vaccines linked to vaccine hesitancy in pregnant women. Unclear messaging on COVID-19 vaccines by health professionals and lack of vaccine trials in pregnant women are driving vaccine hesitancy among them. COVID-19 vaccine hesitancy is multi-dimensional and trust in public health agencies is key to vaccine acceptance.
Vaccine hesitancy among women adds to the risks to economic recovery by prolonging the pandemic. Reports across Indian states raise concern on the rise in vaccine hesitancy in pregnant women and lack of data on the number of vaccinated. Reasons including fear of fever, vaccine scepticism and myths, mistrust, social inequality, dependence on family members, and lack of awareness are pulling back pregnant women from taking vaccination. Some states have stepped up efforts to handle vaccine hesitancy in pregnant women through counselling or launching special campaigns to vaccinate. Health activists have appealed for incentivising families to counter vaccine hesitancy.
The health ministry has issued a note to counsel, educate and support pregnant women to take the COVID-19 vaccine. A systemic review indicates the need for a multi-dimensional strategy and targeted approach to overcome vaccine hesitancy. Improved health education and outreach to pregnant women as well as involving family members in vaccination decisions can build vaccine confidence. A counselling approach like motivational interviewing has been effective in addressing vaccine hesitancy. Communicating accurate and timely information is key to enhancing trust and overcoming fear of vaccine safety.
The approach to focus on knowledge and awareness building around vaccination along with improved access can also yield results. There is a need for behaviour change communication to help people move from hesitance to acceptance.
The infodemic on social media—the widespread vaccine misinformation—has led to reduced vaccination rates worldwide. A dedicated media strategy bringing in ‘influencers’ to share positive stories to boost confidence is needed.
Policymakers must prioritise effective roll-out of COVID-19 communication strategy to address vaccine hesitancy, by building public confidence on safety and efficacy of vaccine. Social mobilization and community engagement are needed to check vaccine hesitancy by targeting three factors: Confidence, Complacency and Convenience. COVID-19 crisis provides an opportunity to reignite confidence and overcome mistrust in vaccines in a resolute way.
Dr Shoba Suri is a Senior Fellow with ORF’s Health Initiative. She is a nutritionist with experience in community and clinical research. The views expressed in this article are those of the author and do not represent the stand of this publication.