Article

Hesitancy for the vaccine in the Covid Era

AUTHOR : DR. SHRUTI

In December 2k19, many got symptoms of shortness of breath, cold, cough, etc. caused by a pathogen that is unknown. Eventually, it was found out to be linked to the seafood market in China, particularly in Wuhan. Subsequently, the virus was identified as Coronavirus or COVID-19 by WHO (World Health Organization). It belongs to respiratory syndrome classification and is named SARS-CoV-2 (severe acute respiratory syndrome Coronavirus 2) by the International Committee on Taxonomy of Viruses. It has infected many and caused deaths in China initially and then spread to Italy, Europe, USA, and India, by this time WHO declared it as pandemic due to spread around the globe due to high level of infection and mortality rate. 

Covid-19 has affected the world drastically; it brought personal losses to the economy at an individual as well as country level. The lockdown was introduced in almost every country for several months to break this chain of infection in the year 2020 which has many ill-effects like unemployment, financial losses, personal losses, etc. Worldwide, the two waves of this virus were observed, one on 2k20 and the second on 2k21. Also, many scientists and mathematicians have already predicted the third wave of this virus by the end of 2k21, especially affecting children up to 18 yrs of age. Covid-19 behavior was also introduced in all the nations which include – 

• Frequent hand sanitization/washing
• Mask on while going out
• Social Distancing
• Reducing unnecessary outside houses

To control the spread of this virus, countries including India worked to introduce the vaccine against this novel Coronavirus. Many trials were conducted worldwide before the vaccine got administered as per the protocols of Drug Safety and Compliance. And finally, the day has arrived in Jan, 2k21 when the first jab was given to healthcare professionals and the front line workers, followed by the general public. 

According to the recent data, there are a handful of countries that have curbed the novel virus and are not using masks anymore like-

1. Israel
2. Bhutan
3. USA
4. New Zealand
5. China

This achievement is a result of vaccine coverage for the nation. Below are the data for the vaccination coverage for the countries that are mask free now :-

Country	Coverage in percentage
Israel	70%
Bhutan	90%
USA	44.4 % of the population fully immunized
New Zealand	6.6 % of the population fully immunized
China	N/A

Other than above there are more places like-

1. Tuvalu
2. Turkmenistan
3. Tonga
4. Tokelau
5. Saint Helena
6. Pitcairn Islands
7. Palau
8. North Korea
9. Niue
10. Nauru
11. Kiribati
12. Federated States of Micronesia
13. Cook Islands
14. American Samoa

These places have curbed the virus due to the only reason for high immunization rates. Worldwide we are not getting the immunization rate as it was desired to be due to vaccine hesitancy. Vaccine hesitancy is a spectrum to refuse all vaccines to accept some vaccines. WHO defines the term “vaccine hesitancy” as a behavior that is influenced by numerous factors such as lack of confidence in vaccine or provider, complacency (don’t perceive it feeling not required), and access or convenience. The individuals who are vaccine-hesitant may accept few and then doubt on few, some delay or refuse to get immunized. Each one of us should understand and respect the availability of the vaccines as it is the crucial aspect in this Covid era to minimize the infections, specifically the healthcare or front line workers. Population which is vaccine-hesitant or showing negative behavior towards immunizations is a major concern towards the safety and efficacy of the vaccine. 

As per the literature review, there are many studies done in the past worldwide showing low acceptance of the vaccine. Factors or reasons given by participants are as follows-

• Employment – Less educated/ unemployed showed low acceptance
• Personal perception 
• Religion
• Politics
• Gender
• Income
• Covid infection
• Other comorbidities
• Medical diseases like Cancer etc.

Literature review from high-income countries suggested the 5 determinants responsible for vaccine-hesitant behavior. 5C framework is as follows :-

If this hesitancy remains high due to the above reasons, it will be a critical situation for the nation or the world as it will lead to less coverage which further leads to disease outbreaks. It is a great threat to global health. Hesitancy to the vaccine is contagious, misinformed, misinformed, and not limited to COVID-19. It not only risks the people who show hesitant behavior towards the vaccine but also the broader community.

As per the history of vaccination drive happened in the past, it helped many nations to forget the diseases like smallpox, polio, yellow fever, etc. which caused millions of deaths. All thanks to vaccination, for COVID-19 also it could have shown this picture but hesitancy towards the same is a big hindrance to overcome. This reluctance is not limited to only COVID vaccine but to other vaccinations as well. Director-General of WHO right said that “We are not just fighting with an epidemic; we are fighting with an infomedic. Infodemic is excess of information that got spread during an outbreak, some correct and some not via media or physical communications leading to poor access to accurate information.

Fb (Facebook) has conducted a survey – COVID-19 symptom survey (CSS) in India, the results are not impressive, it showed the hesitancy rate in India to be 28.7% Hesitancy is the highest in Tamil Nadu as high as 42% followed by Punjab with 41%. Recent government reports also suggested that it is more prevalent in rural or remote areas even after multiple visits of healthcare professionals. In the past when the vaccine for polio was introduced, India has faced this hesitancy. Vaccine hesitancy is not new to India. At that time also, some collaborations were made with leaders of either politics or religion. This time also the government is adopting many initiatives to reduce vaccine hesitancy-

• Folk songs used to aware local people
• Misinformation for vaccines is creating havoc. To alert officials about unreliable or fake news related to it.
• Leaders or influencers like Mr. Amitabh Bachchan did campaign for Polio. 
• Delay should be addressed immediately.
• Healthcare professionals are aware of people and inform them about the benefits of vaccines.
• The general public be made aware of myths about vaccinations linked to medical diseases like, patients with blood cancers or any other types of cancer, etc., or other conditions like menstruating women, lactating women. There is no contraindication related to the above. Only contraindications exist for allergic patients or patients with low platelet count.

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