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High vaccination rates among trusted individuals correlate positively with their willingness to recommend COVID-19 vaccination
High vaccination rates among trusted individuals correlate positively with their willingness to recommend COVID-19 vaccination

Demystifying vaccinations: COVID-19 vaccine hesitancies in Ghana, proposed counter measures

Vaccine hesitancy is a complex phenomenon that has been defined as either delay in acceptance or refusal of vaccination despite availability of vaccination services.

Vaccine hesitancy varies across geographical spaces, time and type of vaccines. It is also influenced by factors such as convenience, confidence and complacency.

High levels of hesitancy mean low vaccine demand, on the contrary, low levels of hesitancy may not necessarily lead to high vaccine demand.

Generally, the determinants of vaccine hesitancy can be placed under three main categories: individual/group, contextual and vaccine-specific influences.

None of the vaccines for COVID-19 was manufactured using fresh foetal stem cells

The World Health Organisation (WHO) has already identified vaccine hesitancy as a major threat to global health.

Rejection or delay in accepting the COVID-19 vaccine prolongs the attainment of herd immunity, which ultimately extends the pandemic.

Especially concerning is vaccine hesitancy among health care workers, including para-medical staff, nurses and doctors, since they have a powerful influence on vaccination decisions by patients.

A vaccinated health care worker is more likely to recommend vaccination to others, hence, addressing health care worker’s vaccination attitudes is crucial to promoting COVID-19 vaccine acceptance.

There are several factors that influence vaccine attitudes. The following are some of the key reasons for vaccine hesitancy in Ghana, and proposed ways to counter them.

Personal Freedom

Increasing analyses and reports indicate that a sense of personal freedom informs people’s attitudes toward the COVID-19 vaccines.

The first successful use of mRNA technology was reported more than three decades ago

While clinicians and health care workers are trusted and held to standards of informed consent when administering treatments, and while COVID-19 vaccination largely remains elective, it is easy to understand why a significant number of people prefer to make their personal choices about vaccination.

Motivational testimonies or interviews may increase the effectiveness of vaccine-acceptance messages in such instances.

The success of such an approach has been recorded in India, South Korea and the U.S.A where the use of motivational interviews spiked post-partum vaccination uptake by approximately 10 per cent.

It is essential that health care workers are the focus of such intervention strategies because when their opinion is heard and appreciated, they will be more inclined to consider vaccine acceptance a personal choice rather than coercion, which would eventually trickle down to their patients.

Another strategy in persuasive communication is the use of an emotional approach to complement other approaches in the public health education campaigns.

Education by clinicians and other health care workers would go a long way in convincing the vaccine-hesitant to get the shot

Emotion can be leveraged in communication by acknowledging negative emotions like fear and anxiety (being careful when watering down such emotions), and activating positive emotions such as hope, confidence and altruism.

The emotional allure and fascination with anti-vaccine misinformation campaigns should be acknowledged and examined so they can be countered with effective pro-vaccination communication.

There are several self-identity reasons why someone may reject COVID-19 vaccination, including stigma associated with vaccinations, personal fear of vaccinations, adverse interactions with other medications, and inability to travel to a vaccination centre.

Understanding these personal barriers to COVID-19 vaccination is key to avoiding the vaccine-averse attitudes and identities.

In such instances, the narrative forms of communication (as opposed to strictly scientific forms) would be persuasive in countering vaccine hesitancy.

Safety, efficacy concerns

Even though the Food and Drug Administration (FDA) has not yet fully approved the current COVID-19 vaccines for commercial use, the FDA (based on reliable data from clinical trials), has issued Emergency Use Authorisation (EUA) in the light of the public health emergency.

Nevertheless, the compressed timelines of the processes, and the unusual speed in which the vaccines were developed and received EUA, have raised safety and efficacy concerns for quite an appreciable number of people especially among public health experts, not to mention the lay population.

Evidence however, suggests that consistent and reliable vaccine data can help assuage these concerns.

Other reports also indicate that among the general population, particularly among health care workers, ample knowledge and understanding of a particular vaccine production increased the willingness to accept that vaccine.

For instance, concerns about the speed with which COVID-19 vaccine was developed are based on the erroneous belief that mRNA technology is entirely new.

The first successful use of mRNA technology was reported more than three decades ago, with enormous successes chalked over the past decade in animals.

Private health care systems, public health agencies, and the government can work together to provide accurate information about the vaccines to point-of-care workers, which can later be communicated to the general public.

It goes without saying that increased understanding and communication of vaccine safety and efficacy data are critical factors in the increased acceptance of vaccines.

Preference natural immunity

Population immunity, popularly known as herd immunity, (i.e. indirect protection of a population from an infectious disease) is achieved via (1) vaccination or (2) from previous infections which then results in natural immunity.

Current data has shown that a significant number of health care workers, as well as the rest of the population in Europe, the Americas, and some parts of Asia, have expressed a preference for natural immunity, rather than vaccination-induced immunity.

There is every likelihood that this is a plausible reason for rejection of vaccination in Ghana.

Indeed, a ‘Vox Pop’ of a section of Ghanaians on our TV Stations indicate the frightening number of individuals who believe that the seriousness of COVID-19 has been exaggerated by government.

To them, the risk of vaccination is far greater than the risk of infection.

It is important to note that here is a clear difference in consequential lethality between these two approaches (the latter being thoroughly researched and controlled), before reaching herd immunity, and this must be clearly articulated to the population who may prefer natural immunity over vaccination-induced immunity.

Herd immunity attained via prior infection takes significantly longer periods, incurs a heightened cost in health care resources, and ultimately, costs many lives.

To buttress this, there is evidence of vaccine acceptance among workers who have cared for hospitalised COVID-19 patients, presumably due to an accurate perception of the severity of COVID-19.

Education by clinicians and other health care workers (who are usually the first point of contact) who have had these experiences therefore, would go a long way in convincing the vaccine-hesitant to get the shot.

Trust is one of the major factors in gaining acceptance of a new vaccine. Media disinformation and misinformation can create doubts about the (1) transmissibility of the disease, (2) proven preventive protocols, (3) severity/lethality of the disease, and (4) vaccine safety — which can promote mistrust of the health authorities, policy makers, and the government.

The public (educated and uneducated alike) has been exposed to several conspiracy theories (especially on social media) such as claims that the novel coronavirus (SARS-CoV-2) was deliberately created in the laboratory, that COVID-19 is caused by a 5G telecommunication network, or that health organisations have exaggerated COVID-19’s lethality for pharmaceutical and political gain.

Such misinformation casts a doubt on authorities’ integrity and undermines the global efforts to accept COVID-19 vaccines.

There is evidence that people have greater trust in medical professionals prescribing the vaccine than in policy makers, public authorities, and the government.

Simply delivering accurate information, however, is inadequate. Confidence can be heightened through properly structured education and discussion among trainer-of-trainees, eliciting concerns, and participation in vaccine recommendations.

Social media and traditional media exposure have both been repositories of high levels of disinformation and misinformation about the SARS-CoV-2 virus.

It has, therefore, become imperative to track, educate, and help lace accurate information, particularly on social media, with verified and credible sources in order to counter the misinformation.

COVID-19 vaccine mark?

A section of the global population (mostly Christians) are terrified about being coerced to take the “mark of the beast” (supposedly referring to COVID-19 vaccine).

This class of people has been sucked into the alluring conspiracy theory that the vaccine is a computer chip of a sort, that could be “666” mark of the beast.

While different explanations may exist for this fear, renowned theologians and scholars of the Bible have propounded that the “mark of the beast” isn’t something taken accidentally, or even mandatorily, instead, it’s a mark of loyalty and worship, which requires full cognitive awareness of our actions (else it’s not worship).

As an example, there is no biblical reason to think that obtaining a government-mandated social security number is equivalent to taking the mark of the beast.

It, therefore, stands to reason that in accepting social security numbers, biochip implants, vaccines, SIM cards, etc., extreme care is taken not to confuse our personal convictions with the meaning of a biblical text.

It must be said however that generally, public policies are well-intentioned, but needless to say, some need extra diligence before roll-out.

Nevertheless, unless the policies require you to forsake your faith as the exclusive object of your worship, they have no relation to the mark of the beast.

To further dispel myths about the COVID-19 vaccination among conservative religious communities, church leaders need to be an integral part in the communication drive because their followers are more likely to trust the church leaders than scientists and the government.

In most of these faith-based instances, the opinion of a government official matters far less to the practising conservative than advice from a church leader.

Religious leaders who have benefited from accurate information can, therefore, be placed in a strategic position to encourage their followers that the vaccine is safe and in line with religious doctrines.

Many Christians and conservative evangelicals are also troubled by the mistaken impression that the vaccines were developed using fresh foetal stem cells.

In reality, none of the vaccines for COVID-19 was manufactured using fresh foetal stem cells.

The Pfizer/BioNTech and Moderna vaccines used foetal cell lines in their testing stages.

Johnson & Johnson used a foetal cell line from an 18-week-old foetus aborted more than three decades ago in its manufacturing stages.

These foetal cell lines are not taken from recent abortions, but are derived from decades-old foetal cells, replicating thousands of times over decades under regulated laboratory settings, separated from the original foetus cells, and finally becoming known as foetal cell lines.

In the communication to avert vaccine hesitancy among staunch religious conservatives, it’s important for the church to understand the true science, and act as a beacon that believes in tested and proven scientific truth.

Conclusion

High vaccination rates among trusted individuals (community leaders, religious leaders, health care professionals, etc.) correlate positively with their willingness to recommend COVID-19 vaccination.

Delays in COVID-19 vaccination among the general population slows down the attainment of herd immunity, resulting in increased COVID-19-related illnesses and deaths, and ultimately creating a strain on health care resources.

Increasing COVID-19 vaccine uptake will be essential in reducing severe infections and deaths.

In line with this, accurate messages delivered by trusted individuals, can increase the vaccination rates.

It’s also imperative that innovative ways of communication is undertaken to increase understanding of the scientific evidence underpinning COVID-19 vaccines.

The writer is a Professor in Virology and Molecular Pathology,
Regent University College of Science and Technology,
Accra.

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