Last week, I wrote that misinformation was fuelling vaccine hesitancy. Many readers reached out to me and asked what about mistrust. I then decided to launch a survey on LinkedIn asking respondents: what do you think is mostly driving COVID-19 vaccine hesitancy? To date, 142 respondents have responded to the survey that is still open. They were given four options: lack of information, misinformation, mistrust, and safety issues. 42% of the respondents stated mistrust while 40% stated misinformation.
There seems not to be significant concerns around the availability of information or vaccine safety issues with only 8 and 9% respectively.
This finding must not be taken lightly by public health officials. As health care providers we have to ask ourselves a number of questions. Whom has the population lost trust in? Why is this trust broken especially during a pandemic and what can be done to regain trust?
Vaccine hesitancy — a reluctance or refusal to be immunised is still high, especially when we speak of the COVID-19 vaccine. That reluctance is probably due to long-standing mistrust in technical, health and government institutions, and challenges efforts to achieve herd immunity and ultimately return some semblance of normalcy.
Communities question whether their governments, and scientific, technological, and medical institutions, really represent their needs and priorities. Long legacies of mistreatment of marginalised communities further fuel this mistrust. People are still referring to the Tuskegee experiment, and other ethical violations have occurred over the years.
Vaccine hesitancy may be a problem of public mistrust in institutions. For decades, public health, medical, and science and technology policy institutions have ignored and even mistreated our most marginalised communities, and these communities are now understandably sceptical of this intense focus on their vaccination. It seems as if the vaccines are pushed on them and so they are naturally pushing back.
In order to address these feelings of mistrust and alienation, in this pandemic and for future public health and policy initiatives, these institutions need to take the needs and priorities of these communities seriously and make systemic change accordingly.
Similarly, to what was recommended in my last article, communities must be at the center of the COVID-19 response and the vaccination campaign. Governments and public health officials must reason with communities so that all of their questions and concerns are answered, and they feel comfortable taking the vaccines.
There should not be a tale of two worlds -the vaccinated and the unvaccinated. When this is done people become alienated and it widens the trust gap. Those who are hesitant will continue to hold their position.
Public health campaign must swing into full action to provide information and allow people to build trust in the institutions.
They must also feel that the institutions are working with and for them instead of against them. Conspiracy theories must be debunked, and the correct information provided. This can be a difficult task as we race to vaccinate the population to achieve herd immunity, but it may be worthwhile investing in building the trust of communities and slowly increasing vaccine uptake than to get a total push back.