Managing the rollout: On addressing vaccine hesitancy

The government must investigate and publicise the reasons for vaccine hesitancy

Nearly a fortnight after it won approval for Covaxin under ‘restricted emergency use’ conditions, Bharat Biotech has formally informed, via its website, that the vaccine is inadvisable in those with a history of allergies, fever and bleeding disorders. Those on medication or blood thinners and whose immunity has been compromised have also been told not to take the vaccine. This is along with a recommendation that the vaccine is not to be given to the pregnant or the lactating. A similar set of restrictions has been given to prospective recipients of Covishield too, the vaccine now available in greater numbers and developed by the Serum Institute of India. Ordinarily, a fact sheet as well as product insert — a note that accompanies every vial of a vaccine — is a mandatory formality. However, the context in which the two vaccines are being administered in India imbues them with magnified significance. Covaxin has been rolled out with insufficient evidence of its efficacy, or whether it is actually protective. The vaccines have been so far made available to health-care and sanitation workers and other frontline staff, who do not have a choice in the vaccine being administered, but can decide not to be inoculated. Nine States, according to data provided by the Health Ministry, have rates of over 70%, and three States, less than 40%. More than half the States fall somewhere in the middle. While India has given jabs to nearly 786,000 of those eligible, it is far short of the target of 1.4 million.

It is certainly early days, and presumably there will be acceleration in the days ahead. However, the government is yet to explain, based on feedback from the States, why the vaccine — the single most awaited product of 2021 — has not seen more enthusiastic queues. This, in spite of Health Ministry officials underlining that adverse events following vaccination have been negligibly low, accentuating the safety of the product. Hospitals have begun internal campaigns exhorting senior doctors to get a shot to “build confidence” and officials in the highest government offices say that not opting for a vaccine, when one is available, amounts to dereliction “in duty”. The adoption trend is unsurprising. The medically literate, as many recipients are, realise the difference between a vaccine being ‘safe’ and ‘efficacious’. Moreover, the declining trend in new cases as well as the knowledge that an array of vaccines will be available in the months ahead further contribute to the temporary ‘hesitancy’ pervading hospitals now. A way forward for the government to inspire confidence is to monitor, report and be forthright with the challenges it is facing. There should also be greater coordination between the Centre and the States on sharing, investigating and publicising reasons for hesitancy.

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