By Lan Li, on 14 March 2023
The COVID-19 pandemic has posed major challenges to public health systems across the world. Meanwhile, vaccination has been developed and delivered at record speed, while its application has been limited by vaccine hesitancy, which refers to “a delay in acceptance or refusal of vaccination despite the availability of vaccination services”, defined by the World Health Organization (WHO) strategic advisory group of experts (WHO SAGE). This can be due to various reasons at various levels, such as misinformation, lack of trust in the healthcare system, or personal beliefs and values. It is a complex problem, resulting in challenges in understanding and designing targeted interventions to solve it.
A venue for all
The 16th Vaccine Congress held in Italy aimed to address vaccine-related issues and to build health system resilience by discussing the latest advancements in vaccine research, development and implementation. The congress brought together leading experts from the fields of vaccinology, public health, medicine, epidemiology, and social sciences, who discussed the challenges posed by vaccine development, vaccine delivery and vaccine hesitancy and ways to overcome them.
As one of the early career researchers in vaccine hesitancy, it is a great opportunity for me to discuss this issue with researchers from other backgrounds and understand the hesitancy problem through a broader lens. During the conference, our discussions centred around the importance of promoting accurate information about vaccines, improving communication between healthcare providers and the public, and increasing public trust in the healthcare system. In addition, we also discussed whether vaccination is actually safe and what kind of vaccination is safer. Admittedly, these questions were hard to answer and the only reliable evidence is the data from RCTs (in short term). However, it opens a new way for understanding the vaccine hesitancy problem – the vaccine itself has created the ideal conditions for mistrust to thrive, due to its complexity and variability of development and evaluation. To solve this problem, more collaboration is needed between experts from vaccine R&D, health education, behaviour science and more.
The role of social media
One of the most-impressed presentations was “addressing vaccine hesitancy: integrating the Vaccine Trust Gauge and effective communication to advance confidence and uptake”, given by Prof Scott Ratzan, from CUNY School of Public Health and Health Policy. His speech highlighted the role of media in shaping public perception of vaccines and emphasized the need for health organizations to engage with the public and correct misinformation about vaccines on mass media and social media. In particular, social media platforms have become a major source of information for many people, and the spread of false information about vaccines on these platforms can lead to confusion and fear. In turn, this can lead to lower vaccine uptake and increase the risk of outbreaks of vaccine-preventable diseases.
However, the role of social media in shaping public perception of vaccines is crucial, and it is essential for health organizations to engage with the public on these platforms. Health organizations can use social media to correct misinformation about vaccines, provide accurate information, and address the concerns of the public, which is the way to build public trust and increase vaccine uptake. It can also be used to promote positive stories and experiences of people who have been vaccinated. By using social media in a proactive and strategic way, health organizations can counter the spread of misinformation about vaccines and help to increase public understanding of the importance of vaccination.
Admittedly, it is also important to note that social media can also be used to spread false information and to promote anti-vaccine messages. Health organizations must be vigilant in monitoring social media and must take action to counter false information and misinformation. They can do this by partnering with trusted sources, such as public health organizations and scientific institutions, to provide accurate information about vaccines.
Challenges at community-level
Another key area of discussion was the importance of involving communities in the decision-making process about vaccines. In the second day of the conference, a roundtable discussion was held to make the statement on multisectoral actions for building trust to promote vaccine acceptance. I was fortunately involved in the discussion and shared my opinions. The discussion emphasized the need for health organizations to listen to the concerns of the public, provide clear and concise information about vaccines, and involve communities in the planning and implementation of vaccine programs. The challenges for addressing vaccine hesitancy at the community level includes:
- Misinformation and distrust: The spread of misinformation and false information about vaccines can lead to confusion and distrust among the public. This can be particularly challenging for health organizations, as people are often exposed to a large amount of information from a variety of sources, including social media, friends, and family.
- Personal beliefs and values: individuals may have personal beliefs or values that conflict with getting vaccinated. For example, they may believe that vaccines are unnatural or harmful, or that they are not necessary.
- Lack of access to accurate information: communities may not have access to accurate information about vaccines, or may not understand the benefits of vaccination. This can lead to misunderstandings and reluctance to get vaccinated.
- Healthcare provider distrust: individuals may not trust healthcare providers or the healthcare system, which can make them reluctant to get vaccinated.
- Barriers to accessing vaccines: communities may face barriers to accessing vaccines, such as poverty, lack of transportation, or limited access to healthcare.
- Resistance to change: individuals may resist getting vaccinated because they have always lived a certain way and are resistant to changing their habits or beliefs.
To address these challenges, several discussions were made between experts from different background, including researcher, healthcare workers, vaccine company staff, community workers and the public. They provided many insightful strategies to solve this problem. A statement paper proposed the framework for engaging multiple sectors for building vaccine trust was under preparation and will be published following the conference.
The congress also discussed the importance of providing equitable access to vaccines, particularly for marginalized communities. The speakers emphasized the need to address the root causes of vaccine hesitancy, such as poverty, lack of education, and poor access to healthcare, in order to ensure that everyone has access to vaccines.
Strengthen health system resilience
The congress also highlighted the importance of building a strong health system in order to improve vaccine uptake. The speakers discussed the need for investment in health systems to increase access to vaccines, improve the quality of care, and ensure that health systems are prepared to respond to the next public health crisis. It provided a new way for me to reconsider the role of my research in the health system and DRR.
Firstly, vaccine hesitancy can have a significant impact on the health system, both in terms of public health outcomes and healthcare costs. When individuals are reluctant or refuse to get vaccinated, it can lead to outbreaks of vaccine-preventable diseases, which can put vulnerable populations, such as the elderly, young children, and individuals with weakened immune systems, at risk. Outbreaks of vaccine-preventable diseases can also put a strain on the healthcare system, as more resources are needed to diagnose and treat cases and to control the spread of the disease. Secondly, vaccine hesitancy can lead to increased healthcare costs, as individuals who are not vaccinated are more likely to require medical care, including hospitalization, for vaccine-preventable diseases. This can put a strain on healthcare budgets, particularly in resource-limited settings, and can divert resources away from other important healthcare needs. In addition to the impact on public health and healthcare costs, vaccine hesitancy can also undermine efforts to achieve herd immunity, which is critical for controlling the spread of vaccine-preventable diseases.
Overall, attending the 16th Vaccine Congress was a valuable and enriching experience for me as a PhD student. It provided a valuable opportunity to deepen my understanding of the current challenges and strategies for addressing vaccine hesitancy. During the conference, I had the opportunity to listen to leading experts in the field, and to engage in discussions with other researchers, healthcare professionals, and policymakers. This helped me to gain a comprehensive understanding of the current state of knowledge on vaccine hesitancy, and to identify areas for future research and inquiry, and enhance my own PhD project. I am grateful for the opportunity to attend this important event, and I look forward to continuing to engage with others in the field to advance our understanding of this important issue.
I would like to gratefully acknowledge the China Scholarship Council and University College London for funding my PhD study and the UCL Institute for Risk and Disaster Reduction for funding the expenses for me to attend the 16th Vaccine Congress in Italy. I would like to appreciate my supervisors Prof Patty Kostkova and Dr Caroline Wood for providing guidance to support my PhD research.
Lan Li is a PhD student at IRDR dPHE. Her research topic is integrating behavioural science into digital intervention to increase vaccine confidence. She is interested in social media research, digital public health, and vaccine hesitancy studies.