Why more needs to be done

For one full year, the world was praying for an effective vaccine to make an appearance. And incredibly, science delivered not just one, but several excellent options. It would be natural to expect that the world would be tripping over itself in trying to get vaccinated. And indeed, for a large number of people, this is true. There are attempts to cut the line, frustration at finding oneself low down on the list of who is eligible to get the vaccine right now, and impatience at having to wait to get one’s fix.

But there is a significant segment that does not seem enthusiastic. Vaccine hesitancy takes different forms for different people. For some there is a blanket scepticism about any mainstream narrative, and a nagging suspicion that some conspiracy is afoot. For others, it is a more specific distrust of Big Pharma. Then there are those that are naturally cautious anything new and sudden, and need a lot of re-assurance before being able to accept the vaccine. Some have the wrong information about the vaccine, being avid followers of the kind of knowledge most prevalent on WhatsApp. Still others are passive and indifferent, and believe that the vaccine has nothing to do with them.

There is little that can be done to allay the doubts of the hardcore conspiracy theorists, in fact all attempts to do so simply confirm to them that everyone is in on the conspiracy. But the others are worth understanding and acting upon.

Part of the doubt about the vaccine comes from the unprecedented manner in which it has been developed. 2020 was a great advertisement for science as it underlined its continued criticality to the world. But it also gave us a ringside view of exactly how untidy the scientific process is. Guidelines were changed frequently as scientists began to understand the virus and its effects better. Masks were initially through to be useless and then recognised as the single most important instrument in the battle against Covid, miracle drugs were found and subsequently denounced, the directive to be guard against contaminated surfaces led to a frenzy to hand and vegetable washing which was later seen to be an overreaction. Even now a lot of questions remain unanswered.

Usually all this happens inside laboratories and scientific journals and the we, the lay public do not see any of it. We receive a shiny new product which we proceed to use without hesitation. Clearly, today it is easier for people to be more doubtful about the claims of science because they have got a peek inside the kitchen. But the truth is that this is exactly how every scientific development takes place. What matters is that what we have at the end of the process is a rigorously tested, safe and effective vaccine.

The manner in which some vaccines have communicated their progress has also done the effort no favours. AstraZeneca in particular has acted in a way that beggars belief. Time after time, it has scored self-goals and jeopardised the reputation of what otherwise looks like an excellent vaccine. The latest imbroglio around its claimed efficacy of 79%, the public rebuke that it received from US regulators that it was sharing dated information, and against the subsequent clarification that it was actually 76% only 48 hours later is impossible to comprehend.

The Indian experience of the same vaccine has fortunately been smoother. The local partner, charged with the responsibility of manufacturing for large parts of the developed world, has had its share of challenges, but has managed to deliver to the needs of the local market. The roll-out too has been smooth enough, and compared to how its principals have acted, well managed.

The other problem comes from a tendency to privilege personal anecdotal experience over large scale impersonal data. Take the doubt sowed by instances of fully vaccinated people getting infected again. If vaccine efficacy is as high as 95%, even then some people will get sick. Given the large base of those vaccinated, this small number in terms of percentage will translate into a large physical number. However, the emergence of such cases, particularly if they occur in people one knows of, is psychologically difficult to reconcile with the expectation of being protected. It doesn’t help that these instances, along with many stories of sundry side-effects (gain hardly ever serious or unanticipated) get disproportionate play.

Unlike the West, particularly America, where the anti-vaccination segment is a significant one, in India there is no organised attempt to challenge the idea of the vaccine. The problem in India is different- for one, inertia is a big barrier; witness the number of people who are casual about wearing masks correctly or distancing themselves socially. Then there are those that are full of doubts about the efficacy of the vaccine and the possibility of side-effects.

There is a danger in believing that simply getting the vaccine to people is enough. The experience of the Immunisation programme in India is clear about the need to communicate and to persuade those who are hanging back to get themselves vaccinated. Mere information dissemination is not enough; although clear and authoritative communication about the correct scientific picture is important, what is truly needed is a nuanced understanding of the barriers that hold people back and an appropriate framing that converts an information-heavy message into one that is motivating and persuasive.

We have a government at the Centre that is a communication sophisticate. It has an extremely effective communication ecosystem that it uses for its political ends. It is time that this network gets deployed to address a larger national need. In addition, the government needs to mount a large, thoughtfully constructed campaign to ensure that the different psychological barriers to vaccination are addressed. The soaring numbers that we are seeing today will continue to rise unless there is a serious attempt to get everyone vaccinated.



Views expressed above are the author’s own.


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