As millions of people within high-income countries anxiously await their turn to receive a COVID-19 vaccine, not only will billions of people in low and lower-middle income countries not have access this year, but many that do will opt not to receive the vaccine due to mistrust or misinformation.
Defined as a “delay in acceptance or refusal of vaccines despite availability of vaccination services,” vaccine hesitancy has been reported in more than 90% of countries around the world and can be caused by a range of factors from safety concerns, myths and misconceptions to mistrust in healthcare professionals or the healthcare system.
A rise in misinformation during COVID-19—such as inaccurate health advice as well as disinformation, including deceptive propaganda—has further compounded already-present vaccine hesitancy. For example, as the pandemic surged in Afghanistan—a country whose health system has already been weakened by decades of instability—misinformation circulated among IRC beneficiaries claiming that Muslims were immune to the virus, that closure of madrassas and mosques would further spread COVID-19, and those even suspected of having the virus would be injected with poison in hospital facilities.
This challenge is not unique to COVID-19. During the peak of the Ebola outbreak, communities were largely kept in the dark with minimal access to information about the disease, prevention, or treatment. Coupled with existing mistrust of the government and institutions including the United Nations—misinformation was rampant and allowed the disease to spread further.
A recent poll in six African countries suggests 62% of people would choose to receive a COVID-19 vaccine, which would not be enough for population immunity, while a social media survey found that 79% of participants in Lebanon have hesitancy toward a COVID-19 vaccine. Distrust in government and health officials is one of the primary reasons for this. In places such as Syria, Yemen, and Somalia, a lack of trust in officials has been a particular challenge in disseminating public health information about COVID-19, while within the United States, a December survey found that 40% of Black people are unwilling to get vaccinated due to distrust of the medical system.
Based on the International Rescue Committee’s (IRC) experience and expertise working to combat infectious diseases within conflict and crisis-affected countries, we know that if information is scientifically accurate, but not adapted for local contexts, people are less likely to trust it and may look for answers elsewhere.
As many people will not have wide-spread access to COVID-19 vaccines this year, these months are crucial to begin building trust, engaging communities, and increasing both knowledge and acceptance of the vaccine so that once doses do arrive, a successful rollout can occur.