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| COMMENTARY |
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| Year : 2021 | Volume
: 65
| Issue : 2 | Page : 206-208 |
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COVID-19 vaccination and the power of rumors: Why we must “Tune in”
Rajib Dasgupta1, Pallavi Mishra2, Kavita Yadav3
1 Chairperson, Co-Investigator, UKRI-GCRF - One Health Poultry Hub; Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
2 Post-Doctoral Research Associate, Co-Investigator, UKRI-GCRF - One Health Poultry Hub; Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
3 Research Associate, Co-Investigator, UKRI-GCRF - One Health Poultry Hub; Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
| Date of Submission | 02-Feb-2021 |
| Date of Decision | 19-Mar-2021 |
| Date of Acceptance | 09-May-2021 |
| Date of Web Publication | 14-Jun-2021 |
Correspondence Address:
Rajib Dasgupta
UKRI-GCRF- One Health Poultry Hub, Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijph.IJPH_89_21
 Abstract | | |
Rumors have significantly affected immunization campaigns in the past. The ongoing COVID-19 vaccination program in India needs to frame public communication messages both to promote vaccine demand and update as well as counter COVID-related rumors. COVID-related rumors have had wide-ranging effects in the country, from stigmatization of health workers to a crash of prices in the poultry sector. Appropriate communication strategies are critical for tracking, negotiating, and shaping perceptions around the vaccines and the program. Issues that will shape perceptions around the vaccines include product development, prioritization strategies, program rollout activities, and adverse effects following immunization and adverse effects of special interest.
Keywords: Covid-19 vaccination, rumors, vaccine hesitancy and confidence
How to cite this article:
Dasgupta R, Mishra P, Yadav K. COVID-19 vaccination and the power of rumors: Why we must “Tune in”. Indian J Public Health 2021;65:206-8 |
How to cite this URL:
Dasgupta R, Mishra P, Yadav K. COVID-19 vaccination and the power of rumors: Why we must “Tune in”. Indian J Public Health [serial online] 2021 [cited 2023 Mar 26];65:206-8. Available from: https://www.ijph.in/text.asp?2021/65/2/206/318369 |
| Introduction | |  |
The COVID-19 pandemic witnessed the simultaneous rise of an infodemic, described as “an overabundance of information – some accurate and some not – that makes it hard for people to find trustworthy sources and reliable guidance when they need it.[1] Health misinformation on social media that the World Economic Forum cautioned as “digital wildfires"[2] packs a compelling power of narrative with demonstrable effects on public health processes and outcomes such as amplifying controversy about vaccines.[3] Rumors spread in “uncertain and ambiguous environments” that make the process of decision-making such as vaccine acceptance, difficult.[4] In that environment, when news media also fail to provide “coherent explanation” to rumors, people construct their own explanation and justification with the help of information available to them.[4] Rumors can mask themselves as credible prevention and control strategies and have potentially serious implications if prioritized over evidence-based guidelines, particularly in the context of India's ongoing COVID-19 vaccination efforts.
The UN secretary-general considered COVID-19-related rumors a global enemy.[5] An interdisciplinary global social media analysis reviewed 2311 COVID-19 infodemic-related reports in 25 languages from 87 countries and classified 89% (of the reports) as rumors.[6] The first wave was identified as early as January 21 and lasted till February 13, 2020. The poultry sector in India began to be affected by rumors during the second wave (February 14 to March 7) and more severely during the third wave (March 8 to March 31). This commentary provides a thumbnail view of rumors in the context of the COVID-19 situation in general and the ongoing vaccination program in specific. It draws upon key examples from national and international experiences to underscore the relevance of this vital element for vaccine confidence and hesitancy.
| COVID-19 Rumors in India | | |
The content of rumors can vary from gossip to advance propaganda and marketing material[7] and has the power to influence public opinion and financial markets.[8],[9] In February, many misleading posts over social media went viral, giving a false impression that “humans can contract corona through chicken."[10] Messages and videos pertaining to poultry consumption were presented as warnings from the Ministry of Health and UNICEF. The Ministry of Health and Family Welfare, Department of Animal Husbandry and Dairying and the Food Safety and Standards Authority of India issued denials only as late as mid-March.[11] Health workers had to face the wrath of people on account of rumors alleging the smuggling of human organs in the name COVID-19 diagnosis.[12]
Social resistance to the polio eradication program in some of the most endemic parts of India has been marked by rumors. A recent review of human papilloma vaccination programs noted that acceptance on account of rumors related to vaccine safety in the majority of developed countries remain unsatisfactory. A review of rumors in the context of H1N1 and SARS epidemics that public health officials faced substantial challenges in negotiating a multitude of diverse of rumors, that ought to be understood as “complex situations” rather than a “simple case of failures in communication, to be rectified by the provision of more accurate information."[13],[14]
| Comprehending Vaccine Confidence and Hesitancy | | |
The Vaccine Hesitancy Strategic Advisory Group of Experts on Immunization Working Group defined vaccine hesitancy as a behavioral phenomenon that is vaccine and context-specific and measured against an expectation of reaching a specific vaccination coverage goal, given that immunization services are available. They also recognized that demand and hesitancy are not completely congruent and that an individual or a community may fully accept vaccination without hesitancy but may not demand a specific vaccine.[15] The WHO EURO Vaccine Communications Working Group proposed the 3C's model to unravel the layered challenges: complacency, confidence, and convenience. Vaccine confidence encompasses trust in the effectiveness and safety of the vaccine; the system that delivers, including reliability and competence of the health services and professionals, and the perceived motivations of policy-makers making decisions on the vaccine. Vaccination complacency exists where perceived risks of the disease in question are low, and vaccination is not deemed a necessary preventive action. Vaccination convenience is a significant factor that entails physical availability, affordability, and willingness-to-pay (for those who would not be eligible for or would not like to avail of the government program) for the vaccine as well as the ability to understand (language and health literacy) and appeal of the vaccine and the real or perceived quality of service.[15]
| What are the Messages for the COVID-19 Vaccination Program? | | |
A survey in India of approximately 11,000 respondents revealed that 53% were unsure about taking the COVID-19 vaccine.[16] Another citizen-survey platform in Delhi found that about 69% of respondents saw no urgent need to get immunized and noted that key reasons for hesitancy included limited information about side-effects, efficacy levels, and perceived high immunity levels.[17] This resonates with a global survey (in collaboration with the World Economic Forum) conducted in October 2020 of more than 18,000 adults from 15 countries that reported confidence being down by 4 points compared to the previous round in August 2020.[18] Vaccination intent declined in 10 of the 15 countries, most of all in China, Australia, Spain, and Brazil. Globally, 10% reported that they were against vaccines in general, including 14% in India and South Africa. Other key reasons included perceptions that the vaccine will not be effective (up to a sixth of the respondents in Germany) and that the risk of their getting COVID is low (up to a fifth of all respondents in China and Australia).
An estimated 10% of the target population in the country was vaccinated by end-March (in 2½ months since the launch) implying that the remaining 90% need to be covered in the remaining 4 months to complete the target by end-July. With rumors circulating about the efficacy of COVID-19 vaccine within a fortnight of the launch, the central government had to issue advisory to the states check the spread of such misinformation and take penal action against those found to be involved.[19]
Rumors and vaccine hesitancy perceptions can act synergistically to shape demand, vaccine confidence, and vaccine hesitancy. In view of the fact that it is a new disease against which several candidate vaccines are being developed and licensed in a fast-tracked manner communication strategies, communication messages shall need to address four key themes: (i) product development, (ii) prioritization strategies, (iii) program rollout activities, and (iv) adverse events following immunization and adverse events of special interest.
Conventional health information messages with corrective information have shown mixed efficacy.[20] While contemporary analyses focus on Twitter and Facebook data, popular key platforms such as Telegram, WeChat, Tumbir, Reddit, and Pinterest remain understudied. It is equally critical to use techniques such as computer-assisted visual analysis to focus on nontextual content, including images, memes, and videos on platforms such as Instagram and YouTube.[21] Chou et al. outline a five-pronged strategy to disengage individual communities from health information seeking, avoid health care or making decisions detrimental to their health:
- Enhancing surveillance on understudied platforms; visual content; spatial/temporal/network/cross-platform dynamics of misinformation sharing
- Understanding psychological drivers of emotions (e.g. fear, anxiety); identity; cognitive biases (e.g. confirmation bias)
- Assessing real-world consequences: health behaviors/outcomes; attitudes (apathy, confusion, mistrust); decision-making
- Focusing on vulnerable populations: minorities; marginalized; and
- Developing effective responses: standards for determining when/how to best respond; innovative approaches to penetrating silos; health/science/media literacy initiatives; policy measures.
Early on in the pandemic, it was recognized that human behavior will be critical in shaping its course, and behavioral interventions of individuals and groups will have a significant roles to play.[22] Insights from behavioral and social sciences shall be equally crucial for vaccine confidence and acceptance – the goal ought to be unpacking and understanding fears and concerns around these (new) vaccines introduced in the program through emergency authorization. Risk communication for the vaccination program thus requires instituting a two-way process to capture people's “voices,” promote dialogue and build a relationship with diverse publics to build trust.[23],[24]
| Way Forward | | |
The immunization program in India has matured over the last couple of decades and demonstrated considerable resilience. Program strategies dealing with vaccine hesitancy and social resistance based on experiences of the pulse polio and measles-rubella campaigns may not prove to be sufficient for COVID-19 vaccines that encompass both vaccine optimism and vaccine scepticism. Risk communication and community engagement strategies need to account for both psychological responses and social contexts under which misinformation spreads. This shall entail not only working at individual, community, and systems levels but also developing an understanding of how epistemic and ideological beliefs act as obstacles to accepting scientific evidence. The responsibility at the systems level lies in being able to amend the information ecosystem to reduce selective exposure and opinion polarization. This calls for on the one hand, an interdisciplinary team of social scientists, psychologists, computer scientists, and public health professionals and on the other, an “IT war room” to be in constant engagement with industries and internet consumers – during and beyond the campaign.
Financial support and sponsorship
This study was financially supported by UK Research and Innovation (UKRI) Global Challenges Research Fund (GCRF) One Health Poultry Hub (grant BB/SO11269/1.
Conflicts of interest
There are no conflicts of interest.
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