vaccines

Combatting Vaccine Hesitancy by ‘Tackling Disinformation at Its Root’

In the Fall 2021 course How to License a Vaccine, SPH students explored the complex causes and challenges of vaccine hesitancy in Africa. They detailed their findings, as well as strategies to increase vaccine uptake, in a new paper.

Developed at an unprecedented speed, COVID-19 vaccines have substantially decreased the impact of the coronavirus over the course of the pandemic, likely preventing more than one million deaths as of November 2021—and that’s just in the United States.

Despite the record production, safety, and efficacy of the vaccines, a sizable portion of the global population remains reluctant to get the shots. In particular, low- and middle-income countries that initially struggled to acquire ample supply of vaccines amid widespread inequities in vaccine access and distribution are grappling with large segments of their populations that are hesitant to receive available vaccines. From safety concerns to mistrust of the healthcare system, the reasons for vaccine hesitancy are complex and multi-faceted.

To better understand these complexities and root causes of vaccine hesitancy, School of Public Health students researched this topic and presented their findings during a mini symposium in the course How to License a New Vaccine (GH801) last semester. Taught by Christopher Gill, associate professor of global health, the course explores how to increase supply, access, and utilization of vaccines across Africa, and the fall 2021 class naturally focused on COVID-19 vaccines.

“This course was based on my prior experience leading a vaccine clinical development team in industry, and it touches on many of the fascinating aspects of vaccinology and clinical development that was my world during my three years at Novartis Vaccines and Diagnostics, now GSK,” says Gill, who is also an infectious disease specialist. “While vaccine hesitancy is distinct from the process of vaccine licensure, hesitancy was front and center in terms of its relevance to vaccine use post-licensure.”

Following the symposium, several students in the class captured their research in a comprehensive paper that sheds light into the origins and root causes of COVID-19 vaccine hesitancy in Africa, including cultural and religious norms, mistrust of the healthcare system, personal safety fears, and misinformation on social media. It proposes sustainable strategies and interventions that can increase vaccine uptake across the continent, where only 11 percent of the population is vaccinated.

The students who authored the paper—several of whom graduated from SPH last December and are now alums—include alums Madolyn Dauphinais (SPH’22), Michael Olaseni Bamgbose (SPH’22), and Kelsey Flannery (SPH’22), and MPH students Deena Afana, Josh Harvey, Andy Hui, Taylor Paiva, Elena Stratis, and Maria Tjilos.

“As we continue battling the COVID-19 pandemic, it is crucial to affirm the feelings and experiences of those who feel hesitant, rather than impose judgment,” the authors write in the paper. “There are many reasons why individuals may be hesitant—our priority is not to judge, but to listen.”

They caution against making broad conclusions about hesitancy in African countries, as each country has unique challenges and cultural differences.

“Africa is a vast continent, and no sweeping generalizations or recommendations can be made that will fully address the needs of all its countries and republics,” they write. “However, by tackling vaccine disinformation at its root, there is hope that pro-vaccine sentiments will be able to spread and promote public health knowledge for millions.”

“This experience was incredibly eye-opening,” says Madolyn Dauphinais, who completed the MPH program last semester with a certificate in environmental health and works as a research assistant in the Department of Medicine at Boston Medical Center. “Many of my classmates and I hadn’t realized the legitimacy of vaccine hesitancy in Africa until we took on this task. Because vaccine hesitancy in Africa evolved in such a different way than what we’re experiencing in the US, resolving these fears requires a completely different approach.”

Reducing vaccine hesitancy is especially difficult to achieve considering the vastness of Africa, along with the many cultural differences spanning across the continent, Dauphinais says.

“I hope that, moving forward, public health entities can restructure their frameworks in a way that rebuilds trust and encourages vaccinations, coming from a place of understanding rather than paternalism.”

To read the full paper, click here.