Omicron spread and vaccine hesitancy in India: Only around 44% Indians are fully vaccinated. To get more jabbed, governments need to go local
Even as experts are diving deep into understanding Omicron, the most potent tool available in our arsenal is vaccination and anything we can do to accelerate universal vaccination will go a long way in blunting the impact of the new variant and variants to come. Twelve months in, Covid-19 vaccines appear to be safe, efficacious and, at least in India, accessible.
According to Our World in Data, by the end of 2021, close to 1.5 billion doses of Covid-19 vaccine were administered and about 61% of the population had received at least one dose of the vaccine in India. To put it in context, the US had administered a little over 500 million doses. And GoI has expanded the Covid vaccination programme to include teenagers 15-18 years old and will be adding 'precautionary' doses for health workers and citizens aged more than 60 years on January 10.
But more critical is the datum that only 44% have been fully vaccinated, still leaving hundreds of millions exposed to potential infection. It is here that more aggressive efforts are warranted. In our prior work, we identified the five Cs of vaccine hesitancy: Confidence, Complacency, Convenience, Communications and Context. If India is to move towards more widespread vaccination, all these drivers of vaccine hesitancy must be addressed. Simultaneously!
Line up the neighbourhood influencers
Efforts are being made in India to tackle the 5Cs. When political leaders, celebrities and influentials advocate vaccines and take them in public, the actions contribute to fostering confidence, and the perception that vaccination is protective and normative, not an exception. While the role of national leaders and celebrities is critical, it is more important to engage local leaders in communities and neighbourhoods who are culturally, geographically and demographically proximal to building confidence in Covid-19 vaccines. As an example, The Aspirational Districts Collaborative (ADC), an initiative of Niti Aayog and NGOs, identified and engaged community influencers – Panchayati Raj Institution (PRI) members, faith/religious leaders, and tribal chiefs - who took the lead in dispelling vaccine myths and misconceptions at gram sabhas, community religious and festival gatherings and set an example for community members by getting vaccinated themselves, thereby building confidence. In Nuh, a district in Haryana, the district administration, local NGOs, and leaders of faithbased organisations took the lead, making announcements at community gatherings, during prayer meetings and through community radios, organising vaccination camps and urging families to take the vaccine.
Fight complacency: One dose isn't enough
The fact that a large number of people have received only one dose of the vaccine speaks to prevailing complacency among the people. Resumption of activities such as return to offices, shopping or travel has generated a false sense that the danger has passed. The sense that one is immune if others are vaccinated needs to be addressed.
Vaccine equity, ensuring that people have access to vaccines irrespective of their class or caste or place is central to addressing low vaccination rates. Programmes such as Har Ghar Dastak, reaching out to people where they are, not only make vaccines accessible but allow for directly addressing complacency, convenience and hesitancy. Communication remains central to addressing vaccine hesitancy. Our studies have shown that feeling that one is not vulnerable or, at least unlikely to get seriously sick, may contribute to complacency. Effectively communicating the risk of Covid-19 for both oneself and one's family will weaken complacency and promote urgency.
Misinformation too is a culprit
Inaccurate and provably false myths such as that vaccines are not safe, have ingredients that are religiously proscribed, affect one's fertility, implant chips in one's body, continue to persist despite being repeatedly debunked. There are effective strategies to debunk them. Scare tactics or shaming do not necessarily work. Strategic communications that are positive, aspirational, that focus on one's close family and friends are more likely to be effective.
Social media platforms contribute to the amplification of misinformation and must be more aggressive and proactive in making it difficult to spread such information. They bear the onus of stemming misinformation.
India has done it before. Despite misinformation about polio vaccines, extensive campaigning and communication through the Pulse Polio Initiative (launched in 1995) helped India achieve a polio-free status, with no reported cases since January 2011. For over 40 years now, India has been providing free vaccines against vaccine-preventable diseases, and childhood vaccination rates have continued to rise. If we can tap into this rich history of successes, work with enterprising NGOs and dedicated healthcare workers, and draw on communication science, India can blunt the impact of the Omicron variant and her people can get closer to resuming a sense of 'normal' life.
(The writers are Dr. Swati Piramal, Ramya Pinnamaneni, K Viswanath; views are personal)
This article was first published on 05 January 2022, on The Times of India