From the start of the COVID-19 vaccine rollout, experts and doctors emphasized equitable vaccine distribution as the key to ending the pandemic. Unfortunately, aside from having more physical barriers to vaccination, those of lower socioeconomic status are also more hesitant to be vaccinated.
On May 27, Secretary Carlito Galvez reported that 40% of those in classes D and E are unwilling to be vaccinated against COVID-19. Vaccine uptake is much higher among classes A, B, and C. This is concerning, as the poor are at high risk for COVID-19 due to their limited access to healthcare services and living in close quarters.
As local government units (LGUs) expand their vaccination program to the A5 group or indigent population, it’s crucial to understand the root of vaccine hesitancy so that communication strategies can fit to their situations. After all, there’s no simple, one-size-fits-all solution or response to vaccine hesitancy.
Action for Economic Reforms (AER), in partnership with the Healthcare Professionals Alliance Against COVID-19 (HPAAC), organized a focus group discussion towards understanding the reasons behind Filipinos’ vaccine hesitancy. Further, the discussion attempted to address specific concerns of the participants through explanations from doctors. The participants were composed of vaccine-hesitant people, including beneficiaries of the Pantawid Pamilyang Pilipino Program; members of AKTIB, an alliance of community organizations; and senior citizens from Metro Manila and the Visayas.
The main sources of vaccine hesitancy among the group include concerns on side effects, fear due to existing comorbidities, mistrust of the vaccine development process, preference for a certain vaccine brand, and false information circulating in their communities.
Fear of side effects was frequently brought up during the discussion. In exit interviews, frontline government workers were worried about being unable to work due to the fever, chills, and body pains that they heard were common reactions to the vaccine. In no-work, no-pay settings, the poor cannot risk sacrificing a day off to recuperate from vaccine side effects.
Based on the exit interviews conducted, participants responded well to the doctors’ discussions and were now willing to be vaccinated.
What worked in convincing the small group we gathered to get vaccinated?
Ensuring participants’ comfort helped in effectively communicating with the group. The doctors who facilitated the discussion kept the tone casual, engaging, and relatable, as if they were having a one-on-one chismis (gossip) session with participants. This put participants at ease and made them more open. They acknowledged and validated their concerns rather than dismissing them and explained every concern in simple terms. This healthy exchange of ideas and concerns provided a strong foundation of trust.
The results from the roundtable discussion showed that having empathy and trust, not using force nor shaming, is what encourages vaccination.
Clearly, our President could stand to practice this empathy and compassion. In a public address last week, he threatened to jail those who refuse to be vaccinated. Forcing people into being vaccinated only heightens their mistrust of authority, which contributes to vaccine hesitancy.
However, while it’s easy to tell people to “listen to the science,” we have to accept that, often, it’s not science that bears greater weight when people make decisions. Even after attending the roundtable discussion in which doctors lengthily explained the vaccine development process, one participant (who was otherwise still willing to be vaccinated) still had questions on its long-term effects due to the perception of a rushed vaccine process. “Sabi ng kaibigan ko, hindi sapat ang studies, seven years dapat ‘yung paggawa ng vaccine, ‘e ito one year lang.” (My friend said, the studies are insufficient; making a vaccine takes seven years, but here, it took only one year to produce the vaccine.)
Gossip and personal experiences often prove to be more potent than scientific studies in convincing people. This is understandable, as personal stories from friends appeal to their emotions, triggering a response that’s hard to calm by citing evidence from trials.
Studies show that one of the most effective ways to combat vaccine hesitancy is to highlight the personal benefits of vaccination. But from our discussion, the message people said stuck with them was the emphasis on the collective benefits from vaccination — how getting vaccinated against COVID-19 can protect the larger community from COVID-19 and help in reopening the economy.
As the government continues the vaccine rollout, we hope that more people are also able to utilize the power of a simple conversation in convincing those around them to get vaccinated. Sharing links to videos on how vaccines are developed or pronouncements from government authorities can often work but may not be as direct or effective as sitting down with people and having an open, respectful, validating conversation to discuss their specific concerns. More than this, community discussions and information campaigns are crucial especially for those who do not have access to the internet. The government needs to listen to the communities to learn the information being spread so they can immediately correct misinformation.
Responsible reporting from the media on vaccine side effects and effectiveness is still crucial, and the Department of Health’s initiative of setting up KIRA (Katuwang na Impormasyon para sa Responsableng Aksyon), a chatbot on Facebook Messenger built to address questions about COVID-19, is worth lauding.
But the problem of vaccine hesitancy is more than just a knowledge gap that can be solved with information drives; it is a complex issue that requires empathy and pakikipagkapwa-tao (humanitarianism).