The development and widespread use of vaccines has revolutionized the situation where the only way to prevent infectious disease is through behavioral changes such as quarantine. Vaccines have made immunization possible and have successfully controlled and eradicated various infectious diseases in many parts of the world. However, even when a vaccine is offered that is “scientifically” effective according to peer-reviewed academic papers, a certain number of people are not vaccinated, and this presents the problem of vaccine hesitancy.
It is estimated that 5-10% of the vaccine hesitant population has a strong aversion to vaccines. Vaccine hesitancy continues to threaten childhood immunization. Public awareness of the importance of childhood immunizations has declined during the COVID-19 pandemic in 52 of the 55 countries studied, warns a new UNICEF report. It is also clear that, even without such explicit intent, a large proportion of the population is reluctant to get vaccinated.
Why Vaccine Hesitancy? It has been pointed out that the reason is not only the risk of contracting infectious diseases from not being vaccinated, but also the lack of herd immunity. Herd immunity means that by immunizing everyone, the risk of infection can be reduced for those in the herd who are not immune, such as those who are highly sensitive or allergic to certain pathogens. A large number of people in a given population acquire immunity against infectious diseases through vaccination, which reduces the rate of infection in the population.
Vaccines are an effective means of acquiring immunity. However, no matter how efficient a vaccine is developed, if the vaccination rate does not exceed a certain number, herd immunity cannot be achieved. While it would be inappropriate to overemphasize herd immunity, its effectiveness can certainly be demonstrated. Therefore, how to increase the vaccination rate of the population is a major public health challenge.
How Does Vaccine Hesitancy Arise?
Vaccine hesitancy is not just mistrust of vaccines or the risk of side effects of vaccines as it is commonly believed, but mistrust of the subject of vaccination propaganda. In other words, people’s mistrust of the medical industry, government, and administration was cited as a reason for their vaccine hesitancy. In fact, no matter how scientifically proven the safety of vaccines by the medical community, governments and executives, no matter how they claim that people’s health damage is not only caused by the side effects of vaccines, it may change people’s perceptions.
Hesitant about some vaccines, but it can’t reduce that to zero. Various approaches to reducing vaccine hesitancy have been pointed out, including education, health literacy, and consideration of individual stress levels. The aforementioned vaccine hesitators, people who hesitate to get vaccinated even without such clear intentions, have no trust in the camps that recommend vaccines: vaccine manufacturers, the medical profession, ministries of health, labor and welfare, and politicians.
Negative Rumors about Vaccinations
Risk Perceptions of Vaccines
Vaccines carry a risk of side effects, and adverse reactions may occur after vaccination. Immunization has the benefit of preventing disease, but it also has adverse reactions and serious side effects (risk). People with underlying medical conditions or immune system disorders (such as allergies) are considered at high risk for vaccination. Therefore, for these individuals, the risks outweigh the benefits of vaccination. Therefore, it is precisely because there may be people who are not immune in society that it is necessary to vaccinate those who are immune to prevent infectious diseases. This is the concept of herd immunity, a fundamental public health mechanism.
But it will be difficult to achieve some form of herd immunity if everyone is considered at risk of being vaccinated. This will increase the risk of infection for those who are physically unable to be vaccinated. Because people have corrected the information that vaccination cannot avoid side effects, they may weigh the benefits of vaccination against the risks and believe that the risks are greater. Even though experts believe that the benefits are greater and the risks are less, some people still try to avoid the risks.
Burden of Vaccination
Rumors and concerns about risks aren’t the only reasons for vaccine hesitancy. Multiple studies have shown that time and cost burdens are the main reasons for vaccine hesitancy. For example, the cost of the nine-valent HPV vaccine in China is relatively high. The cost of one vaccine is about 1,300 yuan, and the total cost is about 4,000 yuan after three shots. It is relatively difficult to make an appointment. For this reason, parents have to adjust their schedules , Take your child to a medical institution for multiple vaccinations.
The cost of the vaccine itself plus the cost of transportation from home to the medical facility, the cost of babysitting if there are other children, and lost income due to absence from work are listed as a financial burden.
Conclusion
Over the past 3 years, the COVID-19 pandemic has demonstrated the efficacy and potential of timely vaccination. But the COVID-19 pandemic has also disrupted health services, created supply chain challenges, and led to a stall, or even rollback, of routine immunization. For example, global coverage of the third dose of the DTP vaccine dropped from 86% in 2019 to 81% in 2021, the lowest level since 2008. Many other routine vaccines have seen similar declines. In 2021, 25 million children will not be immunized against life-saving measles, diphtheria and tetanus vaccines. Eighteen million children have never received any vaccines, and this population is called zero-dose children.
Japanese doctor Kentaro Iwata (Kentaro Iwata) wrote: “Zero risk is only an impossible illusion, the important thing is to provide a vaccine that is safe to some extent, which is more meaningful than the immediate pain”. Disease prevention should be considered not only through vaccines but also through physical examinations. When trust in the medical profession, government, and administration is low, the public will not trust vaccines, no matter how governments recommend them. To address vaccine hesitancy, trust in the medical, political and government communities must be built.
References:
[1] Miwako Hosoda. Vaccine Hesitancy in Japan: From a Perspective on Medical Uncertainty and Trans-Scientific Theory. F1000Res. 2022 Sep 27;11:1103. doi: 10.12688/f1000research.125159.2.
[2] Paul L. Delamater, Erica J. Street, et al. Complexity of the Basic Reproduction Number (R0). Emerg Infect Dis. 2019 Jan; 25(1): 1–4. doi: 10.3201/eid2501.171901.
