• Reaching out to those in Sri Lanka’s anti-vaxx or vaccine-hesitant community

BY Sumudu Chamara The challenges the ongoing vaccination programme faces are not limited to the scarcity of doses and issues pertaining to the effectiveness of the vaccines, as predicted before. As the vaccination programme improves and expands, newer issues, such as misinformation and misconceptions, can be seen to emerge, and these issues call for innovative solutions. The spread of misinformation and misconceptions about the vaccination programme, or vaccines, is gradually becoming a bigger issue that has the potential to affect the vaccination programme, and according to foreign media outlets, it is an issue that has affected many countries. Alarmingly, Sri Lanka’s vaccination drive too seems to be getting negatively impacted by these issues, and health authorities too have acknowledged it. Young people and misconceptions The Government has announced its plans to complete the vaccination drive for those between the ages of 20 and 30 years before the end of next month. However, according to the health authorities, they are facing challenges due to young people’s belief in misinformation about Covid-19 vaccines in general as well as certain types of vaccines. However, Sri Lanka’s health authorities have debunked most such misconceptions. Speaking on the widespread belief that entry to certain countries, especially western countries, would be granted or declined on the basis of the type of vaccine one has got, the Health Ministry recently stated that no country has banned entry on such grounds. This was stated by Health Ministry Communications Director, Public Health Services Deputy Director General (DDG), and the Disaster Preparedness and Response Division Head Dr. Hemantha Herath, who discussed the misconceptions widely associated with the German-US-made Pfizer-BioNTech Covid-19 vaccine, which some believe is the only type of vaccine western countries recognise and consider to be effective when granting entry to those countries.  However, this appears not to be the only belief that compels young people to be selective when getting vaccinated against Covid-19. During the past few months, especially after the vaccine became available to the public, social media users were exposed to an idea that the Pfizer-BioNTech vaccine is more effective against Covid-19 than other types of vaccines, especially China-made vaccines.   According to the official websites of foreign countries’ immigration and emigration departments, the type of vaccine affects quarantine and polymerase chain reaction (PCR) tests and rapid antigen tests (RATs)-related requirements, and not entry. The authorities spoke about this concern as well. Production, Supply, and Regulation of Pharmaceuticals State Minister Prof. Channa Jayasumana had earlier stated that the type of Covid-19 vaccine given to young people should not be an issue.  He explained: “There is no problem with the type of Covid-19 vaccines given to young people. Especially through international studies, it is shown that young people get better immunity through the vaccines given against Covid-19 regardless of the type of vaccines. Be it the Chinese Sinopharm or Pfizer-BioNTech vaccine, most probably, there is no considerable difference in the immunity achieved when it comes to young people.” Moreover, Dr. Herath’s comments come in a context where Prof. Jayasumana had also claimed that the young population in certain areas show reluctance to get the Covid-19 vaccine due to rumours circulated on social media platforms that the vaccine can result in impotence and sub-fertility, stressing that there is no truth in these claims. He added that these claims, which he referred to as misconceptions, had led to a decrease in the number of young people getting vaccinated in certain areas. Prof. Jayasumana further said that the authorities have looked into these misconceptions, and have concluded that they are not accurate. Meanwhile, when The Morning queried about the same from Royal Free Hospital, London, UK, Consultant in Clinical Immunology and Allergy Prof. Suranjith L. Seneviratne, recently, he also noted that there is no evidence to suggest that the Covid-19 vaccine could cause impotence, nor has any evidence been found to suggest that the Covid-19 vaccines could have an adverse effect on fertility. However, according to Prof. Seneviratne, in the event a person develops “Long Covid-19 (signs and symptoms that last for longer than four weeks after contracting Covid-19)”, they could be more likely to suffer from impotence.   He further stated that individuals do not need to avoid getting pregnant after being vaccinated against Covid-19. Furthermore, the World Health Organisation (WHO) too has rejected claims about Covid-19 vaccines causing impotence and infertility.  Debunking myths  Although the authorities have discussed the above-mentioned misconceptions, there are more, such as vaccines kill more people than Covid-19, vaccines include magnetic microchips, vaccines include substances that have not been revealed to the world, severe side effects of the vaccines could result after a few years, the chances of recovering from Covid-19 with no medication or vaccine is 99.9%, using various other medicines can protect against Covid-19, booster shots are necessary to protect against Covid-19, and masks are not as effective as doctors claim. Such misconceptions circulated widely on social media platforms and are yet to be addressed.  Further, some media reports claim that there are similar widely accepted misconceptions among parents as well.  However, experts say that young people are more vulnerable to these claims, as their use of social media is significantly higher than those in other age groups, and that the younger generations are more likely to be hesitant to get vaccinated, to a degree, due to the perception that they are at a lower risk of experiencing severe complications from Covid-19. According to researchers and medical experts from the public health research and consulting firm John Snow, Inc. (JSI), when delivering accurate and positive messages regarding vaccination (online or offline), health practitioners’ attention should be paid to focusing on vaccine acceptance instead of vaccine hesitancy, dispelling misinformation about vaccines, using testimonials and personal stories to compel others to get vaccinated, and putting potential side effects in context. To address this issue, which has been reported from England, among other countries, the Local Government Association, England’s national membership body for local authorities, suggested a few steps (behavioural insights) to encourage younger generations to get vaccinated. The Association noted that highlighting social norms about vaccination such as that there are growing intentions to get vaccinated, that most people are getting vaccinated, and that they approve of getting vaccinated, can effectively encourage vaccination among young people. According to researchers, because of young persons’ tendency to be more susceptible to peer influence, it is likely that social norms can be particularly effective when targeting this group. Moreover, highlighting the social benefits of vaccination with a focus on the importance of achieving herd immunity and protecting others, especially vulnerable groups and those that cannot get vaccinated, is recommended. Spreading awareness about the long-term health consequences of Covid-19 is another recommendation by the Local Government Association, owing to young people being more likely to get vaccinated if they believe that Covid-19 is serious and if they believe that they are at a risk of contracting it. Highlighting the potential long-term consequences of the illness is important because young people are less at risk of developing severe complications. Addressing physical and/or logistical barriers to vaccination is also recommended to encourage the people to get vaccinated, and with regard to young people, setting up vaccination centres in locations that are convenient for young people such as near schools, universities, and areas with young demographics is recommended. The Local Government Association also suggested motivating young people through financial incentives, which researchers have identified to be effective, even when it comes to those that perceive the risks of infection as low, especially young people.  As far as offering financial incentives are concerned, researchers, however, opine that such incentives are more acceptable if given as vouchers rather than cash, smaller values rather than large sums, and certain rewards as opposed to lotteries. However, they also noted that this measure should be adopted carefully, as “financial incentives can undermine people’s intrinsic motivation to get vaccinated, and could be perceived as a confirmation that the vaccination is risky or undesirable”. Due to the behavioural pattern that people are influenced by the person that delivers the message i.e. to get vaccinated, it also recommended using “soft messengers” (figures that are influential because they are perceived as similar, relatable, and trustworthy). Getting the support of social media influencers, especially those in the same age group as the target population, is recommended as one way of doing so. Social media and communication Young people expressing reluctance to get vaccinated despite being eligible has been observed in many parts of the world, and despite age, it has been identified that raising awareness is the key to addressing this issue.  However, according to several researchers who have studied the global situation in this regard, when considering awareness among young people, as highlighted above, social media plays a special role, as it is a platform which exposes young people to both accurate and inaccurate information alike and misconceptions, and is also a tool that can be used to address those effectively. Several countries have, in this context, started looking into using social media to raise awareness, debunk misconceptions, and discuss concerns young people have. This year, social media platforms YouTube, Snapchat, Reddit, and TikTok partnered with the UK Government and the UK’s National Health Service (NHS) to encourage young people to get vaccinated. The US too has sought the support of social media and social media influencers to boost vaccination rates. Colorado, Chicago, Oklahoma City, San Jose, California, and New Jersey have initiated a state and city-based movement using social media influencers to reach and encourage those hesitant to get vaccinated. According to foreign media outlets, in Colorado, the State pays citizen (social media) influencers up to $ 1,000 per month for their work on Instagram, TikTok, Snapchat, Facebook, and other platforms, and the social media-related activities include posting about the influencers’ own vaccine experiences; dispelling myths, misinformation, and misconceptions; informing people (followers) of newer vaccine clinics; and raising awareness using information provided by state health authorities. Meanwhile, US President Joe Biden became famous as the “dude with a sign” after a photo of him and an Instagram influencer, holding cardboard signs with messages supporting and encouraging vaccinating, went viral.   NHS medical professional Dr. Karan Rangarajan, who uses social media to tackle the spread of misinformation had told a news agency: “If you really want to get on top of the misinformation, and get ahead of the game, you need to go to the source of where it is coming from – and most of it is coming from social media.”  Adding that the dangerous and potent combination of misinformation happens when falsehoods are mixed with some small level of truth, he observed that this is the frustrating element – mixing the truth and concocting something that is false. A 2020 study conducted by a researcher of the Washington State University, US, said that social media use increases belief in Covid-19 misinformation, and that the more people rely on social media as their main news source, the more likely they are to believe misinformation about the Covid-19 pandemic. It also said that levels of worry about Covid-19 increased the strength of people’s belief in misinformation, and that two factors, namely, having faith in scientists and a preference for discussing with others who held different views, could weaken beliefs in false information. The researcher who conducted the study, Yan Su, said: “Fact checkers are important for social media platforms to implement. When there is no fact checker, people just choose to believe what is consistent with their pre-existing beliefs. It is also important for people to try to get out of their comfort zones and echo chambers by talking with people who have different points of view and political ideologies. When people are exposed to different ideas, they have a chance to do some self-reflection and self-correction, which is particularly beneficial for deliberation. During the Covid-19 pandemic, social media has spread a lot of conspiracy theories and misinformation, which has negative consequences because many people use these false statements as evidence to consolidate their pre-existing political ideologies and attack each other.” Sri Lankan authorities identifying the issue of misconceptions and misinformation discouraging people, especially the young people, from getting vaccinated without delay, is a good sign. However, the programmes to raise awareness which the authorities claim to have considered should be focused on not only accurate information, but also effective ways of communication. Other countries have already initiated effective social media-based activities to encourage people to get vaccinated, and it is not something that Sri Lanka cannot do.