From Concerned to Convinced

Vaccine Hesitancy as a Threat to Global Health   

How many people really mistrust the COVID-19 vaccine? Why?

The vaccination roll-out continues to accelerate and spread geographically. The global COVID-19 vaccination campaign is by no means a small or easy job, considering its scale and the scope and complexity of activities. Logistical hurdles, such as cold supply chains, pose one set of challenges, while falling short of vaccination targets due to vaccine hesitancy provides another.   

Recent publications have drawn attention to the public sentiment towards the coronavirus vaccine acceptance in different countries. A policy brief from the RECOVER Social Sciences team in collaboration with the European Centre for Disease Prevention and Control (ECDC) concludes that “vaccine hesitancy is striking” in the seven countries in which the study was conducted (France, Germany, Belgium, Italy, Spain, Sweden and Ukraine).  

In the UK, the Office for National Statistics released data based on the Opinions and Lifestyle Survey that shows that around 1 in 20 adults reported negative sentiment towards the coronavirus vaccine.   

In the U.S., the results of the survey by the Pew Research Centre indicate that about 30 percent of the respondents (10,121 adults) do not currently plan to get a COVID-19 vaccine.   

Across the surveyed countries, concerns about vaccine side effects, vaccine effectiveness, potential long-term impact on health and concerns about the rapid vaccine development timeline are common underlying causes of vaccine hesitancy.  

Vaccine hesitancy is not unique or specific to the COVID-19 vaccines. It had long been growing steadily across the world, to the point that, in 2019, it was declared as one of the top threats to global health by the World Health Organization (WHO).  

Vaccine hesitancy arises for varied reasons. For some people, it may be a matter of trust (or, rather, distrust) in public health authorities and pharmaceutical industry. For others, it may be lack of information about the vaccine and vaccination process that is easily accessible and easily understood.   

How do vaccine manufacturers communicate the essential information about the COVID-19 vaccines to the public?   

The primary source of information about a vaccine is product-specific material supplied by the respective vaccine manufacturer. The product-specific information includes recommendations about how and when the vaccine should be administered, any special warnings and conditions for use, and known undesirable effects. Regulatory authorities require this product-specific information for people administering and receiving be reviewed and approved by the relevant regulatory authority in order for the product itself to be authorized.  

The product-specific information goes by different names depending on the jurisdiction involved. For example, the U.S. Food and Drug Administration (FDA) mandates the provision of “authorized labelling,” which includes “Fact Sheets” for healthcare providers administering vaccines, and for recipients and caregivers, respectively.  

The European Medicines Agency (EMA) requires the provision of the “Package Leaflet" (PL) for members of the public and “Summary of Product Characteristics" SmPC for healthcare professionals.   

New information submitted to the appropriate regulatory agency prompts continuous review and updates of the product-specific information as needed. 

The approved product information is often used to develop associated instructional and educational materials. These materials may be available on the vaccine manufacturer’s website or through alternative sources.    

The product information materials are intended to serve as authoritative guidance. It would be impossible to gauge just how accessible (or not) and useful (or not) these materials have been to the public during the vaccination campaign. This assessment is especially difficult since regulators have been allowing some flexibility in the labelling and packaging requirements to facilitate the rapid deployment of the COVID-19 vaccines.  

Future research into these topics may help adapt these materials further, particularly in the light of the unique challenges associated with communicating about the vaccines offered under the emergency use authorization (EUA) or conditional approvals, and the public’s acceptance of such vaccines.  

What steps have public health authorities and pharmaceutical companies been taking to address coronavirus vaccine hesitancy?   

A number of strategies, targeted both at healthcare professionals and the wider public, have been deployed by public health authorities in order to address vaccine hesitancy and support vaccine uptake. These include social media promotions, enlisting the support of faith leaders, roll-out of training programs and setting up research grants (JITSUVAX; VAX-TRUST).   

For pharmaceutical companies, engaging in the communication and educational activities with the general public or medical professionals is a complex endeavor. The work is fraught with risks of falling on the wrong side of various advertising, marketing and data protection regulations. In a broad sense, such engagement is possible through the “indirect sponsorship” via grants provided to healthcare organizations.  

Educational grants support the development and provision of the educational programs or initiatives. The industry’s regulations and codes of practice surrounding educational grants are very stringent, ensuring that the pharmaceutical companies do not have any control or influence over those initiatives and programs.   

A good example of the indirect sponsorship is a recent Independent Medical Education Grant Request for Proposal by Pfizer. The request for proposal (RFP) seeks out the candidates who can develop patient education programs designed to increase the understanding and familiarity with the COVID-19 pandemic and vaccination among the general population. This RFP expresses a particular interest in educational programs that focus on reaching medically underserved and other under-immunized populations. Some techniques including re-purposing existing educational resources into easy-to-use and easy-to-access delivery formats (for example, by developing mobile apps), and modification and translation of the existing educational materials to other languages and their roll-out in different geographies. 

Choosing the best approach to deal with vaccine hesitancy  

The research from the University of Waterloo’s School of Pharmacy (Ontario) suggests that when engaging with vaccine-hesitant individuals, moving away from the idea of only two possible immediate outcomes (i.e. of a person either accepting or not accepting a vaccine) is less effective than focusing on positively influencing those individuals by addressing their concerns and by supporting them in making informed vaccine decisions in their own time.    

Indeed, a vaccination campaign is a dynamic and complex ecosystem, which draws on a broad spectrum of participants and their individual motivations, health behaviors and influences. Mutual trust and effective communication among these participants (or lack thereof) can make (or break) the success of the campaign.   

Messaging tailored to specific populations, transparency in information sharing, openness in understanding the concerns underlying vaccine hesitancy, sensitivity and patience in addressing those concerns have shown to be essential factors in building public confidence in vaccination and successfully dealing with vaccine hesitancy. 

Lionbridge has twenty years of experience tailoring communication in any language on any topic to improve understanding. Our Life Sciences experts can help you guide these creations whether you’re writing them from scratch or localizing language for a niche market dialect.