Vaccine Hesitancy – Where Did We Get It Wrong?
6 March 2021
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MDC Alliance Weekly Health Alert
7th Edition

The pandemic has caused a lot of suffering among our people. We know that a pandemic can become a disaster if the response to it is not adequate. We have been calling for effective leadership that addresses the concerns and needs of its people, and deals with all the myths and conspiracy theories surrounding covid-19 vaccines. The MDC-Alliance and its President rose above partisan politics by offering advice & support to government in the fight against this pandemic. We went on to welcome enthusiastically the arrival of the COVID-19 Sinopharm vaccine in Zimbabwe. We know that just having the vaccine does not in itself save lives, but rather the actual administration of the vaccine to a large enough proportion of the population. Globally, COVID-19 vaccines are proving that they prevent morbidity and mortality associated with Corona virus disease 2019. In order for these benefits to be realized in Zimbabwe, high vaccine uptake rates must be achieved.

MDC-Alliance Secretary for Health and Child welfare, Dr Henry Madzorera, received the Sinopharm vaccine a week ago in the first stage of Phase one vaccination of front line workers. “I did not experience any discomfort or adverse effect so far. I’m waiting for data on efficacy against the circulating variants of covid-19 in Zimbabwe”.

It may be too early to conclude but uptake of the Sinopharm COVID-19 vaccine is not encouraging at all, even among the frontline health workers. Less than two fifths of the expected numbers in phase one stage one have been vaccinated so far in some provinces. We have also seen some religious leaders being hesitant to embrace the vaccine. This is a cause for concern, because these are important influencers in society. We need to look at what is causing the vaccine hesitancy among our population.

According to the WHO, vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccine services. Factors influencing vaccine hesitancy have been classified into three C’s, namely Complacency, Convenience and Confidence.

Confidence refers to the trust people have in the safety & efficacy of the vaccine, and the system that delivers the vaccine, including reliability and competence of the health professionals. I doubt that anybody in Zimbabwe has questions on the competence of our health professionals. I would however dare add here as confidence determining factors, the manufacturer of the vaccine and the factors influencing the decision of government to procure one vaccine versus another. The perceived transparency in procurement, any due diligence done by the authorities before procurement, perceived presence or absence of personal or selfish motives like personal financial gain, and any historical track record of corruption or irregular procurement on the part of government, affect confidence of the population in a big way. Communication therefore becomes extremely important in allaying any anxieties the people may have. On this score the government has been found wanting, and many simple questions like what is it costing us to procure this vaccine per dose, and how does it compare to other market offerings in terms of efficacy, safety and cost, remain unanswered. This is lethal to the people’s confidence in the vaccine, and may explain the hitherto low uptake.

Convenience refers to availability, accessibility, & affordability, all of which do not seem to be an issue in our current program. The outreach teams are doing a fantastic job despite other constraints in their conditions of service. We must pause a little to thank them and encourage them to keep going for the good of the nation.

Complacency exists when the perceived risk of the disease covid-19 is low and vaccination is not perceived as a necessary preventive measure. This I must say is not the case in Zimbabwe at the moment. Everyone is anxious to see the backside of covid-19, and vaccination is generally accepted as the way out of this pandemic. The root causes for vaccine hesitancy are complex and not straight forward, but a caring, committed and inclusive government that listens to its people and works with them to address their concerns will boost their confidence in the vaccines being rolled out.

There is a great need to communicate with the hesitant populations as a priority. We must understand both individual and community hesitation to be vaccinated. The reasons for hesitation must be addressed to achieve herd immunity. Vaccine hesitancy is not only confined to one individual or one community. It is both a countrywide as well as a worldwide problem, which has been worsened by social media. The social media is full on anti-vaccination messages and conspiracy theories. If we do not have effective leadership that is trusted by its people then the people will turn to unreliable sources on social media. It is imperative that the government prioritise raising COVID-19 vaccine awareness and addresses the worries and concerns that our people have.

There is need to reassure the nation that the vaccines are being checked for quality before being rolled out. The safety and effectiveness of these vaccines must be made clear to our population. We know that the evidence coming out of other countries that have vaccinated millions of people is that these vaccines are safe and effective. There is need to show that the vaccines that we are choosing are also as safe and effective as those being rolled out in other countries. We do not doubt the effectiveness of Sinopharm vaccine being rolled out but we are concerned by the lack of communication so that the average person is confident enough to take it.

We now sound like a broken record in calling for the need to align our priorities with the needs of our people. Poorly prepared lockdowns caused the suffering our people. The intention was noble but execution was dismal and smelt of either incompetence or lack of care. Right now pushing the vaccine on starving people who are struggling to survive is likely to be met with resistance. Our people are arguing that if the government cares about us then it should be making sure that we have something to eat, jobs to work and land to till. If these basics are not met then the vaccine will be perceived as of low in priority. The proposed forced eviction of 12500 Chilonga villagers to grow grass for animals on their land erodes the people’s confidence in government’s capability to make sound sober choices and decisions for the people of Zimbabwe in any other area of life, including vaccines.

We call upon the government to improve the welfare of our people as we roll out this vaccine.
Let us join hands in an honest and transparent way to rebuild lost trust through robust and trustworthy communication. That is the only way to eliminate vaccine hesitancy. We need effective leadership that is trusted by its people. We believe that this is achievable in Zimbabwe in our generation.

Once again, many thanks to the MDC-Alliance health portfolio committee for this presentation.

Dr Henry Madzorera.
Secretary for Health and Child welfare.

Dr Madzorera