Vaccines work. They have saved the lives of billions of people around the world, and today they are our best hope in putting an end to this terrible pandemic. However, as with all major public health campaigns, communication is a very important component that can make or break the success of immunization programs.
This is underscored by the fact that, according to a recent Pulse Asia survey, only 32 percent showed willingness to be vaccinated, a figure made more alarming in light of persistently low immunization rates even before, and especially after, the dengue vaccine scandal.
I know that some of our health officials are taking communication seriously, but judging by recent developments and government officials’ latest pronouncements, there is reason to be seriously concerned. Leaving aside issues surrounding the procurement and selection of vaccines, I would like to devote this column to offer some thoughts on how to boost vaccine confidence in the Philippines, drawing on the principles outlined in the World Health Organization guidelines on Vaccine Safety Communication.
First of all, it is vital for communicators to have trust and credibility, and this is achieved by letting nonpartisan experts take the lead, offering accurate information in a way the general public can understand, showing consistency and impartiality, avoiding promises that cannot be met. Alas, the President fails in this mark, presenting falsehoods (e.g., his claim that vaccines have the same efficacy), displaying bias for Chinese and Russian vaccines, evincing inconsistency (e.g., in his vow to be vaccinated in public), and failing to deliver on his promises (e.g., “By December we will be back to normal”).
Second, empathy. If there’s one thing that the scholarship on vaccine communication has taught us, it is that facts are not enough. Communicators must be sensitive to—not dismissive of—people’s fears. In this regard, Harry Roque’s “Don’t be choosy” retort, as well as condescending language to the effect of “Sumunod na lang kayo” or “Makinig na lang kayo,” are not helpful. You do not increase confidence by demanding that the public not ask any questions; you increase vaccine confidence by providing answers to their questions.
Third, transparency, defined by the WHO as “a sincere and consistent effort to disclose information… [and provide] accurate, unbiased, and evidence-based messages.” Without transparency, it will be difficult to build trust. When it comes to vaccines, “confidential” is the enemy of confidence. Echoing the Department of Health’s own stated principles, I call on the government to be as transparent as possible in the decision-making process behind vaccine procurement, cost, and rollout—and to be forthcoming about risks inherent in vaccination.
Fourth, equity, or the inclusion of people both in the vaccination program itself and the communication efforts. In this regard, Mr. Duterte’s repeated vow of “vaccines for all” is welcome, but actions speak louder than words, especially when such statements are undermined by reports of Presidential Security Group officers receiving clandestine vaccines. We need more material, offline and online, in local languages—emphasis in the plural—if we are to assuage people’s concerns all over the country.
Fifth, participation and feedback that would involve various sectors, giving them specific guidance, listening to their concerns, and also listening to their insights. Surely, barangay health workers can give us a lesson or two about talking about vaccines. Medical expertise is not enough: We need communications and social science expertise. Because of their own tremendous responsibility—and past shortcomings—media entities are an important partner, and so are religious groups. Encouragingly, I see this reflected in the DOH virtual “town hall” meetings and the Inter-Agency Task Force for the Management of Emerging Infectious Diseases’ Demand Generation and Communications task group. But they should be meaningfully implemented, ensuring that the message reaches regional and local levels.
In ending, I would add another important principle: accountability. There must be consequences if public officials deliberately misinform, sow mistrust, block efforts toward transparency and equity, or fail their mandate.
Despite our past setbacks, vaccine hesitancy is not irreversible, and surely we can all rally behind the effort to achieve a successful national immunization program. But government officials, including the President, need to communicate properly, speaking and acting with competence, clarity, consistency, and compassion, if we are to build confidence in COVID-19 vaccines.
——————
glasco@inquirer.com.ph