Vaccine hesitancy as scapegoat

Over the past months, we have seen government officials and health experts problematize the issue of “vaccine hesitancy,” holding it as the primary barrier to our country achieving a high level of immunization. This has been reflected in public communications efforts and campaigns from the IATF and the Department of Health that exhort people to get vaccinated. The most extreme so far is perhaps President Duterte’s threat to criminalize people refusing to be immunized.

Surveys show that many Filipinos remain unwilling to be vaccinated, citing a range of reasons from fear of side effects to lingering trauma from the Dengvaxia controversy. Some of this “hesitancy” seem to be brand-specific, with surveys showing a particular mistrust toward Sinovac and other vaccines from China. However, while we agree that vaccine hesitancy is a problem, it remains to be seen whether it is the main driver of our country’s relatively low number of fully vaccinated individuals, which today stands at just 2.4 percent of the population.

An undue focus on vaccine hesitancy can detract attention from equally important reasons why, despite the improved pace of vaccine acquisition and administration in recent weeks, our vaccination program has remained sluggish and inadequate, especially amid the threat of new variants.

In the first place, access to vaccines has remained limited to prioritized groups, even as we have seen many individuals utilize technical loopholes to avail themselves of vaccination ahead of those who should be prioritized. Rollout has been slow, with the private sector still eagerly awaiting their orders, although many have since filled the queues in public health services.

Moreover, the narrative of vaccine hesitancy further places undue responsibility and blame on individuals, as if people’s perceptions of vaccines are the only determinant of vaccine hesitancy. Much like the narrative of the entire pandemic response, the people are faulted as “pasaway” without any effort to truly understand their plight.

It is worth noting that while the government has pushed for a “brand agnostic” policy, President Duterte has been the most prominent person in the country to have expressed preference for his favored brands, and even his favored country of origin for vaccines. Meanwhile, the valued overseas foreign workers and OFWs-to-be are discouraged from doing the same despite their potential countries of employment imposing such brand preference.

Another notable aspect has been the inconsistent messaging from the government that has undermined people’s confidence in vaccines. As much as health agencies attempt to establish vaccine confidence with data and slogans, it falls short in alleviating fears and doubts as the health system is barely able to cope with the demands of the pandemic, now combined with vaccination efforts.

Despite misgivings about regulation and procurement leading to the rollout of Sinovac, and despite valid questions today regarding the efficacy of all vaccines against new variants, we are in agreement with health experts and authorities that all the currently approved vaccines are effective and safe. More importantly, the soonest these are given to the wider population, the better.

However, beyond simply telling—or worse, ordering—people to get vaccinated, much needs to be done in terms of actually making these vaccines available and accessible to every Filipino community (also by creating local production and facilitating such efforts through international cooperation). This entails ensuring that there is indeed a functioning health system people can rely on, from which they can get adequate and not dismissive answers to their concerns and fears. When it comes to COVID-19 vaccination, the key is providing access to the vaccines and empowering citizens through informed consent, instead of the “sumunod na lang kayo” narrative that, alas, has characterized much of our pandemic response.

——————

Gideon Lasco, MD, Ph.D., and Joshua San Pedro, MD, are both physicians and anthropologists. Lasco is also a Philippine Daily Inquirer columnist.