The speed with which countries and pharmaceutical companies have developed vaccines for the coronavirus has inspired awe about their scientific prowess. However, it has also fostered a new and fertile breeding ground for anti-vaxxers. While the anti-vax movement has traditionally been a Western phenomenon, its roots are now spreading to India, where leaders and citizens alike have historically placed their trust in vaccinations. With the country now facing its first pandemic in the social media era, the unprecedented exchange of information and ideas has severely jeopardised the effectiveness of India’s upcoming vaccine drive. Although its impact at this stage has been quite limited to the West, Indian policymakers have acknowledged the existence of this dangerous form of vaccine hesitancy, even though they may disagree on what has led to the spread of these ideas.
Vaccine hesitancy or vaccine scepticism obstructing government-led inoculation drives is not a new phenomenon in India. Indian healthcare professionals faced similar resistance during the MMR vaccine drive in 2019, with several communities believing that the vaccines could lead to impotency or even death. Similar resistance was also faced by the Polio vaccine drive, wherein the Rajput community and the Muslim community was sceptical about bringing in their children for immunisation over fears of adverse health effects. Nevertheless, even in the face of these obstacles, through the combined efforts of Indian policymakers and the healthcare workers, Indian authorities worked extensively to bust these myths through several education programmes, thereby furthering the pro-vaccine narrative.
The coronavirus pandemic now threatens to undo much of these invaluable and hard-earned gains in challenging vaccine hesitancy. A recent survey conducted by LocalCircles, a community social media platform, showed that around 60% of participants would not rush to get inoculated, even if a vaccine is available by February. These sentiments can primarily be attributed to the ongoing wave of vaccine scepticism in the West, including the anti-vax movement, which has regained steam during the pandemic and has inevitably spread to India.
The manner in which some Indians have embraced such ideas can be attributed in part to an acute distrust of the ruling government, particularly among minority communities, who have been noted to have a more voracious appetite for conspiracy theories, resisting quarantines, attacking healthcare professionals, and refusing to follow health protocols. Much of this is due to the discriminatory messaging, policies, and rhetoric by the BJP government over the past few years, which has facilitated and even encouraged legal, physical, and emotional abuse of minorities. All of this has contributed to an inherent scepticism towards the efforts of the central government, and this apprehension has even reached the realm of public health.
For instance, driven by the wave of hate that followed the Tablighi Jamaat event (which was criticised for its role in exponentially increasing the number of COVID-19 cases in India), pockets of the Muslim community were quick to believe that the COVID-19 pandemic was an attempt by the Modi-led government to attack their community, thereby creating scepticism about the intentions of the government in enforcing quarantines and lockdowns. The barrage of misinformation, combined with fear, have severely hampered the efforts of the government. A similar scepticism surrounding the good-will of the Indian government is also likely to impede the COVID-19 vaccine drive.
Against this backdrop, Indian pharmaceutical companies and government authorities have failed to engender trust in the public health initiative. The vaccine approval process has been tainted with a distinct lack of transparency, which has merely provided even further room for conspiracy theories to flourish. The approvals of COVAXIN—which was developed by Bharat Biotech in collaboration with the India Council for Medical Research (ICMR)—and the COVISHIELD—which is the Oxford-Astra-Zeneca vaccine that is being developed by the Serum Institute in India—in particular, have left several questions unaddressed and unanswered. For instance, the ICMR has yet to release the Phase III efficacy data for COVAXIN. Moreover, no publicly-accessible information has been provided on the authorisation process for both COVAXIN and COVISHIELD.
This lack of transparency has irked both political leaders and members of the medical community. Several opposition leaders, including Shashi Tharoor and Akhilesh Yadav, have raised concerns about the manner in which the COVAXIN candidate was pushed through. This was then echoed by the All India Drug Action Network, a group of non-governmental organisations looking increase transparency and accountability in the use of essential medicines, which expressed its “shock” over the hasty approval, specifically in light of the “intense concerns arising from the absence of the efficacy data.” They also raised doubt about the “scientific logic” used by the authorities to approve the “incompletely studied vaccine”.
This information gap created political, medical, and pharmaceutical authorities has merely amplified the existing environment of mistrust and is sure to be capitalised on by anti-vax campaigners, who have already begun to establish a minor foothold in India. For example, a rumour about the vaccine containing beef, the consumption of which is considered unholy in Hinduism, has already gained popularity in several circles in India.
In light of these concerns, albeit unfounded, Indian authorities would do well to look to their French counterparts to see what the dangers of leaving such attitudes unchecked are. Despite having a robust healthcare system and securing a considerably large number of Pfizer and Moderna vaccines, France merely inoculated 1000 citizens in the first week of its COVID-19 vaccine drive. This is particularly alarming when compared to Germany, which despite having a similar target and facilities as France was able to achieve over 250,000 inoculations in the first week. The slow roll-out in France can be attributed to intense anti-vax lobbying, which has severely hampered the efforts of public health authorities. A survey reported that 58% of French nationals would reject any vaccine candidate. The initial days of the roll-out saw several rumours surrounding the vaccine, such as one that believes that the mRNA technology will convert them into “genetically modified organisms”, which made people more sceptical about voluntary inoculations. However, the government made no attempt to counter this narrative. It is yet to be seen how the French government intends to tackle these challenges and confront the conspiracy theorists obstructing its efforts to vaccinate its population. However, given the economic damage wrought by the pandemic, the government is no doubt keen to accelerate the process so as to be able to return to a sense of normalcy.
One shudders at the implications of a similar percentage of India’s 1.35 billion population expressing vaccine hesitancy. Therefore, it is imperative for Indian government authorities to address and nullify the threat of such dangerous beliefs before they become unmanageable. At this stage, the ruling government has dismissed the potency of these disinformation campaigns by describing them as opposition-led conspiracies. However, politicising the issue could create an even more inviting atmosphere for the anti-vax movement, which has already been relying on mistrust of the government. As in the case of previous vaccination drives, the Indian government must instead rely on creating dialogue and propagating value-neutral information. Although social media provides a vehicle for the anti-vax movement to thrive and spread, it also offers an invaluable instrument for political, medical, and pharmaceutical authorities to join hands in reaching a wider audience with scientifically-backed counter-narratives. Authorities must also seek to involve religious leaders, social influencers, and healthcare professionals in such campaigns in order to effectively limit the proliferation of such beliefs. Hence, a collaborative pro-vaccine campaign that is based on information, communication, and education needs to be swiftly introduced alongside the vaccine to ensure its timely roll-out and help bring this dreadful pandemic to an end.
India’s Opaque Vaccine Approval Process Provides an Ideal Breeding Ground for Anti-Vaxxers
India has managed to remain insulated from the Western Anti-Vax movement. However, the COVID-19 vaccine may just be the force that changes this.
January 7, 2021
SOURCE: THE INDIAN EXPRESS