Medicosnext
Words by Dr Jyotshna Sapkota
The COVID-19 vaccine became the world’s fastest vaccine in record time. This incredible medical achievement represents a transition from the identification of a novel pathogen to discovering an immune response and ultimately development of vaccine with approval within an extraordinary timeframe of a year. Simultaneously, rumors suggesting that pandemics are a hoax designed to drive vaccine sales fueled longstanding vaccine hesitancy and anti-vaccine sentiments. In contrast to anti-vaccine stance, the pandemic has also illuminated the stark reality of unequal access to vaccines. Developed countries, on one hand, have been procuring vaccines at rates four times higher than their population, while poor nations consistently faced challenges in securing an adequate supply as compared to their wealthier counterparts. As per the 2022 Global Vaccine Report, WHO said that the challenges in achieving vaccine equity observed during COVID-19 pandemics have bought attention to similar issues in other vaccine markets. Notably, the Human Papillomavirus (HPV) vaccine is introduced in only 41% of low-income countries, in contrast to 83% in high-income countries.
Vaccine access and hesitancy are two critical aspects that significantly influence the success of immunization programs and public health outcomes. While vaccine access focuses on the availability, affordability, and distribution of vaccines. Vaccine hesitancy centers around individual and community attitudes, beliefs, and concerns regarding vaccination. Both factors play intricate roles in shaping vaccination rates, success and consequently, herd immunity.
Access to vaccines basically serves as a pillar of success in any immunization program; it includes several basic aspects that altogether define how easy or difficult is the vaccine availability for individuals. The physical availability of vaccines in healthcare facilities is fundamental, which requires consistent and sustainable supply chains to prevent shortages. Efficient distribution systems are also vital, ensuring equitable assess to all populations, particularly in remote or underserved territories like refugee camps or war zones. Vaccine prices are also an important issue related to both cost of vaccines and associated administration fee. Multisector collaborations involving government subsidies, international aid, and partnerships with pharmaceutical companies, contribute to making vaccines financially accessible.
The overall healthcare infrastructure including facilities, trained manpower and technical support play a huge role in determining efficiency of vaccine delivery. Strong logistics especially cold chain management is crucial for preserving vaccine efficacy during transport and storage. Despite progresses in healthcare, challenges persist in achieving universal vaccine access. Geographical gaps pose challenges for remote and marginalized populations requiring development of innovative delivery models and outreach campaigns. Socioeconomic factors can create disparities in vaccine access. Low-income individuals may struggle with the cost associated with vaccination prompting the need for targeted financial assistance programs and subsidy schemes for vaccines. Globally, vaccine access disparities extend beyond national borders, with developing countries experiencing delays in receiving vaccines compared to their wealthier counterparts. These challenges can be resolved through international multicountry collaborations, donation of vaccines and equitable distribution strategies to ensure comprehensive wide access at global level.
Vaccine hesitancy is a multidimensional phenomenon influenced by diverse range of factors both- cultural and societal, necessitating the need for understanding its root cause for development of targeted interventions. Major factor that contributes for hesitancy include individual beliefs and attitudes concerning vaccine safety and efficacy. Misinformation often propagated through social media may increase vaccine hesitancy thus emphasizing the importance of transparent communication, education campaigns and myth debunking for building trust.
Individuals often hesitate to get vaccinated if they perceive the risk of disease to be low or question the benefit of vaccinations. Convenience and access issues as well as social and peer influences, play integral roles in shaping vaccine hesitancy. To overcome these aspects of vaccine hesitancy, educational campaigns emphasizing on disease severity and vaccine effectiveness, increasing access through mobile clinics, or extending hours and fostering positive peer influences are crucial.
The relationship between vaccine access and hesitancy is complex, including an inverse relationship wherein communities with high vaccine hesitancy might still have well-established healthcare infrastructure and easy access to vaccines, but individual may choose not to get vaccinated. Both limited access and hesitancy can contribute to low vaccination rates, with some individuals desiring to get vaccinated but facing barriers, while others with easy access choose not to get vaccinated due to hesitancy. Achieving equitable vaccination coverage demands addressing both access and hesitancy, acknowledging the unique challenges of different communities, and implementing culturally sensitive and inclusive interventions.
To enhance access and address hesitancy, community engagement emerges as crucial step for understanding local concerns and developing targeted interventions. Building trust through open communication and involving community leaders or influential people from community positively influences vaccine acceptance. Education campaigns offering reliable information and addressing specific issues as well as mobile clinics and outreach programs contribute to barrier reduction mainly for remote populations. Government policies supporting access and addressing hesitancy along with international collaboration like COVAX and ‘campaigns to immunize zero-dose children’ ensures equitable vaccine distribution globally.
In conclusion, vaccine access and hesitancy pose an important public health concern that requires multifaceted strategies for effective intervention. Successful vaccination coverage demands not only improving physical access to the vaccines but also understanding and addressing diverse factors contributing to hesitancy. A comprehensive approach that combines community involvement, education campaigns and targeted programs can bridge gaps in access and overcoming barriers. In times of ongoing and future health challenges, the use of these approaches will play a crucial role in ensuring success for immunization programs and global public health.
Dr. Jyotshna Sapkota
Associate Professor
Department of Microbiology
Nepal Medical College
