Vaccination hesitation endangers India’s gains against virus

The family hid there for hours and did not return until the workers left in the evening.

“I would rather die than take the vaccine,” Kol said.

A deadly wave of coronavirus infections that ravaged India in April and May, killing more than 180,000 people, has eased and new cases have declined. But the relief could be fleeting because a significant part of the population is still hesitant to be vaccinated. This has alarmed health experts who say reluctance to vaccinate, especially in India’s vast hinterland, could endanger the country’s fragile gains against COVID-19.

Delivering vaccines to the world’s second most populous country was always going to be a challenge. Even though India did relatively well at the start of its massive vaccination campaign, the campaign ran into a problem almost immediately due to shortages and a complicated vaccination policy, exacerbate existing inequalities.

Only less than 5% of the Indian population is fully immune. Experts warn that by the end of the year, vaccination rates must increase dramatically to protect most Indians from the virus that has so far killed more than 386,000 people – a figure seen as a vast sub -enumeration.

Starting Monday, every adult in India will be entitled to an injection paid for by the federal government. The new policy, announced last week, ends a complex system of vaccine procurement and distribution that overburdened states and led to inequalities in the way vaccines were distributed.

There is still widespread hesitation fueled by misinformation and mistrust, especially in rural areas where two-thirds of the country’s nearly 1.4 billion people live.

Health workers face stiff resistance from people who believe that vaccines cause impotence, severe side effects and could even kill. Some just say they don’t need the vaccines because they are immune to the coronavirus.

Rumors that jabs disrupt the menstrual cycle and reduce fertility have also contributed to the fear and skewed the data in favor of men. In almost every state in India, more men than women get vaccinated – and this gap is widening every day.

Quashing such rumors and conspiracy theories is a difficult task for many, especially in tribal-dominated Indian districts which have recorded disproportionate vaccine coverage compared to other districts, according to official data.

Yogesh Kalkonde, a public health doctor in Gadchiroli, a tribal area in the western state of Maharashtra, said his district was overrun with the belief that the vaccine was more dangerous than the virus.

Some in the region have made the false claim that the shots can cause infertility, Kalkonde said. Others simply question its effectiveness.

“We have to convince people, go door to door and rely on the people who have taken the vaccine to spread the word,” he said. “It’s an extremely slow process.

There is hindsight. State governments have mounted aggressive awareness campaigns through posters and radio announcements to allay some of the anxiety and confusion. Some local governments have started to move to vaccination centers, especially from remote villages. Volunteers conduct door-to-door surveys and even small gatherings to encourage people to receive the jab.

For months, Vibha Singh, a government-appointed nurse, has been door-to-door in villages in Uttar Pradesh.

“People tell us to leave or they will beat us,” Singh said. “Sometimes they also throw stones and bricks at us. “

Prime Minister Narendra Modi and other leaders have regularly spoken about the need to avoid vaccine hesitancy, but health experts say more needs to be done.

“We need to make it clear to people, ideally through trusted local networks,” said K. Srinath Reddy, President of the Public Health Foundation of India. He said state governments should strengthen local self-help groups, village councils and call on local religious leaders to intervene.

“It requires a conversation, not just downlink messaging,” he said.

Dr Vinod K. Paul, head of the country’s COVID-19 task force, recognized the immediate need to tackle the problem, but said public participation to dispel rumors and misinformation was important.

“It is the responsibility not only of government but also of society as a whole to create such an environment in which unfounded hesitation is addressed,” said Paul.

Virologists and public health experts say that eradicating vaccine doubts in rural India and getting people vaccinated quickly should be of paramount importance, as the majority of Indians live in the hinterlands. Already, city dwellers are getting the pictures much faster.

“If they are protected, a large part of India will be protected,” Reddy said of rural areas. “Their vulnerability to a generalized pandemic is much more than that. Vaccinating them quickly must therefore be a priority. “

Not everyone is convinced.

When a team of health workers tried last week to vaccinate Panna Lal, a resident of the village of Sikanderpur in Uttar Pradesh, they were met with outright refusal.

Lal even discouraged the rest of his family from getting the jab.

“The vaccine will not protect me,” the 56-year-old told workers. “God sent me here safely, and he will continue to protect me.”


Associated Press editors Sheikh Saaliq and Krutika Pathi in New Delhi contributed to this report.