MHM Magazine

I was vaccinated in March 2021 during the healthcare worker vaccination rollout, and it was an unexpectedly emotive experience. I was excited beforehand; after- wards, I was comforted by the thought that I would soon have effective antibodies, and because I was among the relatively few South Africans at the time who had the privilege to claim a vac- cine I felt both grateful and guilty. I did experience side effects (sore arm, fever and malaise), but wasn’t concerned. There was a positive communal response to vaccination at my workplace; groups of colleagues went togeth- er on a vaccination outing, the ‘I was just vaccinated’ photos were peppering WhatsApp, and those who had side effects commis- erated with each other. Working at the NICD, we all received the daily COVID-19 situation updates and the communications team were proactive in sharing relevant COVID-19 disease - and vac- cine-related information. I naively assumed that all NICD co-workers would be vaccinated within the first phase of the rollout, and so was shocked and stupefied to find that some, including a few in the team I work in, who were vaccine hesitant. I had one-on-one discussions with my hesitant team members, and thought it would be a fairly straightforward task to address any concerns and set them to rights. I knew the science and recited the facts and figures. I reminded them that of all the NICD co-workers who’d been vaccinated, nobody had experienced severe side effects (and in fact, many experienced none). But I was completely unprepared for the response; my facts and figures were simply no match for the misinformation that had already taken hold. I was incredulous that such educated, informed individuals who worked in the very public health institute intimately involved in responding to the COVID-19 pandemic could possibly believe (and very likely propagate) such utter nonsense, and said as much (though I did try to couch it in slightly softer terms). Needless to say, I failed dismally! There’s no better teacher than experience; after making the effort to read around vaccine hesitancy and inform myself about misinformation, it was clear that the dice were loaded at the outset – I missed almost all the ladders and landed on every snake. I’m glad to say that I’ve since reformed my approach to vaccine hesitancy, and have had some success. In 2019 (pre-dating the COVID-19 era), the World Health Organization (WHO) included ‘vaccine hesitancy’ on their list of the ‘Top Ten’ threats to global health. Vaccine hesitancy is defined as the delay in acceptance or refusal of vaccines despite the availability of vaccine services. There is a spectrum of vaccine attitudes, ranging from total acceptance (vaccine advocates) to complete refusal (people with extreme anti-vaccine views and fringe conspiracy theorists), with vaccine-hesitant individuals sitting squarely in the middle. Vaccine hesitancy is complex and context specific. Researchers have broadly grouped the drivers of vaccine hesitancy into the ‘5 Cs’: confidence, complacency, convenience (or constraints), risk calculation, and collective responsibility. Because vaccine hesitancy is so nuanced and context specific, we need to understand the main drivers at a local level in order to guide interventions. South African researchers have highlighted the intensely social nature of COVID-19 vaccine hesitancy in our country, with attitudes potentially influenced by age, race, education, politics, geographical location, and employment. Every healthcare professional needs to learn how to become an effective vaccine advocate in their own right and tackle vaccine hesitancy, one hesitant person at a time. Practical recommendations for developing your own approach to discuss vaccine hesitancy with patients include: • Start the conversation about COVID-19 vaccination with your patients, but remember to be an active listener • Quality healthcare professional-patient communication places the patient at the centre of care. Respect and respond to the patients’ preferences, needs and values; it’s the patient’s values which guide medical By Dr Juno Thomas Head of the Centre for Enteric Diseases TACKLING VACCINE HESITANCY EDITORIAL Issue 5 | 2021 | MENTALHEALTHMATTERS | 1 MHM

RkJQdWJsaXNoZXIy MTI4MTE=