Exploring interventions against COVID-19 vaccine hesitancy in the Philippines

Dear Editor,

In a recent special article published in this journal, the authors explored the challenges of managing coronavirus disease 2019 (COVID-19) vaccine-induced immune thrombotic thrombocytopenia in low-middle income countries. They claimed that this adverse effect might not represent a public health problem in itself but it is already causing vaccine hesitancy in population groups susceptible to severe COVID-19 and poses a challenge in low resource settings [1]. This is a very good observation that calls out the need for hospitals to have testing for this condition since many hospitals in these categorized countries do not have approved testing for accurate diagnosis of the effect. With this, I would like to raise a similar problem in the Philippines about vaccine hesitancy due to these side effects which in turn leads to unfortunate wastage of resources. As of this date, 4 April 2022, the Philippines is still in a tight battle against the COVID-19 pandemic with only 65.8 million citizens fully vaccinated, which is only 60% of the total population [2]. One of the main reasons is still vaccine hesitancy due to the reported side effects of different vaccine brands. In fact, despite the availability of vaccines, a whopping 27 million doses will expire in July. Aside from vaccine hesitancy, the delivery of near-expiring vaccines has been a frequent issue highlighting the logistical difficulties of distributing shots with short shelf lives. While in need of shots, fragmented distribution networks and a lack of manpower, among other reasons, have bogged down efforts to quickly vaccinate populations in lower-middle income countries like the Philippines [3]. This is indeed an unfortunate waste of resources as the country’s international debts ballooned to almost P12 trillion (equal to 229.4 billion US dollars) primarily because of massive borrowing to deal with the pandemic. To address this problem, the country should focus on its root cause which is reducing vaccine hesitancy.

Several factors related to information are among the reasons for hesitancy. Lack of information about vaccines, misinformation about their efficacy or side effects, mistrust, and underestimation of benefits compared to overestimation of risks and costs of vaccination, are among the potential reasons [4]. With this, experts and researchers have suggested different interventions. One of these is strengthening health literacy which is a critical tool to combat misinformation that undermines vaccine confidence. Health literacy is the degree to which individuals can find, understand, and use information and services to inform health-related decisions and actions for themselves and others [5]. Vaccination systems must also consider the needs of marginalized and vulnerable groups to ensure their access to vaccines [6]. Some proposed the important role of healthcare professionals through roundtable discussions to establish trust and empathy with the public. Others suggested that government officials should serve as role models by having inoculated first so that the public will have enough preparation in case side effects come out. In addition, since many Filipinos are living in poverty, giving cash incentives from the government is a big boost for the campaign. This may be a temporary intervention but it can help a lot for the cause. Government funding is also needed for the production of locally made vaccines. Filipinos have higher confidence in local medicines since they are more familiar with them, especially the plant-based which are endemic in the country. Vaccination remains the major key to achieving herd immunity and ending the pandemic. Thus, solving vaccine hesitancy makes this goal attainable for every country.