The latest UNICEF report about the State of the World’s Children revealed that nearly 67 million children worldwide missed one or more essential vaccinations between 2019 and 2021 because of disruptions caused by the COVID-19 pandemic and armed conflict. The report showed decreasing confidence in vaccines.
Although life-saving vaccines were lately discovered, the State of the World’s Children 2023 report found that vaccination coverage levels decreased in 112 countries during the pandemic. It was “the largest sustained backslide in childhood immunization in 30 years,” the report says. And according to UNICEF, the rise in misleading information related to vaccines is one of the factors.
The agency’s executive director said that, despite this historic achievement of developing life-saving vaccines, “fear and disinformation about all types of vaccines circulated as widely as the virus itself.”
Declining Confidence in Childhood Vaccines
According to the report, in addition to the stretched health systems and COVID-19 restrictions, the pandemic interrupted childhood vaccination everywhere. Data has shown a trend of declining confidence in childhood vaccines of up to 44% points in several countries. The report suggested that vaccine confidence can fluctuate depending on factors, including rumors and misinformation.
For UNICEF's Executive Director, “This data is a worrying warning signal.” She adds: “We cannot allow confidence in routine immunizations to become another victim of the pandemic. Otherwise, the next wave of deaths could be of more children with measles, diphtheria, or other preventable diseases.”
Although vaccine hesitancy predated the COVID-19 pandemic and had already been identified by the World Health Organization (WHO) earlier, the virus brought new dimensions to the problem at a global scale. For UNICEF, uncertainty about the pandemic and the rapid introduction of new vaccines played a part in the decreasing confidence. The repetitive questions about the vaccines led people to search online for information, where “accurate information is often presented alongside a bewildering mix of misinformation and disinformation.”
As some misleading news or information about the vaccine can prevent parents and caregivers from immunizing their child, “the consequences are straightforward: greater risk of illness and death.”
The report gave examples of “deadly misinformation” about the vaccines that put lives at stake. A 1998 article linked the measles, mumps, and rubella vaccine with autism. The misleading information was debunked, but amplification on social media kept the misinformation alive. As a result, in the United Kingdom, where the article originated, vaccination was 92% in 1998. However, by 2003, it had dropped to 79%.
The report confirmed the role of social media in the misinformation spread, especially in Pakistan, where, in 2019, a staged video claimed that a polio vaccine had hospitalized children and showed staged images of children lying motionless in beds. After the footage gained thousands of interactions on social media within hours, almost 45,000 children were taken to the hospital by fearful parents. During the same week, “a mob set fire to a health clinic in Peshawar, killing two police officers and a health worker.” This misinformation later led to the suspension of the anti-polio campaign.
“Trust in vaccination is hard won and easily lost,” the report concluded.
Building Vaccine Confidence
To effectively build vaccine confidence in the age of misinformation, the report suggests multiple strategies deployment in a comprehensive approach. “Political will and a national commitment to immunization is a precondition for vaccine acceptability,” the report says.
For UNICEF, it is crucial to understand the drivers of vaccine confidence in each community to design effective interventions. The programmers also need to understand the factors or mix of factors affecting people and holding them back.
The report also mentioned the importance of community representatives, behavioral scientists, program managers, and other stakeholders in the behavioral and social data understanding and analysis.
`An investment in understanding people’s attitudes toward vaccines may also help. Social listening was among the recommendations of the UNICEF report. The vaccine acceptance monitoring through regular surveys that include questions about attitudes, intentions, and behaviors can allow the program managers to understand how people think and identify potential signs of decreasing confidence to better evaluate the actions and improve the upcoming campaigns.
The agency has already published guidance for establishing or strengthening a national vaccine social listening program to help implement plans to rapidly counter the vaccine misinformation.
UNICEF called on countries to urgently unlock resources to accelerate catch-up vaccination efforts and rebuild lost vaccine confidence. According to the UN agency, routine immunizations and powerful health systems are the best shot at preventing future pandemics, unnecessary deaths, and suffering.