20/05/21

Mistrust in governments ‘impeding child vaccination’

Administering vaccine on a farm in Nigeria
Administering vaccine on a farm in Nigeria. A report says child vaccination rates in African countries are much lower in areas where the local population has high levels of mistrust in their government. Copyright:CDC Global,(CC由2.0)

Speed read

  • Almost 20 million infants globally are missing out on essential vaccines each year
  • Mistrust in governments plays a role in Africa’s low vaccine take-up, a study suggests
  • Governments should ‘leverage popular media’ to promote vaccination

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[内罗毕]当地和国家的不信任governmentsis slowing downchild疫苗接种在非洲的进步,一半的the world’s unvaccinated and undervaccinated children, astudy显示。

According to World Health Organization (WHO) estimates, vaccination prevents two to three million deaths annually worldwide from diseases such as tetanus, pertussis (whooping cough), influenza and measles but almost 20 million infants each year lack adequate access tovaccines.

“There is an urgent need to recognise the importance of mistrust in vaccination campaigns.”

Jean-Francois Maystadt, Lancaster University

The study published last month inBMJ Global Healthsays that child vaccination rates in African countries are much lower in areas where the local population has high levels of mistrust in local and national institutions.

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“即使比较了具有相似社会经济特征的家庭的孩子,他们生活在同一地区,并且有类似的机会healthcarefacilities, mistrust in local authorities, government, courts or the electoral system matters significantly when it comes to parents vaccinating their children,” says Jean-Francois Maystadt, study co-author and an associate professor in economics at Lancaster University, in northern England.

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When mistrust in local government — smaller regional authority in a country — increased by ten percentage points, children living in that region were 3.4 per cent less likely to receive all eight of the basic child vaccines including polio and measles.

“There is an urgent need to recognise the importance of mistrust in vaccination campaigns, especially in a post-COVID world where the global rollout of vaccines is considered crucial in bringing the pandemic to an end,” Maystadt tellsSciDev.Net.

比利时安特卫普大学的合着者兼博士后研究员尼克·斯普普(Nik Stoop)说,甚至在COVID-19大流行之前,他都认识到疫苗犹豫不决是对全球健康最重要的十大威胁之一。

“This [study] is particularly important for Africa…Qualitative case studies in Africa, for instance, Cameroon, Democratic Republic of Congo, Liberia, Nigeria and South Sudan suggests that mistrust toward local and national authorities could be an important contributor to vaccine hesitancy,” Stoop says. “Finding ways to improve vaccination uptake may help countries to reach theSustainable Development Goalstarget of reducing under-five mortality to at least 25 per 1,000 live births by 2030.”

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Lack of trust in governments, according to Maystadt, may lead to parents questioning the vaccine information they receive from health authorities. For instance, the Nigeria boycott of the polio vaccination campaign in the early 2000s was based on the false claim that the polio vaccine was contaminated with a fertility-reducing substance, as part of a plot by Western powers against Muslim populations.

Researchers analysed information on child vaccination status for almost 167,000 children from 22 African countries using demographic and health surveys conducted from 2004 to 2018. They compared this with information on how much people in their subnational region trusted public authorities as indicated in the Afrobarometer survey, which measures public attitudes on socio-political issues in Africa.


Richard Mihigo, programme coordinator for WHO Africa’s Immunisation and Vaccines Development Programme, tellsSciDev.Netthat child vaccination is one of the most cost-effective public health interventions, adding that every US$1 spent on childhood immunisations globally returns US$44 in economic benefits.

“We are continuing to work closely with countries and partners to better understand why people might not accept vaccination, find ways to address their concerns, and build trust and confidence in vaccines and immunisation programmes,” says Mihigo.

He adds that to improve vaccination rates, public health messages andcommunication应通过社区领导人领导的社区参与来量身定制疫苗犹豫的策略。

他解释说:“对疫苗的不信任可能来自……诸如卫生部门的虚假谣言和误解,过去或历史医学经验之类的因素,或者对公共卫生机构,政府和公司等缺乏信任。”
“Governments and partners can also leverage popular media, social media platforms, or other sources of information within communities to reach as many people as possible with positive, evidence-based and tailored messages about vaccination,” he adds.

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.

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参考

Nick Stoop and othersInstitutional mistrust and child vaccination coverage in Africa(BMJ Global Health, 30 April, 2021)