Diminishing vaccine hesitancy in rural India

Prakash Satyavageeswaran & Anima Nivsarkar talks about vaccine hesitancy in rural India despite India’s vaccination drive setting new records

Susheel, a patient of diabetes, lives in a small village of Madhya Pradesh, some 400 km from the state capital Bhopal. As such, Susheel is at a high risk of complications that can arise if he contracts COVID-19 and should get vaccinated. However, Susheel says he has heard rumours about deaths post vaccination, and he is not planning on getting vaccinated.

Even as we witness the second wave of covid-19 pandemic ebbing away, we are flooded with news and rumors about a probable third wave as well as about the many mutations of the coronavirus yet to manifest. But there is hope this time around. As of 18 June 2021, 16.2% of the Indian population has received its first vaccine dose (Our World in Data). But is this really reassuring? The anecdote of Susheel suggests that there is vaccine hesitancy, especially based on roumors, and Susheel is not an isolated case. The first phase covered the frontline workers; doctors, nurses, police. For the second phase, those over 60 and those with co-morbidities were prioritized. The third phase opened up the vaccine to all adults.

While supply issues did hamper vaccination drive, another major reason for the low vaccination rates was vaccine hesitancy among Indians. And it is not just India where the people are skeptical about getting the jab. Vaccine hesitancy has emerged as a key barrier to ending the covid-19 pandemic across the world.  In USA, the government has tried to combat hesitancy by putting several vaccine incentives on offer to encourage the population. India, in fact has one of the lowest hesitancy rates at 12%, second only to China at 8% (Forbes).

Vaccine hesitancy across the world is gradually diminishing. For example, in the USA, it was 56.9% in April 2021, and ranged from 67.0% to 75.0% in May 2021, and reached 75.4% in June 2021. Anecdotal evidence for India suggested concerns and hesitation earlier during the year among rural populace for taking the covid-19 vaccine. With a large part of the country living in rural, this was of great concern.

In order to gauge the extent of this hesitancy, Karma Healthcare, a technology-based healthcare provider, and Indian Institute of Management Udaipur conducted a rapid survey in June 2021. The survey was conducted in rural parts of three states in eastern and western India and was designed to gauge the vaccination rate in these areas as well as understand the reasons for hesitancy among those yet to be vaccinated.

158 individuals were surveyed across these three states. More than half of the surveyed population had already been vaccinated with at least one dose of the vaccine. Not only were most respondents vaccinated, but among those yet to get the vaccine, the willingness for vaccination was high at almost 61%. Most of these individuals were planning to get their first dose later in June.

Some of the emergent reasons for turning down the vaccines were concerns about the side effects, distrust in vaccines in general and the belief that the risk of them contracting covid-19 is very low. These insights on reasons for hesitancy can inform field level NGOs and health workers on what they can communicate to improve vaccine acceptance.  Additionally, this will also help them to focus their efforts to combat hesitancy in areas where it is needed instead of a generic drive to reduce vaccine hesitancy.

With the rise in vaccination rates and the drop is vaccine hesitancy, there is a glimmer of light at the end of the tunnel.

Prakash Satyavageeswaran is a professor at IIM Udaipur and is co-lead for the IIMU Centre for Healthcare Anima Nivsarkar works with Karma Healthcare, a tech-based primary healthcare provider