How African National Public Health Institutes Can Address COVID-19 Vaccine Misinformation

On September 28, 2021, the IANPHI Africa Regional Network hosted a webinar to better apprehend how national public health institutes (NPHIs) can address COVID-19 vaccine misinformation and rumors resulting in vaccine hesitancy, in order to improve vaccine uptake in African countries.

The webinar offered case studies’ presentations from the Public Health Fellowship Program of Uganda’s National Institute of Public Health (Bob Omoda Amodan) and from the Division of Public Health Institutes and Research of the Africa Centres for Disease Control and Prevention (Dr. Raji Tajudeen). An open discussion followed to exchange ideas, experiences and strategies about specific ways to tackle misinformation.   

The virtual event was co-moderated by Dr. Alex Riolexus Ario, director of the Uganda National Institute of Public Health and chair of the IANPHI Africa Regional Network, and Dr. Hervé Hien, director of the National Public Health Institute of Burkina Faso and vice chair of the IANPHI Africa Regional Network. Dr. Hien also shared introductory remarks on COVID-19 vaccine misinformation in Burkina Faso. Live interpretation in French, English and Portuguese was available thanks to funding support from the U.S. Centers for Disease Control and Prevention.

Case Studies

Introductory Remarks on COVID-19 Vaccine Misinformation in Burkina Faso, by Dr. Hervé Hien, director of the National Public Health Institute of Burkina Faso

Burkina Faso launched its multi-step vaccination campaign on June 2, 2021, aiming to reach at least 70% of its almost 22 million inhabitants. The strategy was to progressively expand the targeted population, to multiply the number of vaccination centers and adapt to the reality on the ground of each district. In September 2021, three months after its launch, 120,937 inhabitants had been vaccinated, from which 83,644 vaccinations had received a first dose. Progress in vaccination seems to be limited to high-risk populations and those who see an interest in receiving the vaccine, such as travellers and health care personnel. One of the major difficulties the country is indubitably facing is the lack of COVID-19 vaccine acceptance from the population. The feeble communication and false rumors are causing, on one hand, denial towards the existence and consequences of the virus, and on the other hand, fear of the vaccine among the population. 

COVID-19 Misinformation in Uganda, by Bob Omoda Amodan, MPH, MSc, fellow, Public Health Fellowship Program, Uganda’s National Institute of Public Health (UNIPH) (see presentation)

After observing a suboptimal level of coverage of various vaccines in Uganda, Bob Omoda Amodan and his team conducted a COVID-19 vaccine acceptability study based on a cross-sectional assessment in the districts with the highest and fewest infection cases. The results of the study (see presentation for further details) emphasize the importance for radio and television, which are deemed the most efficient ways of communicating on COVID-19 vaccines, to give out verified information and to be used to tackle doubts and rumors concerning the effectiveness and the safety of COVID-19 vaccine. A significant part of the Ugandan population believes that the vaccine causes serious health complications or infertility, that the African continent is being used as testing grounds, or that the vaccine is simply not effective. A greater focus has to be placed on urban areas where the interest in getting vaccinated is lower. It also seems that vaccine uptake could be improved by having local and national leaders take the vaccine first to encourage people. The process of demystifying negative information about COVID-19 vaccines is profoundly linked to the diffusion of their benefits, essential to lower the number of serious infection cases.

How National Public Health Institutes Can Address COVID-19 Vaccine Misinformation and Hesitancy, by Dr. Raji Tajudeen, MD, MPH, Head, Division of Public Health Institutes and Research, Africa CDC (see presentation)

On September 27, 2021, Africa had recorded over 8.2 million COVID-19 cases and more than 209,000 deaths. If the control of the pandemic rests on the development and availability of a safe and effective vaccine, it also requires sufficiently widespread willingness of the population to accept it. In 2020, Africa CDC and the London School of Hygiene and Tropical Medicine conducted a COVID-19 vaccine perception study in Africa to investigate vaccine acceptance among adults in fifteen African countries.

Considering the significant regional differences, the potential uptake of a COVID-19 vaccine in Africa appeared to be quite high, with just one in five respondents refusing to get vaccinated. Those more likely to refuse the vaccine seemed to be the populations exposed to COVID-19 disinformation, those who believe COVID-19 risks have been exaggerated, those who trust social media for information, or do not know anyone who has had the virus. These populations consequently believe in vaccine-related rumors and disinformation.

The Ebola outbreak in West Africa taught public health experts the importance of community engagement, as well as epidemic preparedness and response through coordination, cooperation, collaboration and communication. The African Union and Africa CDC’s Risk Communication and Community Engagement Technical Working Group provides tailored help to Members States in the deployment of the COVID-19 vaccine. Weekly communication meetings with WHO AFRO are organized to make sure the continent speaks with one voice, and a mass media strategy using digital public relations and vaccine acceptability campaigns has been engaged. 

One of the lessons learned from the COVID-19 crisis is the critical role of NPHIs in pandemic preparedness and response permitting regular collaboration between Member States and Africa CDC. There is a need to continue advocating for the role of NPHIs and be aware of the importance of human resources and expertise. Actions that played an important role in the African COVID-19 pandemic response included locally contextualized guidelines, political leadership, deployment of rapid responders and community health workers to support coordinated responses, short-term training, a trusted travel platform for vaccine passports, and partnerships to emphasize the message. Efforts to intensify risk communication and community engagement need to be pursued.  

Open Discussion

A first comment from a webinar participant was about the need to make clear that there are distinct targets and that the vaccine message needs to be adapted to each one of them. Healthcare workers and the overall population cannot be addressed in the same way. There is an urgent need to learn how to properly communicate with the population.

Another participant raised the question of what concrete steps can be taken to curb COVID-19 vaccine hesitancy. Bob Omoda Amodan identified two major actions under way in Uganda. First, to promote community dialogue, a collaboration was established with district leaders, which are very respected and influencial within the communities. Short studies refuting rumors responsible for hesitancy were also drafted and spread through different types of media.

A third participant brought to the audience’s attention reports stating that vaccine passports from African countries were not recognized in Europe, but the issue seems to have been sorted out thanks to the close relationship between specialized institutions in the European Union and Africa.

Additionnal tools that can be helpful for NPHIs to address vaccine misinformation and hesitancy include:

  • the Social Media Toolkit for Health Practitioners hosted on the World Health Organization's Digital Health and Innovation pages: this toolkit provides simple, useful information on sharing trusted sources of information, ready-to-go assets to share on social media accounts, and support to create content.
  • the COVID Behaviors Dashboard of the John Hopkins Center for Communication Programs: this dashboard presents data from a global survey of knowledge, attitudes and practices around COVID-19, which you can explore for a country or WHO region. More than 12 million adults in 100+ countries responded to the survey and new data is being added twice a month. The data covers the topic of vaccine hesitancy, reasons for hesitancy and reported structural barriers. Analysis and content on the COVID Behaviors Dashboard is developed by Johns Hopkins Center for Communication Programs and WHO's Global Outbreak Alert and Response Network (GOARN).

Watch the Full Webinar

Find out more about the IANPHI COVID-19 Webinar Series

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