Vaccine Hesitancy in PNG

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National Vaccine Hesitancy Survey

The Field Epidemiology Training Program of PNG, the Expanded Program on Immunisation (NDOH) and the World Health Organisation are collaborating on a national vaccine hesitancy survey. The study is funded by the Indo-Pacific Centre for Health Security and the World Health Organization with logistics support provided by St Johns Ambulance PNG and the Global Outbreak Alert and Response Network. Additional collaborating partners include the University of Papua New Guinea and the United Nations International Children's Emergency Fund.

Study Title:

COVID-19 vaccine hesitancy in essential workers and the community in Papua New Guinea: an exploratory mixed-methods study

Study Goal:

The goal of this study is to assess essential workers and community knowledge and attitudes related to the COVID-19 vaccine, and primary sources of trusted information, to inform public health messaging to increase vaccine uptake in Papua New Guinea

Specific Objectives:

1.     Identify knowledge and attitudes related the COVID-19 vaccine

2.     Identify circulating myths and beliefs related to the COVID-19 vaccine

3.     Identify primary sources of trusted information related to the COVID-19 vaccine

4.     Based on findings from objectives 1-3, provide recommendations for targeted messaging on the COVID-19 vaccination

Methods:

A cross-sectional, exploratory mixed-methods design including an interviewer administered questionnaire, semi-structured interviews, and group discussions.

Study Results:

We will be posting regular updates as the data is analysed. The survey will be launched the week of April 25, 2021.

Result from the UNICEF U-Report is available HERE. This project is a partnership between FEiA and UNICEF and forms part of the overall vaccine hesitancy study in PNG.

A selection of the final results from the survey are shown in the infographics below.

Vaccine Hesitancy Scoping Study

An initial scoping exercise was implemented to explore issues associated with COVID-19 vaccine hesitancy and inform the development of the questionnaire for the national vaccine hesitancy study mentioned above.

This exercise was led by a team from the Field Epidemiology Training Program Papua New Guinea (FETPNG), in partnership with the National Department of Health (NDoH) and the World Health Organization (WHO) country office in Papua New Guinea.

Vaccine hesitancy is defined as ‘a delay in acceptance or refusal of vaccination despite availability of vaccination services’. Misinformation and lack of information propagate vaccinate hesitancy and are a threat to the containment of the COVID-19 pandemic. In addition, the speed at which the COVID-19 vaccinations have been developed and released for emergency use has increased anxiety related to the unknown. Understanding people’s concerns about being vaccinated against COVID-19 is essential to target messaging and responses that provide timely and accurate information, while acknowledging and respecting concerns. 

Key Findings 

In this initial scoping exercise, we engaged with 19 health care workers, and 14 members of the wider community in Manus, Morobe, West and East Sepik, Port Moresby, East New Britain, Oro, and the Autonomous Region of Bougainville. The sample size for the initial scoping and engagement exercise is not representative, therefore, we recommend exercising caution in generalizing from these findings. However, we do believe these findings are indicative of the main concerns circulating in Papua New Guinea (PNG). This scoping exercise also highlighted several recommendations for the dissemination of correct information about the vaccine, including perceptions of trusted sources and suggested methods for communication. 

Perceptions related to vaccine safety 

• Several concerns about the COVID-19 vaccine were highlighted, including concerns related to the safety of the vaccine, side effects and long-term effects. The main side effects of concern were a perceived risk of death post vaccination, risk of blood clots and long-term impacts on DNA.

Perceptions related to vaccine development, research, and evidence 

• Health care workers raised specific concerns related to the speed in which the COVID-19 vaccines were developed, and a perception of lack of evidence associated with safety and efficacy.

• Concerns were raised related to PNG receiving a vaccine that has not yet been trialled and tested in PNG, uncertainty about the ingredients / composition of the vaccine, and a perceived lack of transparency around the decision-making process associated with selection of the AstraZeneca vaccine for PNG.

Myths and beliefs circulating about the COVID-19 vaccine 

• The most common myths and beliefs reported to be circulating in the community about the COVID-19 vaccine were related to the vaccine being used to spread the coronavirus in the population, and the vaccine being used as a tool to reduce the global ‘black’ population. Other myths included the belief that the COVID-19 vaccine was being used to insert a microchip and was a means of marking individuals with the 666 ‘mark of the beast’ associated with government control and a new world order. This is believed to connect people to the 5G network.

• Other myths circulating were associated with preventative measures and therapies that could be adopted in preference to the vaccine, with the perception that these remedies would prevent COVID-19 infection. Such remedies include various types of bathing, eating organic food and having a strong immune system.

Sources of information related to the COVID-19 vaccine 

• There was a recognised need for dissemination of accurate information through trusted sources to help address the misinformation and reported lack of awareness about the vaccine.

• Multiple sources of information related to the vaccine were mentioned including social media networks, internet searches, internet, television and radio news broadcasts, newspapers, informal communication with colleagues, family and friends, health care workers and the NDoH, WHO and National Control Centre (NCC).

Trusted sources of information related to the COVID-19 vaccine 

• Several trusted sources of information were mentioned. For community members the most mentioned trusted source of information related to the vaccine was health care workers. Other trusted sources included church leaders, prominent leaders in the community and radio talk back shows. A concern raised was that in some situations these ‘trusted sources’ were spreading misinformation about the vaccine.

• For Health Care Workers the most trusted sources of information were the WHO, the NDoH and specialist doctors. These sources were also mentioned by members of the general community.

Preferred communication tools for increasing awareness 

• The most preferred means of receiving information about the COVID-19 vaccine was through video messaging and face-to-face communication.

• The use of vaccine champions, including politicians, high profile individuals and health workers who have received the vaccination to share their experience and answer questions was recommended.

• Advocacy and community engagement involving other organizations working in the community, community leaders, youth groups, and church leaders to conduct active social mobilisation were recommended as effective measures for information dissemination in the community. The important role of community members themselves in spreading correct messaging around the COVDI-19 vaccine was highlighted.

• The importance of equipping health workers, as the most trusted source of information, with information and resources to provide accurate and up-to-date information to the community on the COVID-19 vaccine was recognised.

Anticipated challenges in providing awareness 

• Expected challenges with respect to informing the community about the COVID-19 vaccine to reduce vaccine hesitancy were multifaceted and ranged from a lack of training and resources for health care workers to provide accurate information and feel equipped to answer questions to the belief that the community will reject vaccination teams.

Recommendations 

1. The NCC/NDoH and Provincial Health Authorities (PHAs) should prioritise investment in information, education and communication (IEC) for health care workers in all provinces. Health care workers should be equipped with correct information to enable them to answer questions from the community. 

2. The NCC/NDoH and PHAs should prioritise investment in community engagement and risk communication in all provinces. Key community leaders including pastors and church leaders, local health authorities and prominent leaders with a good standing in the community need to be engaged, informed and equipped with up-to-date and accurate knowledge to answer questions related to the COVID-19 vaccine. 

3. Communication strategies need to include videos with high profile, credible individuals who have received the vaccine, discussing their experience, and addressing common questions and views. 

4. Communication about the vaccine should address common beliefs and perceptions reported by frontline workers and the community. Question and Answer IEC material should be disseminated using a combination of methods including videos, posters, social media posts, news stories, radio chat shows, and YouTube.