‘COVID zero’ regions struggle with vaccine complacency

For the handful of locations world wide that successfully stopped COVID-19 transmission, vaccine complacency has change into an unintended facet impact of their success. Though some areas have managed to blunt transmission of the extremely infectious Omicron variant of SARS-CoV-2, others are experiencing appreciable outbreaks in populations with low vaccination charges.

Nowhere is that this extra obvious than in Hong Kong. Its ‘dynamic zero COVID-19’ coverage is being put to the take a look at as day by day confirmed instances of COVID-19 climbed to 56,000 this week and deaths reached 246 on 1 March.

“With the low vaccination charge we’ve got at the moment, I’m actually involved,” says Benjamin Cowling, an epidemiologist on the College of Hong Kong. “Omicron, we all know it’s a bit bit milder, however really in individuals that aren’t vaccinated, it’s not that gentle.” Folks with extreme illness will spend weeks in hospitals, that are already overwhelmed.

The state of affairs was very totally different a 12 months in the past, when weekly confirmed COVID-19 instances averaged 17 a day and didn’t go above 60 a day for the remainder of the 12 months. In February 2021, Hong Kong began providing vaccines to the general public. However uptake has been sluggish: by 1 January this 12 months, solely 62% of its inhabitants was totally vaccinated and as of seven February solely 33% of individuals over 80 years outdated had obtained one dose. A study in June 2021 by lecturers at Hong Kong Baptist College discovered that greater than half of two,753 individuals surveyed have been hesitant about or proof against getting the vaccine.

“One essential cause for vaccine hesitancy is the absence of perceived profit from vaccination when there isn’t any threat in any respect,” says Chunhuei Chi, director of the Heart for World Well being at Oregon State College in Corvallis. Studies show that individuals are much less prone to get vaccinated towards SARS-CoV-2 in the event that they really feel they’re at low threat of catching COVID-19. Researchers have discovered an identical impact throughout previous infectious-disease outbreaks, together with the H1N1 influenza outbreak in 2009–10.

Different areas utilizing methods to suppress and nearly remove COVID-19 — together with Taiwan, Macau, the Chinese language mainland, Tonga and Western Australia — have additionally skilled vaccine complacency.

Older individuals

In Taiwan, vaccination charges for individuals over 75 years of age are the bottom of any age group. As of seven February, solely 69% of individuals over 75 had obtained two doses of a vaccine, in contrast with 88% of individuals aged between 18 and 29 years.

A research of individuals in Taiwan who have been hesitant to get a vaccine discovered a number of causes for this, together with the sensation amongst older individuals that they weren’t at excessive threat of catching the virus as a result of they didn’t exit and encounter others as a lot as younger individuals. Some thought that youthful individuals must be vaccinated first, in response to the results, which have been revealed in January by researchers at Nationwide Taiwan College.

“My conjecture is that the notion of threat of being contaminated by COVID-19 can trump many different elements, particularly in Hong Kong and Taiwan,” says Chi.

Some public-health researchers are optimistic that Taiwan is not going to see as many COVID-19 instances as Hong Kong. Round two native instances of COVID-19 are confirmed day by day, however these numbers are anticipated to rise when entry restrictions for non-resident enterprise travellers are relaxed this month. Chiou Shu-Ti, an epidemiologist and founding president of the Well being and Sustainable Growth Basis in Taipei, thinks native governments and the general public will be capable to stamp out any Omicron outbreaks rapidly.

However others are sceptical. “It’s so tough to cease Omicron,” says Cowling. A single superspreader occasion can get uncontrolled rapidly, he says.

When complacency is an element, governments have to drive vaccine demand with methods that handle individuals’s considerations and obstacles to vaccination, says Katie Attwell, a social scientist on the College of Western Australia in Perth, Australia, who research vaccine hesitancy. “In these nations the place individuals have been complacent, I might recommend governments have been complacent,” she says.

Overcoming complacency

A number of areas with few reported COVID-19 instances have been in a position to overcome vaccine complacency and forestall giant rises in confirmed infections.

A type of is Tonga, which saved the virus at bay till this 12 months. The nation began rolling out vaccines in April 2021, however there was some extent of complacency on the time, says Mark Jacobs, who’s the World Well being Group Consultant to the South Pacific and relies in Fiji.

To counter this, the Tongan Ministry of Well being, supported by the World Well being Group and the United Nations youngsters’s charity UNICEF, visited each village — together with these on distant outer islands — to talk to individuals about vaccines and reply questions. Jacobs says the nation’s first case of COVID-19, detected in quarantine in October 2021, motivated extra individuals to get vaccinated, as did the primary instances of group transmission this February.

“I believe it’s clear that the virus being current in a group does a specific amount of PR for the vaccine,” says Attwell. As of 19 February, 90% of the Tongan inhabitants over 12 years outdated is totally vaccinated and 100% of individuals over 80 have obtained no less than one dose, in response to Jacobs.

However even with excessive charges of vaccination, COVID-19 instances there have elevated, with greater than 700 reported since 3 January. The nation can be recovering from a big volcanic eruption on 15 January that launched giant quantities of ash and gave rise to a tsunami, which brought about widespread devastation similtaneously the nation is attempting to manage the outbreak.