Social media, vaccine hesitancy and trust deficit in immunization programs: a qualitative enquiry in Malappuram District of Kerala, India

Abstract

Background With increased penetration of the internet and social media, there are concerns regarding its negative role in influencing parents’ decisions regarding vaccination for their children. It is perceived that a mix of religious reasons and propaganda by anti-vaccination groups on social media are lowering the vaccination coverage in Malappuram district of Kerala. We undertook a qualitative study to understand the factors responsible for generating and perpetuating vaccine hesitancy, the pathways of trust deficit in immunization programs and the interaction between various social media actors. Methods In-depth interviews and focus group discussions were conducted among parents/caregivers, physicians, public sector health staff, alternative system medical practitioners, field healthcare workers and teachers in areas with highest and lowest vaccination coverage in the district, as well as with communication experts. Results The trust deficit between parents/caregivers and healthcare providers is created by multiple factors, such as providers’ lack of technical knowledge, existing patriarchal societal norms and critical views of vaccine by naturopaths and homeopaths. Anti-vaccine groups use social media to influence caregivers' perceptions and beliefs. Religion does not appear to play a major role in creating vaccine resistance in this setting. Conclusions A long-term, multipronged strategy should be adopted to address the trust deficit. In the short to medium term, the health sector can focus on appropriate and targeted vaccine-related communication strategies, including the use of infographics, soft skills training for healthcare workers, technical competency improvement through a mobile application-based repository of information and creation of a media cell to monitor vaccine-related conversations in social media and to intervene if needed.

Risk communication and community engagement during COVID-19

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Worldwide vaccine inequality threatens to unleash the next COVID-19 variant

“…Lastly, it is critical to address the trust deficit that exists in under-vaccinated regions brought about by lack of knowledge on the part of providers, entrenched negative attitudes about vaccines and social media misinformation. (Nair, Nayar et al 2021) Policymakers must ensure that health care workers have the resources and training to educate their patients, that the deep-seated mistrust in the health care system by many groups is addressed, and that the powerful anti-vaccine messages on social media are countered whenever possible.…”

Promoting Vaccination in India through Videos: The Role of Humor, Collectivistic Appeal and Gender

“…Past research in Odisha, India (the site of the current work), focused on the impact of strong gender norms on health behaviors [ 17 ]. Despite India being a patriarchally oriented society, women do have a voice in family health decisions [ 18 ]. Women are also more likely to hold community health worker roles that are focused on promoting vaccines [ 19 ].…”