Maxing the Vax: why some countries are losing the COVID vaccination race
By Grace Law
As Australia’s COVID vaccination rate reaches 90% for the adult population, are you aware of countries struggling with their vaccination program? This piece discusses three countries, Brazil, Papua New Guinea, and India, and the key challenges they face in increasing their vaccination rate.
Edited by Caitlin Kane and Jessica Nguy
December 10, 2021
Illustration by Aisyah Mohammad Sulhanuddin
Most Australians are now fully vaccinated against COVID-19, but are you aware of how other countries are handling their vaccination programs? Each country has its own set of challenges and setbacks it must overcome in getting its citizens vaccinated. The success and failure of vaccination programs depend on how well these are addressed, and how the people respond.
Political, economic, geographical, and educational factors can have a huge impact on vaccination success. Below, I will discuss the key challenges affecting COVID-19 vaccination in three countries, Brazil, Papua New Guinea, and India, as well as its impact on the country’s vaccination rate.
Brazil – the nation that changed their fate
Brazil has suffered the highest overall death toll in Latin America which is also the second-highest in the world after the United States. Brazil’s President Jair Bolsonaro was strongly opposed to lockdowns, restrictions, and public-health measures such as masks, which some local areas sought to impose (1). He has also spread disinformation regarding the coronavirus and vaccines, such as posting a video falsely associating the coronavirus vaccines with the onset of AIDS, resulting in Facebook removing it after public outcry (2). As a leader, his words and actions have major roles in influencing opinion and informing the public.
While the number of preventable deaths is shocking, the predicted wave of destruction by the Delta variant has not materialised. Over 60% of the population is fully vaccinated despite the mixed messages and deterrence from the central government (3). The city of Serrana became the testing site of the Chinese vaccine Sinovac with most adults being willing towards receiving the vaccine (4). Consequently, the symptomatic cases, hospitalisation and deaths in the area all fell dramatically, becoming a place of envy for the neighbouring communities (5). This initial success also offers hope for low and middle-income countries, which may rely on this cheaper vaccine (6).
Despite governmental resistance throughout the pandemic, Brazilians have defied the odds and faced the virus as a united community. Local leaders have challenged the national government to ensure suitable public health orders are enforced, and citizens have actively sought vaccination, preventing further COVID-19 devastation.
Papua New Guinea – our struggling neighbour
One of Australia’s closest neighbours, Papua New Guinea (PNG), is among the countries with the lowest vaccination rate in the world. According to Our World in Data, only 2% of the population is fully vaccinated (7). One of the most difficult issues to address is mistrust in the vaccine, due to low health education, inadequate health and general resources, and a political and historical distrust in the government.
PNG relies on Australia and New Zealand’s AstraZeneca donations to acquire COVID vaccines, as well as Australian embassy staff to help run pop-up clinics in shopping centres. A Chinese medical team has also been working outside the government to unofficially administer the Sinopharm vaccine at a hospital clinic, leading to speculations of politically-motivated manipulation and interference (8).
PNG is caught between two great powers, and the already sceptical PNG people are neglected and uninformed about vaccine efficacy, safety, and choices (9). Low science literacy and mistrust in political institutions have made it extremely difficult to convince people to get vaccinated (10). This has furthered the development of conspiracy theories, which interplay with cultural beliefs around witchcraft and superstitions (11). Despite the recent introduction of the “no jab, no job” policy, people are turning to mass resignations or the acquisition of fraudulent certificates instead of receiving the COVID-19 vaccine (12). Australia recently offered aviation lift services to high priority provinces, delivering much-needed emergency supplies to geographically isolated areas in PNG (13).
A lot of work is still needed in order to increase the vaccination uptake rate in PNG. Stronger and more impactful campaign messaging will be required to increase public demand for vaccines (14). Foreign aid and assistance should prioritise effective vaccination and long-term health improvement over political agenda (15). The priority must be to stop the pandemic devastation by getting people vaccinated, and addressing long-term infrastructure, funding, and governance issues.
India – great challenges and great ambitions
India has the second-largest population in the world and it has struggled to source an adequate number of vaccines for its people. The government was ambitious that local manufacturing of the Indian vaccine Covaxin would be sufficient for domestic consumption. Instead, Bharat Biotech’s newest facility in Bengaluru reports quality issues in its initial batches, leading to a delay and vaccine shortage (16).
During the country’s destructive second wave from April to June of 2021, the vaccine shortage was exacerbated by the government hesitating to approve vaccines developed and manufactured overseas. Local supply was also hindered by raw material shortages at the beginning of 2021 (17). While the government has sought higher vaccine administrations, setbacks including delays in manufacture, lack of doses received from overseas, and difficulties in obtaining regulatory approval, have contributed to the delayed and restricted nature of the vaccination program.
Initially, the people met the vaccination program with great enthusiasm, and the government aimed to vaccinate all adults against COVID-19 by 31 December 2021. But vaccine uptake has plateaued and declined since October, and there are fears this target will not be met. Many factors have contributed to the decreased vaccine uptake, including vaccine shortage, barriers to vaccination such as lockdowns, high infection rates causing fear of visiting vaccination centres, and misinformation particularly in under-resourced rural areas (18).
Although an improved COVID-19 vaccination program could have reduced the severity of the second wave, attention now is on maintaining the vaccination uptake rate. As the Indian government started to offer free vaccinations to all adults, citizens living in poverty have had the chance to be vaccinated as well. While many countries wish to manufacture their own vaccines at a fraction of the cost of the pharmaceutical giants, quality control and quality assurance remain incredibly complex issues to tackle (19). Lower-income countries require sufficient guidance and support, and Shahid Jameel, a virologist from Ashoka University in New Delhi says, ‘We can’t fix vaccine inequalities until vaccine manufacturing is distributed.’ (20)
Conclusion
Numerous factors impact vaccine uptake, with each country facing its own set of challenges. Mismanagement, limited infrastructure, and rampant misinformation were highlighted here, but there are many problems impacting vaccination programs around the world. Urgently addressing these problems will be needed to reduce vaccination inequality around the world, and hopefully, reach the end of the pandemic very soon.
For more information on COVID-19 and the vaccine, please visit the VaxFACTS website created by the University of Melbourne: https://www.vaxfacts.org.au/
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Jake Horton, “Covid Brazil: Why could Bolsonaro face charges?” BBC News, published 27 October, 2021, https://www.bbc.com/news/world-latin-america-56663217.
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“Facebook removes video in which Brazil’s Bolsonaro links coronavirus vaccines with AIDS,” Washington Post, published 25 October, 2021, https://www.washingtonpost.com/technology/2021/10/25/facebook-papers-live-updates/#link-UA7IQVP5E5D2VGUQX7OJQBCFIE.
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“Coronavirus (COVID-19) Vaccinations,” Our World in Data, published 26 November, 2021, https://ourworldindata.org/covid-vaccinations?country=OWID_WRL.
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Mauricio Savarese, “Sinovac vaccine restores a Brazilian city to near normal,” Associated Press News, published 2 June, 2021, https://apnews.com/article/caribbean-brazil-coronavirus-pandemic-business-health-20bd94d28ac7b373d7a8f3f9c557e5b6.
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“Sinovac vaccine restores a Brazilian city to near normal.”
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Mihai Sora, “Overcoming community resistance to vaccination in Papua New Guinea,” The Interpreter, published 26 October, 2021, https://www.lowyinstitute.org/the-interpreter/overcoming-community-resistance-vaccination-papua-new-guinea.
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Liam Fox and Marian Faa, “Health workers face death threats as COVID-19 vaccine hesitancy takes hold in PNG,” ABC News, published 10 September, 2021, https://www.abc.net.au/news/2021-09-10/png-vaccine-hesitancy-papua-new-guinea-covid-19/100444380.
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Fraser Macdonald, “Just 1.7 per cent of PNG residents are vaccinated against COVID. Why are they so resistant?” SBS News, published 8 November, 2021, https://www.sbs.com.au/news/just-1-7-per-cent-of-png-residents-are-vaccinated-against-covid-why-are-they-so-resistant/72c40029-dec8-4202-b436-31562d983fbc.
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“COVID-19 partnership with Papua New Guinea strengthened” Minister for Foreign Affairs, published 27 October, 2021, https://www.foreignminister.gov.au/minister/marise-payne/media-release/covid-19-partnership-papua-new-guinea-strengthened.
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Shruti Menon, “India vaccination: Does it have enough doses for all adults?” BBC News, published 3 August, 2021, https://www.bbc.com/news/world-asia-india-55571793.
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Liji Thomas, “Factors predicrting vaccine hesitancy in India,” News Medical, published 26 September, 2021, https://www.news-medical.net/news/20210926/Factors-predicting-vaccine-hesitancy-in-India.aspx.
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