How do you fight vaccine hesitancy?

Vaccines are here, but not everyone is willing to get the shot. Now health professionals and community members are working to make the case
By Sabrina Nanji - Published on Mar 11, 2021
MPP Sol Mamakwa receiving his second dose of the Moderna vaccine in Sandy Lake First Nation. (Suzanne Shoush, via Twitter)

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Sparks flew at Queen’s Park Thursday when Premier Doug Ford accused New Democrat Sol Mamakwa of queue-jumping after the MPP for Kiiwetinoong got his vaccine at a fly-in First Nations community.

The vaccination visit and the resulting photo-op, though, were part of a campaign to promote uptake in remote First Nations communities, where sign-ups have been as low as 20 per cent, according to Mamakwa. “I thought that was just a lack of understanding, but actually it’s a lack of respect,” he said of Ford’s remarks.

That statistic reflects a larger challenge for the province. Vaccines are here, but not everyone is willing to get them. The reasons for that are varied, experts say, and include encounters with racism in the Canadian health-care system, online misinformation, and past experience with botched distribution efforts in other countries. So what are health professionals and community members doing about it?

In February, the City of Toronto launched the Black Scientists’ Task Force on Vaccine Equity, which aims to address racial disparities: the coronavirus has hit Toronto’s racialized communities harder than others; 30 per cent of Canadians who are vaccine hesitant are people of African and Caribbean descent.

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Such hesitancy isn’t fuelled only by historical instances of pharmaceutical companies trying to “cut corners” with lower regulatory requirements in other countries, says task-force lead Akwatu Khenti — experiences of anti-Black racism in Canada’s health-care system also play a role.

“Contemporary experiences of racial insensitivity in the health-care system, in terms of experiences of patients — but not just patients — Black health workers, their negative experiences and the negative perceptions of the people they work for and the institutions they work for create a receptor for the messaging around conspiracy theories or bias,” Khenti says. “It sort of makes people believe, ‘Yeah, I could see them doing that.’”

Social media, he adds, is also a hotbed for misinformation that can target racialized groups. One of the ways Khenti is fighting that is through virtual town-hall events at which people can ask questions candidly and get the facts they need to make informed decisions.

“We don’t argue or debate; we just reaffirm that this is the evidence that we can provide to you, but it’s your decision,” Khenti says. “So we affirm people’s individual decision-making. You have to validate people so that they don’t feel that they’ve been dissed.”

That’s already helped alleviate some vaccine-related apprehensions, he says. Among town-hall attendees, hesitancy is down by 16 to 24 per cent, and 80 per cent of people said they would share the information with their friends and family. As Khenti puts it, “The trick is in the messaging.”

Where the message comes from and how it’s relayed is key: the city is deploying 280 “neighbourhood ambassadors” to pump up immunization, because research has shown that, when it comes to hesitancy, people are more likely to listen to those they know and trust.

Andrew Boozary, a physician and the University Health Network’s executive director of health and social policy, lauds the move; he says he recently reassured a woman reluctant to get a shot by answering her questions in Farsi, the only language she speaks. He was able to speak to her in lay terms, answering basic questions about potential side effects, for example. The pair also discovered their fathers grew up in the same town in Iran.

“We weren’t parsing [randomized-controlled trials],” he says with a laugh. “They trust the people they know.”

While vaccine hesitancy is on the decline overall, it remains an issue with some personal support workers in long-term-care homes, according to Miranda Ferrier, president of the Ontario Personal Support Workers Association, an advocacy group. Ferrier says that hesitancy varies from one facility to the next.

“We have some long-term-care homes where all of the PSWs got their vaccinations because they chose to, and then there are other long-term-care homes where, like, 60 per cent of the staff said no,” Ferrier tells TVO.org. She believes about 40 per cent are “really concerned,” while 30 per cent are “on the fence.”

In question period this week, Ford told the legislature he’s worried that 40 per cent of health workers “may not get the vaccine.” (TVO.org asked Health Minister Christine Elliott’s office for comment but did not receive one by publication time.)

Samantha Hill, president of the Ontario Medical Association, stresses that any initial hesitancy among health workers could be about convenience: at first, some PSWs had to trek to a central location to get their shot because of temperature and storage requirements for Pfizer’s dose, but with more flexible transportation rules and other versions on the market, they’re now administered on site. She’s also heard concerns from prioritized workers “about not wanting to be the guinea pig.”

“Most health-care workers are very excited about getting the vaccine and are. If there’s hesitancy, it’s only because they can’t figure out how to make it happen in a way that fits into the reality of their lives,” Hill says. “If we talk about having to go to a mass-vaccination site that is two hours away, on transit, when you’re in lockdown, that becomes a bit of a hard thing to do. That’s not about vaccine hesitancy; that’s just about people trying to juggle life and us failing to meet the requirements to make it easy enough for people to do the right thing.”

The OMA has been sounding alarm bells about vaccine misinformation; Hill says the online chatter has shifted to which of the four versions is best: “Some people [are] feeling that maybe one vaccine is better than another, and maybe they should hold out for a certain vaccine... [But] in order to know if one vaccine was better than the other, you’d actually have to test them side by side in the same group at the same time.”

Whatever vaccine you’re offered “is a good vaccine,” she says, adding, “All of the ones that are available in Canada, they’ve all been shown to be safe. And they have amazing protection rates against the things that are the worst of COVID — so, death, ventilation, extracorporeal membrane oxygenation or being put on a heart lung machine. Things that are disastrous.”

At first, Shelby, a GTA-based worker on the front lines in long-term care, was nervous about how fast the vaccines were coming out and about potential side effects. “It was just scary — there’s been a lot of weird media,” says Shelby, who asked that TVO.org not use her surname.

But after digging into it on her own, she decided to get the shot and to raise awareness on social media, taking her message to TikTok as “PSW chronicles” to shed light on what it’s like to work during a pandemic.

Shelby, who says about 80 per cent of staff at her home have taken the vaccine says she wants people to “know that I’m okay — I didn’t sprout a third arm or anything.”

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