Vulnerable to barriers
Vaccine and perceptions of Fijian women
IN early March this year (2021), Fiji began rolling out its vaccination program with the arrival of the first batch of the AstraZeneca vaccines into the country. Latest statistics by the Health Ministry reveals that about 56 per cent of the target population has received the first jab.
Getting vaccinated is a personal choice, but against the more transmissible Delta variant of COVID-19, herd immunity has been prioritised to counter the impact on our communities.
The biggest challenge, however, for our local public health officials is vaccine hesitancy. Many people are still not accepting the COVID-19 vaccine and this in turn means inadequate protection for all of us.
Through research the cause of vaccine hesitancy in Fiji ranges from the lack of information regarding safety and efficacy of AstraZeneca to distrust of the Government as Fijians continue to get bombarded with negative messages about the vaccine across social media platforms.
The Fiji Women’s Rights Movement (FWRM) released a Rapid Assessment on Fijian Women’s Perceptions on COVID-19 Vaccines in Fiji.
The Assessment was supported by the Australian Government through the We Rise Coalition in partnership with the Pacific Women Shaping Pacific Development.
Research background
The Rapid Assessment was developed on findings of an online survey conducted in early June and gauged a total of 574 responses from Fijian women.
The focus of the survey was on women who were often vulnerable to barriers that could influence their decision to get vaccinated including education level, economic welfare, family influences, access to information and more.
About 59.6 per cent of respondents were in the 25-44 years age group, 13.2 per cent in the 45-54 years age group and 3.9 per cent in the 55 to 64 years age group.
A total of 40.7 per cent of the respondents were single while 41.8 per cent of respondents were married and 62 per cent of the respondents were heterosexual women.
The survey was carried out as Fiji was hit with the second, stronger variant of COVID-19 post April 2021.
What do the findings indicate? Reasons for vaccine hesitancy
Despite the accessibility and availability of the AstraZeneca vaccine and the wide rollout of the vaccination program, vaccine hesitancy poses the biggest challenge to health officials and a key finding of the assessment is the lack of confidence in the COVID-19 vaccines. Many of the women surveyed were in fact positive about the vaccine, but a large percentage noted factors that could influence their decision not to get vaccinated.
A total 83.7 per cent of respondents were positive about COVID-19 vaccinations, however, 35.6 per cent of the respondents stated the following reasons would prevent them from taking the vaccine:
Lack of confidence in the safety and efficacy; Long queues and no two-meter distancing at vaccination sites;
Constitutional right to refuse vaccination; Negative message of vaccines on social media platforms; and
Distrust in the government which is triggered by the inconsistent and unreliable information shared by the Government.
The urgency of addressing vaccine hesitancy is high as hundreds fall victim to the pandemic daily. The vaccination campaign can be supported with appropriate responses to these fears surrounding the vaccine.
Role of information in influencing the perception of Fijian
women of the COVID-19 vaccine
The quality, timely, accuracy and reliability of information by the Government on COVID-19 related matters in print media and social media platforms plays a critical role in the effectiveness of the vaccination program rollout in any country.
About 74 per cent of respondents cited the Fiji Ministry of Health and Medical Services website as their source of information on COVID-19 related matters.
This was closely followed by social media platforms such as Facebook, Instagram etc which stood at 73 per cent while print media stood at 56 per cent compared to radio and the Fiji Government website which stood at 53.3 per cent and 51.4 per cent of respondents respectively. It is important to note that the Ministry of Health and Medical Services and the Fiji Government have Facebook pages as well.
Given the intensity and frequency of COVID-19 related information and the factors outlined above, 38.6 per cent of respondents were positive about the vaccine.
Of concern are 42.3 per cent of respondents who held both a positive and negative view about the COVID-19 vaccine compared to 10.6 per cent of respondents who had a negative attitude about the vaccine.
Also concerning are respondents who were unsure or had mixed feelings about the vaccine. The breakdown is as follows:
42.3 per cent had a mixture of positive and negative information about the COVID-19 vaccine;
4.9 per cent held views that potentially classified them as fence sitters, they neither had a positive or negative attitude about the vaccine; and
3.5 per cent were unsure or don’t know about the COVID-19 vaccine
In other words, 51 per cent of respondents may be viewed as potential recipients of anti-vaccine messages as antivaxxers continue to plant seeds of doubt which could influence Fijian women not to seek out the COVID-19 vaccine.
Also, it confirms that conversations/narratives about vaccines tend to be nuanced and this must be considered accordingly by the relevant authorities.
For example, people sharing their personal experiences about the side effects of taking the vaccines on social media platforms can play a role in determining Fijian women’s vaccine hesitancy or willingness.
Respondents shared that the Government sharing facts about the value of vaccines and debunking myths about vaccines by providing clear and simple answers to frequently answered questions could be one way to address the vaccine hesitancy of Fijian women.
FWRM acknowledges that the Government has information brochures that are circulated by authorities at the vaccination sites but this must be complimented by prominent Fijian community leaders and people of influence reaffirming their support for vaccination.
Herbal and traditional medicine
The use of herbal and traditional medicine sets in motion complex health treatment seeking behaviour by Fijian women.
Even with the rollout of the vaccination program, may women still consider traditional medicine as treatment for COVID-19 symptoms.
The risk associated with this finding is that herbal treatment may help with symptoms of the virus, but does not cure COVID-19 thus placing more people at risk, especially with reports of ongoing social gatherings and the lack of social distancing.
Out those who responded to the question relating to the use of herbal and traditional medicine as a substitute for the COVID-19 vaccine, 31 per cent stated that they thought herbal and traditional medicine was a better substitute for COVID-19 vaccines. 51 per cent of respondents considered taking herbal and traditional medicine if they developed any COVID-19 symptoms.
More research needs to be undertaken on these health seeking behaviours and different healing paradigms. This would help design future policies and implementation of the vaccine program as well as in framing evidence based messaging to discourage women from substituting the COVID-19 vaccine with herbal and traditional remedies.
Recommendations
In light of the findings, FWRM offers six recommendations for various key stakeholders who are directly involved with the administration of COVID-19 vaccines in Fiji. They are:
1. That frontline workers who administer vaccines follow strict COVID-19 safety measures such as mask wearing and physical distancing;
2. That the Ministry of Health (MoH) publish sex disaggregated data for recipients of COVID-19 vaccines, to allow for better policy directions in terms of targeting left behind populations;
3. That MoH work with the Ministry of Women and the women’s NGO community, faith-based organizations in developing evidence-based messages to counter anti-vaccine messages;
4. That MoH revise its Data Policy, specifically in areas relating to COVID-19 infections, recoveries and mortalities to reflect gender, age, non-specific but geographical areas or locales, and ethnicity to aid the design and implementation of an appropriate Communications Strategy and Plan that factors these core cultural nuances that greatly impact Behavioral Change in Fiji;
5. That MoH develops a clear communications policy which is led by nationals who are experts and or have knowledge in public health crisis management and understand the cultural nuances of the Fijian population to, inter alia, prepare all public messages issued by the MoH;
6. That collaborative efforts be made by both academic institutions and the women NGO community in undertaking research about matters related to the complex health seeking behaviours of women as it concerns herbal and traditional medicine in the context of the COVID-19 vaccination program as well as a deeper dive into understanding the high number of educated women who earn $15,000 and how this can be effectively addressed through policy solutions as ways to rebuild Fiji in a better way.
Conclusion
Our healthcare systems are at the brink of collapse if not already stretched to its limit.
The need for more collaboration between government, civil society, non-governmental organisations and other charitable/humanitarian organisations is urgent to ensure that there is equitable access to COVID-19 vaccines to all people of Fiji, including women from all diversities.
The need for a better communications strategy to address vaccine hesitancy and the fears surrounding COVID-19 vaccines is even more paramount.
The Rapid Assessment on Fijian Women’s Perceptions of COVID-19 Vaccines is available on the FWRM website.