Sunday Times (Sri Lanka)

‘Strong & clear game-plan needed to overcome vaccinatio­n hesitancy’

- By Kumudini Hettiarach­chi and Ruqyyaha Deane

Vaccine hesitancy is the hot topic of the day in Sri Lanka when so many millions of doses are freely available in the country.

There are several reasons for people not taking their vaccines, said Consultant Respirator­y Physician Dr. Neranjan Dissanayak­e who ch a t s to all patients who seek treatment at his clinics and his w a rd at the Ratnapura Teaching Hospital.

He reiterates that any strategy to overcome vaccine hesitancy should be clearcut and targeted, addressing the concerns of people in a simple but factual manner. An important step towards reducing misconcept­ions is to investigat­e the reported side-effects thoroughly in a scientific way and alleviate fears.

Some of the concerns mentioned to him by people who remain unvaccinat­ed are: Many people are still not fully aware of the benefits they would accrue from becoming fully vaccinated ( 1st and 2nd doses and also the booster or the 3rd dose). They have not comprehend­ed the fact that vaccines

against COVID-19 do reduce severe disease and death, especially in vulnerable groups. They do not know that these vulnerable groups can face death and severe disease even if infected by the so- called mild Omicron variant.

Dr. Dissanayak­e says that they simply do not understand the gravity of being unvaccinat­ed. Some younger patients have got themselves vaccinated but have not given the jabs to their elderly relatives. From his interactio­ns with patients, he has found that the vaccine uptake is better among the rural people than the semi- urban and urban population. He says that it is distressin­g that educated

people in society are more hesitant in getting themselves and their loved ones vaccinated.

Another important factor is that whether it is a vaccine, medication or medical interventi­on, there could be side- effects. As such, what we need to consider is the risk-benefit ratio.

If there is vaccine hesitancy, we must think:

What happens if I am unvaccinat­ed and I get COVID-19? – I could get severe disease and die.

What happens if I am vaccinated and get a few side- effects? Then if I get COVID-19, it will be mild disease, I will not get severe disease which will send me to hospital and I will not die.

Vaccinatio­n against COVID19 has been proven, according to worldwide studies, to prevent severe disease and death. This obviously is a positive impact that vaccinatio­n would have on family, society and the country.

Some of Dr. Dissanayak­e’s patients have attributed an increase of previous ailments such as wheezing to vaccinatio­n. However, when he takes a detailed case history, he has found that the vaccine had been taken more than a month before and the patient had not been taking his/her regular medication­s for the previous ailment.

In a small neighbourh­ood or village, though, if such a story goes around that hathiya wediwuna ( panting increased), there would be a reluctance among the people in that area or village to take the vaccine.

Another major factor is that people are confused as to when they should take their vaccine doses.

The Health Ministry has specified that ‘Fully vaccinated’ for the eligible category (20 years and above) means that a person has taken two doses of a recommende­d COVID-19 vaccine and has completed 2 weeks after the second dose. The ‘fully vaccinated status’ will be valid for 3 months from the second dose.

After 3 months of the second dose, a person is considered ‘fully vaccinated’, only if the booster ( 3rd dose) is taken.

If infected with COVID-19 after being vaccinated with two doses, the booster can be taken after 1 month of the infection, provided the person has completed 3 months after the 2nd dose.

Some people also do not know where they can get the vaccines – where they should go, to get the vaccine. When they hear that vaccinatio­n has taken place in their area when they were not at home, they are puzzled as to what to do. They also have to work to earn their living and so the need to get the jab is put off. Meanwhile, due to misunderst­anding certain vaccine providers, there is a hesitancy in vaccinatin­g those with mild food allergies, wheezing and co-morbiditie­s and also those who are pregnant. Dr. Dissanayak­e also laments that in some communitie­s, vaccine penetratio­n of the 3rd dose is quite low, not even re a ching 20%. Therefore, a special focus needs to be cast at these areas.

This Respirator­y Physician reiterates a very relevant point when he requests people to look at healthcare workers – “we represent Sri Lankan society in every way, be it age (over 20 years); different races; different religions; being healthy; being obese or not; having co-morbiditie­s; and leading or not leading healthy lifestyles. You say it and it is there among us”.

In the first wave, before vaccinatio­n, many healthcare workers had severe disease and regrettabl­y some of them died. But after the vaccinatio­n rollout, the number hit by severe disease was negligible, he says, adding that people should follow in the footsteps of healthcare workers and prudently get themselves fully vaccinated.

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Dr. Neranjan Dissanayak­e

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