Vaccine hesitancy: Lack of awareness among the poor

Capstone City Health

Despite the fact that India’s covid-19 cases are at an all-time high, there is still a long way to go in terms of raising awareness among poor.

Hyderabad: A lack of awareness about the covid-19 vaccine among the poor in India may result in an increase in cases. There are 450 million blue-collar jobs in India, the vast majority of whom are informal and daily-wage laborers who must work longer hours for low wages in environments devoid of clean drinking water, sanitation, medical treatment, and other occupational safety measures.

Syad Hussain, a Hyderabad-based dry fruits street vendor, said, “Life without vaccines is safe, and I am anti-vaccine. It’s unclear what’s inside the vaccine. I have my doubts on what politicians are taking in the name of a vaccine; who knows what it is; it may be water. Previously, when there was no knowledge of this virus, the transmission speed was slower; now, with complete knowledge of this virus, cases are on the rise. I am not concerned about this virus. When the central government implemented a lockdown in 2020, I roamed the entire city of Hyderabad with my kid. He had pneumonia, and they screened him for covid-19, which came out negative. I took him to every hospital in Hyderabad, and it was at that point that I lost fear of Covid-19.”

“I believe there is no corona and that much of this is just political. My child recovered after an 8-10 day medical course at Niloufer hospital and was able to return home. When my child became ill with pneumonia, my neighbors contacted our local All India Majlis-e-Ittehadul Muslimeen (MIM) MLA, who arranged for a hospital bed. My child coughed 30 times in 60 seconds, which I witnessed,” he added.

Syad Hussain said he admitted his child in Gandhi Hospital, where they performed covid-19 tests on him. The results were negative, but the child’s condition remained critical. Syad took his child to Musheerabad, Malakpet, and Chenchalguda government hospitals. He visited several hospitals until a doctor advised him to go to Niloufer, where his child received good care.

Dr. Peteti Premanandam, Head of the Department, Political Science and Public Administration, Andhra University said that Poor people are unaware of how vaccines function and are afraid of the side effects. He said, “It took nearly 15-20 years for people to become aware of polio. It is difficult to persuade people about the importance of vaccines. Promotions can be made on television and in newspapers on a regular basis. Instead of handing out freebies, the government could use the funds to raise awareness and buy vaccines.”  

Deputy Hyderabad District Medical and Health officer (DHMO) Dr. Birjunnisa said, “Everyone is mindful of the importance of vaccines, and even though certain people are unaware of the Cowin website, their children are assisting them with registration. We are raising awareness through Aasha employees, community leaders, and MLAs. We’re going to the slums to make vaccine announcements. The poor are conscious that the vaccine lets them increase their immunity, so they are willing to have it.”

Syad said that not just him, but no one else in his neighborhood has taken the vaccine. “I’m more concerned with the vaccine’s side effects than the corona. After a year or two, we’ll vaccinate. If I want to get vaccinated, I can contact someone from our slum and make the necessary arrangements, but the point here is that I don’t want to get vaccinated,” he added.

B Anjaiah, Assistant Professor, Master of Social Work, Telangana University, said, “If poor people have any health issues, they ignore and go to work. This demonstrates a lack of understanding in a certain section of the poor. Instead of showing dead bodies and funerals, news outlets should start showcasing vaccine awareness programs. When a poor person has a health problem, they usually head to a Registered Medical Practitioner (RMP). The RMP doctor would have no idea what to prescribe or what tests to do.”

Syad said, “People are testing positive for corona even after taking a second dose. I believe that these private hospitals are displaying phony positive results in order to make profits. I run a small dry fruit stall, and the dry fruits I eat here are enough to boost my immunity; I don’t need any extra vaccines.”

“Every five minutes, I see three ambulances on the road. People are going to hospitals not because they are sick, but because they are afraid. What I’m seeing now will make for interesting stories in the future. Covid-19 is straightforward: if you panic, you will die. I’m not afraid; I’m concentrating on my stall. Three people in my building tested positive, but after a few weeks, the results came back negative, and things returned to normal,” he added.

Dr.Gaurav Kumar, Resident at Ram Manohar Lohia (RML) Hospital, New Delhi and member of Indian Medical Association (IMA) said, “India is worst affected by the 2nd wave of coronavirus. So taking vaccine is the only step towards protecting yourself. There are some side effects such as fever, malaise, muscle ache, and discomfort at the injection site, but these minor issues should not stop people from getting vaccinated.”

“At present, we have covishield and covaxin, both of them are effective, hence one should take either of them which are available. Vaccine won’t make you 100 percent safe, but it will obviously reduce the risk of severity of disease and hence reduce the risk of complications.  If you are immuno compromised or have comorbidities, do consult your doctor before taking vaccines,” he added.

Dr. Birjunnisa said that the state government took the initiative to do a fever survey. The health workers are visiting every slum household and assessing people’s health status. “If they exhibit some covid-19 signs, government will provide them a medical kit containing paracetamol, vitamin C, and calcium tablets. If they have covid-19 symptoms, we are telling them to self-isolate,” she added.

Anjaiah said, “The government launched a door-to-door fever survey, but it failed to cover a significant number of people.  The government must address major concerns such as awareness and accessibility. Covid-19 vaccination centers should be increased and made more accessible to the poor. Some primary hospital centers are 15 kilometers away from slums, so an everyday wage worker is unlikely to take time off from work to get vaccinated.”

Dr. Krishna Reddy Chittedi, Assistant Professor, School of Economics, University of Hyderabad, said, “Getting vaccinated is easy at the taluk and village levels, and even the vulnerable in rural areas are conscious of the benefits of vaccines. Many people in my village, Yadadri, have been vaccinated, including those living below the poverty line. Because of overcrowding, vaccination is scarce in urban areas. A section of the poor does not know how to use smartphones so they may face difficulties in urban areas. There are blue-collar workers who cannot afford vaccinations in private hospitals and are unable to obtain a spot in government hospitals.”

In India, according to a World Health Organization research, only six percent of the poorest 20 percent has access to non-shared sources of improved sanitation, compared to 93.4 percent of the top 20 percent. 37.2 percent of SC households and 25.9 percent of ST households have access to non-shared sanitation facilities, compared to 65.7 percent for the general population.

MD Nisar Ahmed, a street fruits vendor, said, “No one I know received the vaccine. Because of the side effects of vaccines, everybody, including me, is afraid to vaccinate. My stall is also suffering as a result of many reasons such as virus paranoia. Even I am afraid of this infection, but in order to support my family, I must come every day and sell fruits. My immunity comes from the food I eat which is roti and rice every day.”

Dr. Birjunnisa said, “We are not doing tests to everyone with covid-19 symptoms because even RT-PCR tests are only 80 percent reliable, HRCT tests must be performed in order to achieve a perfect result. However, since we cannot do HRCT tests on everyone, we are supplying the medical kit. If an individual has coivd-19 symptoms and if their health status does not improve after five days, we would then perform covid-19 tests and treat them for free. We are raising vaccine awareness while conducting fever survey. The GHMC and police department are both doing their best to raise awareness about vaccines.”

Nisar said that he could not take the vaccine because it has not yet arrived in his surrounding areas. “Once officers arrive and inform me that vaccination has begun, I will go and take the vaccine. As of now, I have no idea how or when to take the vaccine. I’m not sure how to reserve a time slot. I’m waiting for officials to come to our area and call us for vaccination. Till now, nobody had asked us about vaccination. Covid-19 is an illness that is entirely in the hands of God; no human being has any influence over the condition. I live in Shapur, and I’ve seen three or four positive cases and one death in my neighborhood so far,” he added.

Dr. Gaurav said, “Better framework should be there in this country. Vaccine outreach program should be initiated similar to one which we had in past like pulse polio immunization. Government should recruit more health care workers, Auxiliary midwives n nurses and use them to strengthen the outreach program. Mobile clinics to run in rural areas to raise awareness, posting posters in regional languages can be done.”

“Mostly educated and ones who are well acquainted with modern technologies are coming for vaccination. The turn-out of people from rural society is low. The explanation for this is that the majority of them are unaware of it. They may know that a vaccine program is in place, but they do not know when or how to get it. 80-85 percent of vaccination recipients are from the middle and upper-middle classes. Online registration is a major barrier,” he added.

Dr. Krishna said, “Using the Public Distribution System (PDS), the government can identify the poor. Special vaccine drives can be held at these PDS centers, and poor people who go there to get their rations can be vaccinated. Also, the general population is to be blamed. People cannot expect someone to knock on their door and request that they get vaccinated. People should take an interest in what is going on. Vaccination campaigns are well covered on TV news networks and in newspapers.”

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