Widespread mistrust and rejection of the COVID-19 vaccine in Papua New Guinea (PNG) is linked to an increasing number of mothers choosing not to promote their children for other vaccines.
Health experts say it’s only a matter of time before a devastating disease outbreak emerges as immunity levels drop in the most populous Pacific Island nation.
The country successfully kept the COVID epidemic at bay with strict measures, including the closure of borders, until March 2021, when cases began to rise. Now PNG has recorded a total of 46,427 cases, 909 of which in the past month and a half.
Still, the COVID vaccination rate in the great Pacific Island nation remains significantly low, with only 7 percent of the population for the first dose and 5 percent for the second dose. By contrast, Fiji’s COVID vaccine uptake is 99 percent for the first dose and 89 percent for the second dose.
According to local health experts, distrust of the COVID vaccine in PNG has spread to a general distrust of all vaccines.
“COVID vaccine resistance has turned into the hesitation of mothers and families to vaccinate their babies,” said Professor Glen Mola, head of obstetrics, gynecology and reproductive health at the School of Medicine and Health Sciences at the University of Papua New Guinea in Port. moresby
The hesitation is based on “the false fear that nurses at baby clinics could secretly vaccinate the baby against COVID-19,” Mola told Al Jazeera.
While PNG’s healthcare is under severe pressure from the demands of the pandemic, the high public distrust of the vaccine is the leading factor in low uptake.
Dr David Mills, of Kompiam Rural Hospital in remote Enga Province, located in the mountainous highlands of the PNG mainland, said there will be serious health consequences as infant vaccinations dwindle.
According to the United Nations Children’s Fund (UNICEF), intake of the third dose of vital DTP (diphtheria, tetanus and pertussis) vaccine in PNG infants, for example, has dropped from 64 percent in 2009 to 31 percent last year.
“Confidence in the healthcare system has generally deteriorated due to poor information dissemination,” Mills said, referring to the “consistency of conspiracy thinking” around COVID and the exaggeration of the threat level to PNG, and a perception. That COVID health messages are only being spread for financial incentives.
“We expect measles, pertussis epidemics” [whooping cough] Polio – especially measles – that can occur at any time due to chronically low vaccine coverage or chronically low vaccine coverage is a concern,” he said.
Even before COVID-19, there were a number of challenges in launching a routine infant immunization program in PNG, where more than 80 percent of people live in rural and remote areas.
In the highlands, health services have very limited access beyond the main city centres. Nationwide, there is a shortage of qualified health and medical professionals in PNG. The country has fewer than 1,000 doctors for its population of about 9 million.
While the country’s child mortality rate has fallen over the past 15 years, neonatal and infant mortality rates remain the highest in the region, with 22 and 35 per 1,000 live births, respectively.
The PNG government recommends that all children up to age two be vaccinated against at least tuberculosis (BCG vaccine), diphtheria, tetanus, whooping cough, polio and measles. However, the proportion of children in this age group who had all basic vaccinations decreased from 52 percent in 2006 to 35 percent in 2018, while the rate of those who did not receive any vaccination increased from 7 percent to 24 percent in the same period.
Olive Oa, health program manager at humanitarian organization ChildFund in PNG, said the onset of the COVID pandemic in early 2020 put tremendous additional pressure on PNG’s already fragile health system, and opposition to the COVID vaccine posed a huge additional hurdle.
“In the beginning, when the pandemic first appeared in the country, there was a lot of misinformation. [about COVID-19] …was circulating before official information was available,” Oa told Al Jazeera.
“Vaccination ambivalence was prevalent in the general population, including healthcare professionals at all levels, not just mothers. “And there’s still a lot of hesitation,” said Oa, who teaches community health workers in the Central State of PNG on COVID vaccine.
A telephone survey conducted in the country last year found that 78 percent of respondents not planning to get a COVID vaccine were worried about side effects, 53 percent had no confidence in vaccines, and 23 percent thought the vaccine would not work. , according to a World Bank report.
The Australian National University’s Center for Development Policy reported that vaccination rates among children in PNG have now fallen to dangerous levels. For example, a recent study in the high mountain Western and Hela States found that only 20.6 percent of children had three or more vaccinations, and 31 percent were never vaccinated.
Health experts believe the country’s declining immunization rate is the leading cause of the measles outbreak in 2014, the polio resurgence in 2018, and the ongoing tuberculosis epidemic.
The country’s Ministry of Health now warns that “there will be another measles outbreak in the next few years” unless urgent action is taken.
Amid the dire forecasts, the PNG government has outlined a strategy to train more health workers to upgrade community-level healthcare facilities in rural communities and expand the coverage of immunization programs that will require substantial funding and investment.
Health researchers have also recommended interacting more effectively with communities to increase people’s confidence in healthcare and strengthen public health messages about the importance of COVID and other vaccines.
Olive Oa says, based on her experience in this field, “education should be central.”
This means educating healthcare workers, trainee healthcare professionals, parents, community leaders and religious groups about the value of COVID and other vaccines, he says.