COVID-19 vaccine hesitancy: ‘best vaccine is the one that is available’ versus ‘waiting for what is good is the best option’

 

To the editor

A recently published correspondence tries to explore other reasons for vaccine hesitancy, especially among the educated sector, as expressed in the decision to delay inoculation because of the lower efficacy of currently available vaccines and/or lack of access to European Medicines Agency-approved jabs that are required for a European Union vaccine passport.¹ This correspondence adds to this discussion considering that vaccine refusal or hesitancy is the main problem that COVID-19 vaccine rollouts have had to confront and not a brand preference or vaccine ‘choosiness’.²

Health authorities in the Philippines try to sell the idea that ‘the best vaccine is the one that is available’ which adds further hesitancy among many Filipinos and never could build trust in vaccines. In addition, the decision of the President not to disclose the brand of vaccines except at the last moment, while the people are in queues, so they can give their ‘informed consent’, adds another doubting stance among Filipino people. Adding further uncertainty, the President had himself vaccinated with another Chinese vaccine, Sinopharm, which was not even approved by the Food and Drug Administration. Sinovac, which submitted its application at about the same time as Sinopharm, still has not been approved as of today.³

Is ‘waiting for what is good will be the better option?’ I would like to answer this question by citing the Canadian approach to vaccine procurement by largely purchasing large volumes of vaccines from multiple producers.⁴ Just like the Philippines, Canada is unable to rely on domestic manufacturing capacity. Though, unlike Canada, the Philippines relies on only one country and hopes China will ‘prioritize’ the Philippines when it develops a coronavirus vaccine.⁵ As the Canadian government spread its bets across multiple vaccines, Duterte, the Philippine President, spoke of great debt to China for COVID-19 vaccine. Canada’s strategy of heavy procurement and broad regulatory approval means that when vaccines are sufficiently available, Canadians may feel that they should have a choice in which they receive. What could we learn from the Canadian experience? In presenting results on the public’s view of various vaccines, it is important to acknowledge that the public is not, as a whole, a scientific expert and public judgments can never substitute for clinical trials. But public beliefs matter, because they guide behavior. We must understand what the public is thinking as we begin the process of mass vaccination.⁴