Coronavirus vaccine: anti-vax movement threatens Asian recovery

Before authorities across Asia are able to immunise their populations against the novel coronavirus, they will have to find an effective vaccine, manufacture it on a massive scale and distribute it to billions of people. They may also have to overcome anti-vaccine sentiment " a growing concern in a region known for its high vaccination rates.

More than 85 per cent of people across Asia believe vaccines to be safe, according to a 2018 survey by Wellcome Global Monitor, higher than any other region. Vaccination rates for the region are high overall, according to World Health Organisation (WHO) data, with coverage for diseases such as tuberculosis, whooping cough and tetanus surpassing 90 per cent.

But controversies involving specific vaccines in Asian countries in recent years have nonetheless called attention to the negative impact unfounded or exaggerated safety and other concerns could have on the uptake of a vaccine for Covid-19, which has resulted in more than 350,000 confirmed deaths worldwide.

An experimental vaccine for the coronavirus is tested at the Quality Control Laboratory at the Sinovac Biotech facilities in Beijing. Photo: AFP alt=An experimental vaccine for the coronavirus is tested at the Quality Control Laboratory at the Sinovac Biotech facilities in Beijing. Photo: AFP

"What scenarios we might worry about is where we get a safe, effective vaccine but there's some kind of theory that circulates that the vaccine is causing syndrome 'X,' whatever that is," Julie Leask, a professor specialising in vaccination at University of Sydney's school of nursing, said.

"Vaccine safety scares don't often catch fire " a lot of people try and light those fires, but mostly they don't catch fire. But when they do, you can have years of hesitancy around that particular vaccine."

In the Philippines, an outbreak of more than 23,500 measles cases, including 338 deaths, in the first three months of 2019 was widely attributed to a rise in anti-vaccine sentiment following the botched roll-out of the dengue vaccine Dengvaxia.

Philippine authorities suspended use of the vaccine after linking it to a number of deaths and later indicted a number of officials from the Department of Health and the French drug maker Sanofi for "reckless imprudence resulting in homicide".

Local and international medical experts, however, have cast the government's response as being heavily politicised and stressed that there remains insufficient evidence to draw a link between the vaccine and any deaths.

In Japan, health authorities in 2013 decided to stop recommending the HPV vaccine after reports of side effects, including muscle pain and sleep disturbance " a decision a study published in The Lancet Public Health found could result in almost 11,000 preventable deaths from cervical cancer.

The WHO in 2017 expressed concern that attention on "spurious case reports and unsubstantiated allegations" in Japan and elsewhere was having a negative impact on vaccine coverage "despite the extensive safety data available".

John Siu Lun Tam, a vaccination expert at the Hong Kong Polytechnic University, said anti-vaccination sentiment in Asia, while weaker than elsewhere, appeared to be taking cues from Western countries where it is heavily associated with higher socio-economic status.

"In Asia, anti-vaccine sentiment shares many features [with] Western countries," Tam said. "As the economic status of many Asian countries has been on a rapid rise in the recent decades, 'Western' ideas and practices are being adopted and in this incidence of the anti-vaccine movement, such sentiment is expected to rise in the near future. In fact, such activities in some countries are on the rise already. "

Religious or ethical concerns have also been a hindrance to uptake in some predominantly Muslim societies.

In Indonesia, where measles cases doubled between 2015 and 2017, efforts to immunise more than 70 million children were thrown off course after the country's Islamic Council said the measles vaccine was not halal due to its use of pig components.

Auliya Suwantika, a professor of pharmacology at Padjadjaran University in Bandung, said many parents in Indonesia also considered vaccines unsafe for their children "due to the dissemination of misinformation by the media, the internet and anti-vaccine groups".

Across the country, 16 per cent of parents express hesitancy about vaccinating their children due to safety and efficacy concerns, according to research by Suwantika, with childhood immunisation reaching just 58 per cent nationwide.

Jerome Kim, head of the International Vaccine Institute in Seoul, South Korea, said the internet and social media had given new reach to misinformation that would have previously fallen on deaf ears in less developed countries that see some of the greatest benefits of vaccination.

"There's always risk and people are very sophisticated these days," Kim said. "You would think that for instance in Africa that the anti-vaccination movement would actually be pretty weak but in some countries, through social media and other tools " and Asians are very social media-savvy " the anti-vaxxer messages spread very quickly and very effectively, unfortunately."

More than 100 vaccines are in development for the virus officially called SARS-CoV-2, although there is no guarantee that a safe and effective candidate will ever emerge for use by the public. While it typically takes 10 to 15 years to develop a new vaccine, researchers are racing to compress that time frame down to just 12-18 months in the case of the coronavirus, and human trials have begun for a number of candidates. Some scientists have claimed a vaccine could be ready before year end.

Kim said it would be especially important to clearly communicate the precautions undertaken during development, given the risk that an accelerated time frame could fuel public concerns about safety.

"From a safety perspective, the normal mechanisms that we would have to make sure that a vaccine is safe will continue to apply," he said.

"We'll have at least one year of safety information, which is a lot, and when we talk about adverse events to vaccines, most of them occur within a relatively short time span after the vaccine."

Ultimately, though, convincing people to accept a coronavirus vaccine could prove to be far less of a problem than keeping up with enormous demand from a pandemic-weary public.

Leask said a look at how newspapers covered the introduction of the polio vaccine during the 1950s suggested people would be clamouring for a cure.

This article originally appeared on the South China Morning Post (SCMP).

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