Side Effects Threaten to Increase Vaccine Skepticism among Those with the Least Medical Access

There is no point in sugarcoating it: I did not handle my first dose of the COVID-19 vaccine well. Even though people say the first dose should lead to anything more than some arm pain afterward, my reaction was much more severe. Aside from the thumping arm pain that lasted a better part of a month, I found myself sleeping the whole day the day after and even a part of the day after that. Considering that those who reacted badly to the first dose tend to also react heavily to the second, the anticipation for fevers, pains, and worse have been with me ever since I had the injection a few hours ago.

For government authorities, the side effects of fevers and pains are but minor nuisances in the way of achieving a more noble and altruistic goal. The idea of getting more jabs into arms will supposedly create herd immunity that, while not able to eliminate COVID-19 and its various variants completely, will at least ensure that they do not continue to kill in large numbers. As countries around the world strive to live with COVID, in a change in strategy from the prevalent use of lockdowns to contain its rapid spread in the past, the need to get more people vaccinated fast will become more pivotal. 

Yet, at the individual grassroots level, the fact that those who got jabbed experience pains and fevers still help to justify doubts about the fear and supposed ulterior motives of getting jabbed. After, for those without any underlying health issues, the fact that some liquid from a syringe can dramatically affect so many negative physiological changes, sometimes so severely, can be a cause of great skepticism and anxiety. Conspiracy theories relating to the malintent of the vaccines may resonate better with those who have seen friends and family members suffer after getting the vaccines.

For the medically knowledgeable, linking conspiracy theories with side effects from a vaccine sounds like nonsense. For those who are rich and educated enough, being injected with pharmaceuticals of some sort is a regular affair, from getting vaccines as a child as a requirement for going to school to anesthesia associated with being operated on for both medical and cosmetic purposes. Their frequent experience of getting jabbed in reputed medical institutions, without any long-lasting medical issues, means that a sense of trust in the overall system is present, normalizing medical side effects of drugs they are injected with.

The same cannot be said as the next phase of the COVID-19 vaccination campaign heads to some of the world's most deprived regions. In places of the world where vaccination rates remain low, they have been low not just for COVID but for all manners of pharmaceuticals that people elsewhere may deem normal. The lack of regular medical access means that locals would treat the sudden presence of medical personnel jabbing arms with caution and suspicion. With the presence of conservative religious ideologies that are fundamentally opposed to foreigners' presence, plenty of misinformation about foreigners' malintent can deepen fears of the new vaccine.

As those who receive vaccines are left with painful arms and high fevers, that sense of suspicion may turn into outright hostility. For those with regular medical access, any sign of ill-health, no matter how small, will be reflexively thought of as a matter of life and death, and not just in medical terms. In economies where people rely on informal jobs hassling on the streets to make ends meet, a day down with fever in bed can mean a day going hungry. For them, the concerns of being fed tomorrow weigh much more heavily than the altruism of not infecting others with an unknown foreign disease.

Unfortunately, in the rush to get more people jabbed around the world, government and medical authorities have not sufficiently considered the possibilities of small side effects in vaccinations that may fundamentally shift public attitudes toward the vaccine and derail the whole vaccination campaign. In lands where mistrust of medical and government authorities is rife, when those authorities are present at all, their sudden presence to cause pain, however small and temporary, would not inspire confidence in those they proclaim to serve.

The solution may be to undertake extensive information campaigns before vaccinations start at all. In words and actions that locals without medical knowledge can easily understand, trusted local intermediaries need to first explain the danger of COVID-19 and the urgency of getting vaccinated, to arm people with the right knowledge and attitude to get jabbed. Providing people with necessary financial incentives, in the form of at least a couple of days worth of food, is also necessary to give people the willingness of making the sacrifice of lying in bed for a couple of days after getting jabbed.