This article is part of our special report COVID-19 and beyond: Confidence and resilience in vaccine ecosystem.
EU stakeholders are exploring ways to build up confidence in a future COVID-19 vaccine, after polls across the world have suggested that the public opinion still is not convinced.
Vaccine hesitancy does not come as a surprise for Europe. The recent measles outbreak showed that anti-vaccination campaigns have had an impact. The rising trend was quickly reversed after a number of awareness-raising campaigns were launched.
However, with global expectations of quick approval of the COVID-19 vaccine, doubts over its safety have also emerged. A recent poll in the US found that only about half of Americans would try to get a COVID-19 vaccine.
A recent worldwide poll also found mixed feelings among EU member states. In Poland and Hungary, 56% of those surveyed said they would get a vaccine, and 59% in France.
In Spain, the percentage is 72% while in Great Britain it is 85%.
Only in China, an overwhelming majority (97%) would get the vaccine.
The role of health workers
Speaking at the “Resilient Societies – Restoring the Value of Vaccines” event in GLOBSEC 2020 in Bratislava on 7 October, several stakeholders suggested ways to increase confidence in a COVID-19 vaccine.
For Andrea Ammon, head of the European Centre for Disease Prevention and Control (ECDC), the role of health workers will be primarily critical.
“We do know that health care workers are the trusted persons for people that want to get vaccinated and have questions. So, it is important that healthcare workers, first of all, believe themselves in the vaccines,” she said.
“Also, we need to make sure that they are equipped with all the information they need in order to enter a dialogue with the patients or clients that come to them and have questions,” she added.
Ammon added that ECDC, together with the European Medicines Agency, is establishing a monitoring system for the safety of the vaccine and for its effectiveness, which should be in place as soon as the vaccines are licensed.
“From day one, safety and effectiveness can be monitored. And we are setting this up as an independent system of public funding so that there is no question about any interest that can influence that,” she said.
Agnes Galgoczi, an expert in the National Public Health Centre in Hungary, said the plain language should be used when providing information instead of speaking in scientific terms.
“It is very important that the population trusts the government and the authorities,” she added.
Mandatory or voluntary schemes?
Another topic highlighted in the debate was whether vaccination for COVID-19 should be mandatory or voluntary in order to achieve the highest possible vaccination rates.
Galgoczi said Hungary had a successful mandatory vaccination programme with the coverage rate standing at 99% annually.
However, there are problems regarding the uptake of influenza vaccination.
“We only use 50% of the vaccines we are supplied. Particularly healthcare providers refuse the flu vaccine,” she said.
Ammon said there was a need for a mix of approaches depending on the context and circumstances of each country.
No compromise on safety
For Nicoletta Luppi, president and managing director of biopharmaceutical company MSD Italy, without confidence or trust, even the most well-functioning vaccination programme will not succeed.
“Dis- and misinformation may impact both existing and future vaccines, including for COVID-19. We need to build confidence that COVID-19 vaccines work and, most importantly, that they are safe,” she said.
Luppi stressed that no compromise should be made when it comes to safety, but given the scale of vaccination, numerous individuals will inevitably experience health problems, raising questions about the safety of the vaccine, and in some instances resulting in litigation.
“Vaccines, like any medicines, are not completely risk-free. Adverse events may emerge more quickly when millions of people receive a vaccine through anticipated programmes. The potential volumes of claims that could arise could challenge healthcare and legal systems and could undermine public trust in all vaccines,” she added.
Luppi backed legally binding measures to address these challenges, providing for no-fault compensation systems, and exemption from liability for all parties involved.
“No-fault compensation systems are already in place in 11 member states although not all of these schemes automatically apply to COVID-19. These systems should be expanded to also cover COVID-19 vaccines,” she said.
Luppi also supported the long-standing argument of the pharma industry that all related actors need to work together for a resilient vaccines ecosystem.
“This is something that COVID-19 has taught us.”
“Private actors can help provide reliable and accurate information to tackle hesitancy. Whilst working on resilience, we need to also take into account normal medical activity, not only emergencies. This can help us make sure that no disease is left behind,” she warned.
[Edited by Zoran Radosavljevic]