COVID-19: What we should know about vaccine and misinformation

By Wan Norshira Wan Mohd Ghazali

A few days ago, on 4 April, the Health Director-General, Datuk Dr. Noor Hisham Abdullah, announced that Covid-19 vaccine could only be ready in the market after a year as it is still in the early stages of research and tests.

The Guardian (UK) in its 6 April 2020 edition announced that the World Health Organisation (WHO) is researching on a new vaccine to cure the disease. It stated that 35 companies and academic institutions are involved to create such a vaccine. 

The announcement compelled the writer to elaborate on what we should know about vaccines before it is being irresponsibly misinterpreted by individuals or groups on social media as usually happened. 

As evident in the Berita Harian news on 2 January 2020, a Facebook page that despises modern medical methods was reported to have garnered up to 40, 000 followers. The page is not only regarded as a platform to share ideas on how to refuse and criticise the government vaccination programme, but it is also being regarded as the main reference for vaccine-hesitant individuals, the report said. 

Despite the surrounded falsehood, the Facebook page could be said to be powerful that followers often ignore the validity of the information and sources. 

Admittedly, social media has long been considered as the platform for online discussions from trivial to hard-hitting stories. Social media users function pretty well to get their views noticed, hence that set the agenda for public discussions.

This becomes more obvious when Malaysia imposed the Movement Control Order (MCO) on 18 March. 

Misinformation about Vaccines 

Covid-19 is a popular subject on all media including social media as the platform for Malaysians to debate and discuss the issue in relation to vaccine.

However, consumers must be aware of the information termed by WHO as ‘infodemic’.

Infodemic refers to the over-abundance of ‘some accurate’ and ‘some not accurate’ information due to the urge for being timely. The high volume of such information makes it difficult for people to differentiate between fallacy and truth.

This falsehood, according to WHO, is potentially detrimental to the public’s health and safety.

Infodemic circulated around social media could be seen dominant especially when the second wave of Covid-19 hit Malaysia. 

Premature views of vaccines in relation to Covid-19 has been observed to take place in the online discussion platforms involving vaccine denials, vaccine-refusal and vaccine-hesitant individuals which then shared by others who began to believe accounts that are not yet validated. 

According to Dr. Megat Mohammad Amirul Amzar, an activist in vaccination, there are three groups of individuals who refuse vaccine, the first one is vaccine hesitancy which refers to people who have doubts about vaccine. The second group is known as vaccine refusal, individuals who reject vaccines, while the third group is vaccine denial which is considered as the most difficult to change. 

Vaccine denial, as explained by Dr. Amirul, is the common group of people who will spread misunderstanding about vaccines. Although their number is small, but they are very persuasive especially in open online platform to draw attention on their advocacy.

WHO has named vaccine rejection as one of the top 10 global health threats.

An example of vaccine rejection message is assumptions of vaccines are for profit-making because people still get infected by Covid-19 and other vaccines can’t be used to cure Covid-19. This assumption infers an inadequate understanding of how the vaccine works.

A simple analogy to correct the misconception would be, if one has a cough, he should take cough syrup. Whereas if one suffers from back pain, the same medicine would not cure it, hence specific medication should be prescribed. Therefore, the public has to be informed that a distinct vaccine is developed for a specific disease. 

Further, people commonly get confused when interpreting scientific evidence literally. When such a topic is taken on social media and debated among people with no medical background or expertise, there is a high probability that it will lead to misinformation. 

For example, creating a vaccine is not as simple as taking a sample from the body of an infected person and injects it into the body of a healthy person. 

Such unfounded statement could be seen on social media.

The simplistic information could be derogatory to the medical practice because translating scientific and medical terms is not a straightforward task. Rather evidence-based explanation in the form of scientific research and experts’ opinion should be used.

It is therefore suggested that the public should consider the validity of any information on any platform following suggestions made by Dr. Amirul using three criteria namely history, provenance, and authenticity.

“History means the information is taken as a whole without omitting parts of it based on someone’s taste,” said Dr. Amirul. 

“Provenance means the information should come from a first-party or the individual who experienced the event himself. Followed by authenticity, where the information is validated by checking whether the event really took place,” he elaborated. 

The public should be more careful in consuming information online and be wary of or avoid from, a third-party source that might have deviated from the original source. 

Why vaccinate

Current evidence indicates that the public should be continuously educated about the vaccine and its importance to combat diseases. 

From the research on vaccines, several points vital to highlight is, firstly, a vaccine helps the immune system in the body to recognise the virus and to respond to it by producing antibodies that will fight against it. 

Secondly, responses to a vaccine vary. Since human immune system differs from one to another, everyone will have different responses to a particular vaccine, such as developing mild symptom in most cases while adverse effects are very rare. 

Thirdly, everyone should be vaccinated to ensure the success of eradicating a particular disease. This is because if one fails to produce antibodies after taking the vaccine, the majority of the vaccinated people will become the shield that will stop a disease from infecting other people. 

This is known as herd immunity. 

When a large number of people in a community receive the vaccine, they will help protect people of vulnerability and those with the low functioning immune system such as an elderly or a newborn baby. In a way, vaccines could protect future generations and save lives.

Due to vaccine effectiveness and safety, some diseases that once killed or injured thousands of people and children, have been eradicated, if not completely, at least on a large scale.   

As quoted from the Healthline (a web from a medical team), to ensure the effectiveness of a vaccine in stopping the spread of disease, 80% to 95% of the population should be vaccinated. For some diseases, herd immunity could still be achieved when only 40% of the population is vaccinated, the article explained. 

Thus, herd immunity works by “protecting the population when a large percentage becomes immune to the disease, the spread on that disease slows down or stops”, the article stated. Although, the article acknowledged that it is too early to consider that herd immunity is the solution to stop the spread of the Covid-19, but this is not impossible. 

How long vaccine is developed

The world is currently racing to produce a vaccine to combat Covid-19. It is imperative to generally understand how the vaccine is produced before it can be approved.

Here, note that developing a vaccine is not a linear process. It involves safety and efficacy considerations before it could be introduced to human. 

Dr. Nazlina Ibrahim, a virologist, has simplified that there are four phases involved to develop a vaccine. 

The process begins with lab testing that could take up several years on normal vaccine research. The test will be done on animals by injecting a vaccine for two times and then exposed to a real virus. The test could reveal initial information on the possible side effects and mechanism of the immune response of the vaccine.  

Once the test on animals is proven positive, then only further tests will be carried out on human. The research on human will consider all ethical issues. 

As suggested by the Food and Drug Administration (FDA), the first clinical phase begins by testing the vaccine with adults. This phase mainly aims to identify the effects of the vaccine and its suitable dosage. 

The phase will recruit around 20 to 100 healthy people to check on vaccine safety, vaccine reactions on the body, adverse effects of the vaccine, and the dose of the vaccine in relation to vaccine effects. 

Next, more volunteers of up to several hundred individuals will be recruited to receive different vaccines to further test the effects of the vaccine on people. 

The third phase is the extension of the second phase by recruiting more people. Scientists will measure if the benefits outweigh the risks, the vaccine will be given a license. 

The final phase begins once the vaccine is given to the public while the benefits and risks will continue to be observed. Dr. Nazlina further explained, if safety monitoring reveals new information on vaccine risks in the form of adverse effects, the vaccine recommendation could be altered, or revoked altogether.

It is understandable why it will take a minimum of one year and a half to develop Covid-19 vaccine. This period is considered short because some vaccines took at least 10 years before it could be introduced to human. 

The details of vaccine development and approval are hoped to instil trust on vaccine-hesitant or vaccine-refusal individuals that vaccines are not created without considering all the safety measures as they always claim.

Preventive measures

Since the Covid-19 vaccine is on its way, the most that people could do at this moment is to stay at home and practice good hygiene such as frequent handwashing. If they need to go out, always practice social distancing, wear a face mask, and use hand sanitiser when there’s no water.

Let’s hope that the MCO will help to slow, if not break, the spread of the COVID-19 outbreak. As of 9 April, Malaysia has recorded 4, 228 positive cases with 1,608 recovered and 67 deaths.

With the number of infected persons continuing to rise, there is an insignificant sign that the pandemic will subside. Though, the number of COVID-19 cases in Malaysia does not show an immense increase, rather a steady trend, but, it is still too early to make such a conclusion.***

* The writer is researching how media reports vaccination issue from the perspective of health practitioners. The article is written in response to the current issue related to anti-vaccine movement on social media.

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