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[CCP Virus] Indonesia and Philippines face persistent anti-vax hurdle


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Indonesia and Philippines face persistent anti-vax hurdle
Asian hesitancy weighs as inoculation drives make progress
AKANE OKUTSU, CLIFF VENZON and ERWIDA MAULIA, Nikkei staff writersSeptember 14, 2021 06:00 JST


TOKYO/MANILA/JAKARTA -- The number of people in Asia getting vaccinated against COVID-19 has been rising. But further progress in battling the pandemic could be slowed by the continuing appearance of social media hoaxes and disinformation that make it harder to combat hesitancy.


Some of the uglier postings have been in Indonesia, which says it has found and had taken down 2,000 vaccine-related hoaxes on social media platforms. One posting in July showed five coffins in a mosque, with a deliberately-wrong caption saying they contained residents of one house who just got vaccinated.


In an earlier hoax, an Indonesian TV report quoting a scientist was manipulated so captions had him saying "our people will be killed by Chinese vaccines" and that jabs "make the virus more savage" -- which was completely different from what he was saying. Before Facebook took it down, the post received 11,000 "likes" and was shared 182,000 times.


Last month in the Philippines, the Health Department debunked a video -- which went viral on Facebook -- by a "Doc Ron" who asserted that Pfizer's COVID-19 vaccine contains HIV particles. That too was taken down.


Japan too has been hit by misleading social media posts. In the first seven months of 2021, as many as 110,000 Twitter posts that were retweeted at least once suggested that getting vaccinated leads to infertility, Nikkei's research found.



A health worker tends to a coronavirus disease (COVID-19) patient in the chapel of Quezon City General Hospital turned into a COVID-19 ward amid rising infections, in Quezon City, Metro Manila on Aug. 20.   © Reuters


In many Asian countries, governments and experts are trying to find ways to communicate more effectively with the public and -- where there are anti-vax efforts -- to knock them down. There have been some improvements, but it's proving difficult to crush vaccine hesitancy. This is part of the reason there's a long way to go to get vaccination levels high enough to resume most normal activities and travel.


A 31-year-old mother of one in Japan's Kanagawa Prefecture, south of Tokyo, is an example of the hesitancy that the government has not been able to eradicate. She and her husband are aware that the health ministry and other public institutions insist there is no evidence that getting vaccinated is harmful for pregnant women. Still, the woman -- who is not pregnant -- refuses to get COVID-19 shots.


"Because we want a second child, my husband and I decided we would not get vaccinated," she said. In her view, the vaccines were "just developed, and I am worried that something might happen in a few years, even if there was no [worrying side-effect] for now."


Many younger people in Japan are yet to take the vaccines. Based on its research in Tokyo and surrounding areas in July, a government expert committee found that only 45% of people in their 20s and 30s were either already vaccinated or wanted to be, compared with 60% for those in their 40s and 50s. According to the committee, it is ideal to vaccinate 75% of the younger group, and 80% for the older one.


Japan, which just rolled out its vaccination program this year, had fully vaccinated half of its population. It has done well with seniors, fully vaccinating about 88%. Government leaders and experts have been desperately trying to convince the still reluctant, especially among Japan's young.




"There are false rumors that the COVID-19 vaccine makes people infertile, but various institutions around the world are saying that [rumor] is totally not true," Taro Kono, a minister who's in charge of the vaccination program, told a major youth fashion event, Tokyo Girls Collection, on Sept. 4. "I hope you will take [the vaccines] with no such fear," he said. His tweet about TGC was liked 20,000 times.


All parts of the world have varying degrees of vaccine hesitancy, and some have found that the percentage of a nation's people vaccinated starts to plateau after reaching 50% to 70%. As of early September, about 40% of people in the U.S. haven't had any jabs, according to Our World in Data. About 30% still have not been vaccinated in the UK and Israel.


In the Philippines, where 15.4% were fully vaccinated as of Sept. 12, a survey by Pulse Asia in June showed that 43% of respondents said they wanted to be vaccinated, 36% said they didn't, and the rest were undecided or had been vaccinated. This was an improvement from a February poll, which showed only 16% willing to be vaccinated while 61% were not.


Sometimes, minds do change. "Before, I didn't want to be vaccinated, because of news that some people died after being vaccinated," Kathlyn Marcos, a 31-year-old Manila cashier, told Nikkei Asia after receiving her first shot of Sinovac. She was the last to be vaccinated in her family, which eventually convinced her to get it.



A medical worker injects a dose of COVID-19 vaccine in Indonesia on Sept. 6. A survey found 60% of respondents either "less willing" or "very unwilling" to get a jab.   © Getty Images


In Indonesia, 15.4% of the population was fully vaccinated by Sept. 12. Factors slowing progress include some delays in delivery and distribution of the vaccines, but there's also coolness to vaccinations. A survey released by Jakarta-based pollster Indikator Politik Indonesia on Aug. 25 found 60% of respondents were either "less willing" or "very unwilling" to get a jab, half of whom cited worry about unknown side-effects.


Disinformation about vaccines is not new, according to Shinichi Yamaguchi, an associate professor at International University of Japan who researches social media and fake news.


Vaccination involves technical knowledge, causing some people to feel anxious because of their lack of understanding. And drivers of fake news being shared are anger or anxiety, according to Yamaguchi. "Anyone can be fooled, regardless of age or gender," he told Nikkei Asia.


Countering fake news is a challenge for the government, especially when political confidence is low. Amid Japan's recent surge of COVD-19 new cases, support for Prime Minister Yoshihide Suga's government dropped to the 30% range in July for the first time since its inauguration in September 2020. (Suga later announced he will not seek reelection in ruling Liberal Democratic Party's presidential election on Sept. 29.) Lack of trust in the government creates a breeding ground for conspiracy theories and fake news, said Yamaguchi, adding "Unless there's trust in the government, the vaccination rate will not become high."


According to research published in the medical journal Lancet in 2020, Japan in 2018 was among the countries with the lowest vaccine confidence in the world even before the pandemic.


Another survey by Imperial College London as of August also shows Japan is lagging behind the U.K. and the U.S. in building strong trust in COVID-19 vaccines.




Japan has had some bitter experiences with vaccines and drugs. One major setback was when the government lost when defending against lawsuits that made side-effect claims for measles, mumps and rubella (MMR) vaccines. As a result, Japan stopped requiring MMR vaccines in 1993 and made such vaccinations non-mandatory in 1994.


Since 1994, attitudes of the health ministry toward vaccines "have always been passive," said Akihiko Saitoh, a professor of pediatric medicine at Niigata University. Vaccination is now an individual choice, and "the power of the government recommendation is not as [strong] as in the US," he said.


Also, the Japanese government has been sued by more than 100 recipients of human papillomavirus (HPV) vaccines against cervical cancer, which are widely used globally. The class-action case, filed in 2016, remains in court.



Women in face masks walk in the famous Shibuya crossing in Tokyo. Many young people in Japan are yet to get vaccinated against COVID-19 . (Photo by Ken Kobayashi)


Kensuke Yoshimura, president of an educational project called Cov-Navi that provides information to the public on COVID-19 vaccines, said Japan's vaccine policies "had repeated failures, especially for communication," and that the HPV vaccines scare indicated "the ultimate example of failure."


Indonesia, the country with the largest Muslim population, historically has seen some resistance to medicines on the basis they were not certified as halal, or acceptable for Muslims. In August 2018, the Indonesian Ulema Council (MUI) issued a fatwa (edict) saying that the MMR vaccine was "forbidden" because of the use of pork or derivatives in its production, but that the use of the vaccine itself was "permissible" because of Islamic law's leniency in emergency situations.


For COVID-19, the government involved MUI from the beginning in its vaccination drive. In January, the council declared Sinovac, which was the first vaccine used and accounts for the bulk of doses administered in Indonesia so far, as halal. Indikator Politik said that in its poll, 4% of respondents said they either didn't believe or were unsure if government-provided vaccines were halal.


Indonesia's Communications Ministry, in addition to finding and getting social media platforms to take down hoaxes, has been fact checking against problematic contents and publishing counternarratives regularly on its website. In May, it launched a national digital literacy program to educate the public not to easily trust information spreading on the internet.


In the Philippines, unfounded allegations that a dengue vaccine caused the death of children grabbed headlines a few years ago, fueling skepticism on vaccines for a time.


Another issue in the Philippines for COVID-19 is higher trust in Western-made vaccines than Chinese ones which dominate the country's supply. The bias forced the government in May to stop announcing in advance the brands that will be administered in vaccination centers.



Philippine President Rodrigo Duterte holds a vial of Sinovac Biotech's CoronaVac in February.   © Reuters


Confidence in COVID-19 vaccines improved after a government's information campaign on vaccine effectiveness regardless of the brand. Doctors received Sinovac jabs on national TV, while President Rodrigo Duterte's inoculation with a jab of China-made Sinopharm vaccine was also publicized. (Duterte has threatened to jail people who didn't get vaccinated, but it hasn't happened.)


For Yoshimura of the Cov-Navi project in Japan, the key to battling COVID-19 is getting people accurate, easy-to-understand information. Yoshimura, who is also a professor at Chiba University Hospital, launched the project with other experts to educate the medical workers and Japan's general public, communicating information backed by peer-reviewed academic reports and public institutions. He added that efforts must be made to educate youths in their teens, or even younger and their parents.


Vaccine hesitancy is not the sole obstacle to accelerate inoculation drive. There is still more to be done about making vaccines available for those who are wanting to get one. In Japan, vaccination at some universities and companies was put on hold due to lack of supply. A new vaccination site set up for young people under 39 years old at the end of August in Tokyo's Shibuya district was overcrowded on its first day, before the site started to accept online bookings.


Vaccines are believed to be effective for preventing severe symptoms that require extra care in hospitals. "No matter how much the number of beds increases and capacity expands, the main plug must be closed," said Cov-Navi's Yoshimura. Combined with social distancing and border control, "vaccination would be the most effective" measure for fighting COVID-19, he said.

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