Vaccine hesitancy amongst the tribal population of India: a comparative scenario between COVID-19 vaccination and routine immunization
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20240296Keywords:
Vaccine hesitancy, Tribal population, Routine immunization, COVID-19 vaccinationAbstract
Vaccine hesitancy plays a crucial role in slowing down the efforts towards achieving an immunized and healthy society, particularly, children and women. VH is very conspicuous among the economically marginalized tribal and indigenous population. Previous research papers have not presented a comparative scenario between VH for RI and COVID-19 and have not discussed in detail different reasons behind VH from the gender perspective among tribal population. The key research question for this systematic review is whether the vaccine hesitancy for routine child vaccination among the tribal population will reduce or escalate or show no change after COVID-19 vaccination drive. This paper using Google Scholar database identified the research paper and reports, published between 2013 and 2023, and synthesized the factors contributing to vaccine hesitancy among the tribal population. While hesitancy due to reasons such as the safety and trust concerns, related to vaccines and the government; strong dependency on natural remedies; decision making dominated by social and cultural norms prevailing since ages; emerged as the key resistant in case of routine immunization among the tribal population, these were observed to be similar, to a large extent, in case of COVID-19, as well, in spite of two different age groups being the target of the vaccination drive. The paper identified key enablers and barriers of vaccine acceptance, which will be insightful for policy makers, healthcare agencies and professionals working to eliminate VH among tribal and indigenous population.
Metrics
References
WHO. Vaccine hesitancy: A growing challenge for immunization programmes. Available at: https:// www.who.int/news/item/18-08-2015-vaccine-hesitancy-a-growing-challenge-for-immunization-programmes. Accessed on 20 May 2023.
Feemster KA. Vaccines: What Everyone Needs to Know. London: Oxford University Press; 2017.
Vaccines and immunization. Published 2019. Available at: https://www.who.int/health-topics/vacc ines-and-immunization. Accessed on 20 May 2023.
Summary WHO SAGE conclusions and recommendations on Vaccine Hesitancy. Available at: https://cdn.who.int/media/docs/default-source/immu nezation/demand/summary-of-sage-vaccinehesitancy-en.pdf?sfvrsn=abbfd5c8_2. Accessed on 20 May 2023.
Agrawal A, Kolhapure S, Di Pasquale A, Rai J, Mathur A. Vaccine Hesitancy as a Challenge or Vaccine Confidence as an Opportunity for Childhood Immunisation in India. Infect Dis Ther. 2020;9(3):421-32.
Krishnamoorthy Y, Kannusamy S, Sarveswaran G, Majella MG, Sarkar S, Narayanan V. Factors related to vaccine hesitancy during the implementation of Measles-Rubella campaign 2017 in rural Puducherry-A mixed-method study. J Family Med Prim Care. 2019;8(12):3962-70.
Agarwal AK, Sengar A, Preeti G, Gupta R. A Study of Vaccine Hesitancy among Mother and Care Provider during MR Vaccine Campaign. Nat J Community Med. 2019;10(11):605-11.
Gerretsen P, Kim J, Quilty L. Vaccine Hesitancy Is a Barrier to Achieving Equitable Herd Immunity Among Racial Minorities. Front Med. 2021;8:320-8.
Ramya HR, Gopal PVS, Prasad SV, Raja L. Characteristics Determining the Livelihood Security of the Tribal Farmers. Int J Curr Microbiol App Sci. 2017;6(7):4462-70.
Kumar MM, Pathak VK, Ruikar M. Tribal population in India: A public health challenge and road to future. J Family Med Prim Care. 2020;9(2):508-12.
Francis MR, Nuorti JP, Lumme-Sandt K. Vaccination coverage and the factors influencing routine childhood vaccination uptake among communities experiencing disadvantage in Vellore, southern India: a mixed-methods study. BMC Public Health. 2021;21(1):1807.
Bunch L. A Tale of Two Crises: Addressing Covid-19 Vaccine Hesitancy as Promoting Racial Justice. HEC Forum J. 2021;33(1-2):143-54.
Kumar D, Chandra R, Mathur M, Samdariya S, Kapoor N. Vaccine hesitancy: understanding better to address better. Israel J Health Policy Res. 2016;5(1):2.
Dispelling Vaccine Hesitance in Tribal Districts of India. Available at: https://anamaya.org.in/wp-content/uploads/2022/09/Dispelling-Vaccine-Hesit ance.pdf. Accessed on 20 May 2023.
Pattanaik N. In COVID Vaccination Drive, Covering India’s Tribal Communities Is KeyThe Wire Science. Available at: https://science.thewire.in/health/in-covid-vaccination-drive-covering-indias-tribal-communities-is-key/. Accessed on 20 May 2023.
National Family Health Survey (NFHS-5). Available at: https://main.mohfw.gov.in/sites/default/files/NF HS5_Phase-II_0.pdf. Accessed on 20 May 2023.
Wagner AL, Shotwell AR, Boulton ML, Carlson BF, Mathew JL. Demographics of Vaccine Hesitancy in Chandigarh, India. Front Med. 2021;7:585579.
Wiysonge CS, Ndwandwe D, Ryan J. Vaccine hesitancy in the era of COVID-19: could lessons from the past help in divining the future? Hum Vaccin Immunother. 2022;18(1):1-3.
Sarkar A, Dalui A, Sarkar P, Das M, Basu R, Sardar JC. COVID Vaccine Hesitancy among the Tribal Population and Its Determinants: A Community-Based Study at Berhampore Block of Murshidabad District, West Bengal. Indian J Public Health. 2023;67(1):21.
Tribal Health Report, India-Bridging the Gap and a Roadmap for the Future. Available at: http://tribal healthreport.in/full-report/. Accessed on 20 May 2023.
Larson HJ, de Figueiredo A, Xiahong Z. The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey. EBioMedicine. 2016;12:295-301.
Hossain MB, Alam MZ, Islam MS, et al. COVID-19 vaccine hesitancy among the adult population in Bangladesh: A nationwide cross-sectional survey. Plos One. 2021;16(12):e0260821.
Khargekar N, Khargekar VC, Shingade PP. Immunization Status of Children Under 5 Years in a Tribal Area, Parol, Thane District. Nat J Community Med. 2015;23:32-9.
Formative Research on Perceptions Regarding Vaccine for COVID 19. Available at: https://iec. unicef.in/. Accessed on 20 May 2023.
Jacob I. Health and Health Seeking Behaviour among Tribal Communities in India: A Socio-Cultural Perspective. JTICI. 2014;2(1):1-16.
Shrivastwa N, Gillespie BW, Kolenic GE, Lepkowski JM, Boulton ML. Predictors of Vaccination in India for Children Aged 12–36 Months. Am J Prevent Med. 2015;49(6):S435-44.
Roy D, Debnath A, Sarma M, Roy D, Das K. A Decomposition Analysis to Understand the Wealth-Based Inequalities in Child Vaccination in Rural Southern Assam: A Cross-Sectional Study. Indian J Community Med. 2023;48(1):112-25.
Barman D, Dutta A. Access and barriers to immunization in West Bengal, India: quality matters. J Health Popul Nutr. 2013;31(4):510-22.
Dasgupta P, Bhattacherjee S, Mukherjee A, Dasgupta S. Vaccine Hesitancy for Childhood Vaccinations in Slum Areas of Siliguri, India. Indian J Public Health. 2018;62(4):253.
Hawlader MDH, Rahman ML, Nazir A. COVID-19 vaccine acceptance in South Asia: a multi-country study. Int J Infect Dis. 2022;114:1-10.
Guha N. India’s Covid gender gap: women left behind in vaccination drive. Available at: https://www.the guardian.com/global-development/2021/jun/28/india-covid-gender-gap-women-left-behind-in-vaccination-drive. Accessed on 20 May 2023.
Sundaram SP, Ningombam JD, Lyngdoh M, Medhi GK, Lynrah W. Vaccine Hesitancy and Factors Related to Vaccine Hesitancy in COVID Vaccination among a Tribal Community of Meghalaya: A Mixed Methods Study. IJFD. 2023.
Immunization among Tribal Population in India. Available at: https://www.unicef.org/india/media/ 6716/file/Immunization%20among%20Tribal%20Population%20in%20India.pdf. Accessed on 20 May 2023.
Prasad S. Traditional healthcare practices among tribes: A study of Mandla district in Madhya Pradesh. IJTK. 2022;21(4):12-8.
Negi DP, Abdul Azeez EP. Diminishing traditional methods and inaccessible modern healthcare: the dilemma of tribal health in India. J Health Res. 2021;36(5):867-77.
Sharma S, Akhtar F, Singh RK, Mehra S. Understanding the three As (Awareness, Access, and Acceptability) dimensions of vaccine hesitancy in Odisha, India. Cin Epidemiol Global Health. 2020;8(2):399-403.
Boro B, Saikia N. A qualitative study of the barriers to utilizing healthcare services among the tribal population in Assam. Plos One. 2020;15(10):e0240096.
Melki J, Tamim H, Hadid D. Media Exposure and Health Behavior during Pandemics: The Mediating Effect of Perceived Knowledge and Fear on Compliance with COVID-19 Prevention Measures. Health Commun. 2022;37(5):586-96.
Bhadra A, Amin DR. Mass Media Usage and Exposure of Sabar Tribal Community: A Study. Global Media J. 2022;20(53):314.
Mishra R, Newme K. Social Communication and Traditional Folk Media of the Zeme Naga Society. J Health Res. 2015.
Hmar EL. Traditional Folk Media: Its Importance, Awareness and Attitude towards Drug Abuse among Hmar Youth in Dima Hasao District of Assam. J Glob Community. 2018;11(1):33.
Amin DR. COVID-19: Myths, Reality Effect of Pandemic on Tribal Communities. JETIR. 2022;9(8):32-8.
Integrated Tribal Development Project: Vaccine Advocacy Using Local Language in Tribal Areas. Available at: https://network.exemplars.health/india-covid-19-sos/b/best-practices/posts/itdp1. Accessed on 20 May 2023.
Pandit A. Community leaders turn ‘influencers’ to boost vaccination drive in tribal districts. Available at: https://timesofindia.indiatimes.com/india/community-leaders-turn-influencers-to-boost-vaccination-drive-in-tribal-districts/articleshow/86571684.cms. Accessed on 20 May 2023.
Talukdar D, Mete J. Social Media in Changing the Culture of Tribal Community in West Bengal. Saudi J Humanities Social Sci. 2021;6(5):164-74.
Chattopadhyay K, Mohanty S. New media and cultural disconnect: A study on the lodha tribal community of India. Asian J Social Sci. 2022;50(2):137-46.
Ramesh R, Sasikumar M, Israel G. Effect of the covid-19 pandemic on routine childhood immunization in rural communities in Southern India. Int J Infect Dis. 2023;130:S59.
Saurish A, Narayanamurthy MR, Gopi A. Did this pandemic trigger a spike in mothers’ hesitancy over their children’s routine immunizations? -A cross sectional study. Clin Epidemiol Glob Health. 2022;15:101023.
Patel K, Nayak B, Rana S. Enablers and barriers towards ensuring routine immunization services during the COVID-19 pandemic: findings from a qualitative study across five different states in India. Transact Royal Soc Trop Med Hygiene. 2022;116(9):814-21.
Kawalkar U, Balkar V, Naitam D. Barriers and Facilitators of COVID-19 Vaccination Outreach Program in Rural India: A Qualitative Study. Cureus. 2023;15(3):23-8.
Banerjee P, Seth R, Dhaliwal BK. Vaccine acceptance in rural India: Engaging faith leaders as vaccine ambassadors. Front Public Health. 2022;10:979424.
Priya P K, Pathak VK, Giri AK. Vaccination coverage and vaccine hesitancy among vulnerable population of India. Hum Vaccin Immunother. 2020;16(7):1502-7.
Singh DrSK, Gupta G, Bhadana DrS, Negi DrY. Immunization among Tribal Population in India: A Need Assessment Report. Available at: https://www. comminit.com/global/content/immunization-among-tribal-population-india-need-assessment-report. Accessed on 20 May 2023.
Soni GK, Seth S, Arora S. Harnessing the Power of Collaboration to Expand the Coverage and Equity of COVID-19 Vaccinations in India: A Community Collaboration Model. Vaccines. 2023;11(6):1022.
VHAI-Annual-Report-2020-21. Available at: https:// vhai.org/wp-content/uploads/2022/05/VHAI-Annual-Report-2020-21.pdf. Accessed on 20 May 2023.
Hossain I, Ganguli P, Thakur CN. Thinking Out-of-Box in Addressing Communication and Service Delivery Challenges: Use of a Traditional Communication Method for Improving Immunization Coverage in Remote Rural Hard-to-Reach Areas of India. World J Vaccines. 2023;13:1-12.
Agoramoorthy G, Hsu MJ. COVID‐19 and India’s vulnerable indigenous populations. Am J Human Biol. 2022;34(2):602-9.
Umakanthan S, Patil S, Subramaniam N, Sharma R. COVID-19 Vaccine Hesitancy and Resistance in India Explored through a Population-Based Longitudinal Survey. Vaccines. 2021;9(10):1064.
Chakrabarti A, Bair EF, Thirumurthy H. Routine child immunizations in India during the COVID-19 pandemic. SSM Popul Health. 2023;22:101383.
Ramesh R, Sasikumar M, Israel G. Effect of the COVID-19 pandemic on routine childhood immunization in rural communities in southern India. Int J Infect Dis. 2023;130:S59.
