Paper short abstract:

We examine the role of leaders in different communities across the UK through the form of ‘community vaccine champions’, who have been acting as advocates, promoting community engagement among ethnic minority groups and vaccination during the pandemic.

Paper long abstract:

Assoc. Prof Samantha Vanderslott, Kate Joynes-Burgess, Dr Seilesh Kadambari and Prof. Tushna Vandrevala

Abstract

The COVID-19 pandemic has highlighted how ethnic minority groups are disproportionally affected by health crises and also the need for community engagement to provide equitable public health information and services. Community engagement has been presented by policymakers, practitioners, and academics as a way to improve access and uptake of health services, including vaccination. We examine the role of ‘community vaccine champions’, who have been acting as advocates, promoting community engagement among ethnic minority groups and vaccination during the pandemic. Our research explored how champions experienced and confronted the challenges brought on by the pandemic. From April 2021 until May 2022, we conducted 12 semi-structured interviews lasting 45-60 minutes via video call. The interviews were inductively coded and analysed following a discourse approach to health communication. Our findings highlighted the striking role and influence of media and social media misinformation on vaccine decision-making, especially on ethnic minority groups. This rise of false and misleading information during the pandemic has been labelled an ‘infodemic’ by international health institutions and was made evident in community settings through our interviews. However, our informants cautioned about making simplistic assumptions about how misinformation negatively affects vaccine uptake amongst their communities. We conclude by setting out the need for ongoing community support for health issues and how data collection, particularly concerning ethnic minority groups classifications matter in a pandemic setting.

Paper short abstract:

Vaccine hesitancy, a multifaceted issue from mild doubts to outright refusal, is eradicated from the public discourses by media polarization and healthcare sidelining. Amplified by the pandemic, it risks morphing into broader distrust of vaccination and science.

Paper long abstract:

Vaccine hesitancy is often portrayed as a major global problem, addressed by researchers and policy-makers alike. This incredibly complex phenomenon (McDonald 2015) encompasses a plethora of attitudes (from mild doubt to outright refusal) and (in)actions towards vaccines (from vaccinating despite uncertainty, to delaying, to refusing), which need to be addressed. Otherwise, vaccine hesitancy can lead to escalation of fears and radicalisation of attitudes, especially when questions unaddressed in mainstream discourses (also scientific) find their easily digestible answers (online and offline). The media shapes vaccination discourses by disciplining and polarising discussions. In those polarised mainstream and social media, vaccine hesitancy becomes invisible. Additionally, it is sidelined in everyday immunisation practices, with

healthcare professionals only marginally addressing concerns about vaccines. These existing questions and fears (mainly about side effects) were amplified and fuelled (with fears of the unknown and the new) by the pandemic and rapid introduction of Covid-19 vaccines.

Given these complementary tendencies, we suggest that vaccine hesitancy may increasingly evolve into distrust of vaccines and vaccination, but also of science, so eagerly deployed in polarising discourses and, for many, embodied by vaccines. This could lead to a decline in vaccine uptake, a trend already observed in recent years.

The findings are based on extensive qualitative and quantitative research conducted in Poland before and after the pandemic. It included mainstream and social media analysis, interviews with healthcare professionals and hesitant parents, and ethnographic research. More general conclusions are drawn about possible future scenarios for vaccine hesitancy and vaccine mistrust.

Paper short abstract:

This presentation explores vaccine pharmacovigilance. It offers a brief history, emphasizing its role in ensuring safety. The focus on the spontaneous reporting system reveals methodological intricacies, contributing to debates on critical databasing, epistemic justice, and decolonial global health.

Paper long abstract:

This presentation delves into the intricacies of pharmacovigilance, specifically within the realm of vaccines, commonly referred to as vaccinovigilance. Defined as the comprehensive science and activities surrounding the detection, assessment, understanding, prevention, and communication of events following immunization, pharmacovigilance is a crucial component of ensuring consumer and patient safety. This contribution provides a concise historical overview of pharmacovigilance, illustrating how its evolution has been shaped by diverse actors with varying interests, needs, and resources.

In recent decades, the neoliberalization of drug regulation has heightened the significance of pharmacovigilance activities and evidence in influencing drug access and safety. This presentation highlights the intricate flow of pharmacovigilance data across global, national, and regional levels, offering an analysis of the "power geometry" between countries in the Global North and Global South.

With a primary focus on the methodological cornerstone of pharmacovigilance—the spontaneous reporting system—the presentation explores the nature of evidence generated through this form of passive surveillance. By scrutinizing what this system validates and magnifies, as well as what it diminishes and excludes, the analysis sheds light on the methodological intricacies that shape our understanding of vaccine safety and efficacy. This exploration aims to contribute to current debates about critical databasing, epistemic justice and decolonial global health.

Paper short abstract:

In this paper, we discuss the inability of weak states to manage vaccine safety and the transfer of responsibility to supra-national organizations or private companies. We emphasize Romania's loss of control over vaccine production, efficacy, and safety.

Paper long abstract:

During the Covid-19 pandemic, cooperation between states gave way to a global competition for protective equipment and in the production and distribution of vaccines. Governments of some wealthy countries signed privileged deals with manufacturers, leaving the populations of less wealthy states vulnerable to the virus and thus prolonging the pandemic. Although much attention has been devoted to vaccination-related inequity and inequalities, little attention has been paid to competition between states in the control of post-vaccination adverse reactions. This paper is concerned with the inability of weak states to control the efficacy and safety of vaccines administered to their populations. Instead, responsibility has been transferred to other levels, either the supra-national (global bodies such as WHO, or EMA and ECDC in the European Union), or the private (i.e., pharmaceutical companies producing vaccines). The case of post-socialist states supports the ‘hyperglobalist’ thesis. Weak states have ceded some of their prerogatives to supranational institutions or to large private companies. In doing so, they have given up a significant part of the autonomy and the sovereignty they previously had. The paper argues that, because of these processes of transformation and transition, the Romanian state has failed to position itself as a trustworthy and credible institutional actor whose first concern is the protection of its population during a pandemic. The paper examines the mechanisms by which Romania has lost, not only control over domestic vaccine production and distribution, but also its strategic oversight of vaccine efficacy, safety, and quality.

Paper short abstract:

The paper deals with the Latin America and Caribbean states’ efforts to achieve greater coordination and, building on the experiences of Cuba, Argentina, Brazil, and Mexico (which have developed their own vaccines), strengthen the region’s capacities to develop and produce its own pandemic vaccines.

Paper long abstract:

From the early 1900´s, public vaccine manufacturing laboratories in several Latin American and Caribbean countries produced the vaccines their national vaccination programs required. From the 1970’s, the development of more complex vaccines meant that public vaccine laboratories needed to undergo dramatic changes. With this in mind, in the early 1990s, the PAHO led the initiative to create a Regional System for Vaccines in Latin America and the Caribbean. The planned network of member institutions would implement a comprehensive approach covering all stages of vaccine development, production, quality control, and evaluation. However, lack of funding impacted on the initial motivations of collaboration. Only in Brazil, and Mexico, were the necessary political and financial commitments made. The PAHO and WHO considered supporting both public and private vaccine development and production institutions, but, at that time, state vaccine production was being abandoned, so, eventually private industry prevailed and SIREVA disappeared. The COVID-19 pandemic highlighted the region’s limited vaccine production capacity and demonstrated the weaknesses of its health systems. With the aim of reducing dependence on the outside world in the health sector, in 2021 the 33 members of the Community of Latin America and Caribbean states approved the guidelines of a health self-sufficiency plan for the region. The aim is that the countries in the region achieve greater coordination to end the pandemic and, building on the experiences of Cuba, Argentina, Brazil, and Mexico, (which have developed their own vaccines), strengthen the region’s capacities to develop and produce its own pandemic vaccines.

Paper short abstract:

This paper explores vaccine hesitancy in Brazil, examining the Vaccine Riot of 1904 and the 'Doctors for Life' anti-vaccine movement during and after COVID-19. It delves into historical and contemporary contexts to extract lessons for addressing vaccine hesitancy.

Paper long abstract:

The paper delves into the social history of epidemics, particularly focusing on vaccine hesitancy in Brazil within two epidemic contexts: the 'Revolta da Vacina' (Vaccine Riot) of 1904 and the anti-vaccine movement led by 'Médicos pela Vida' (Doctors for Life) during and post the COVID-19 pandemic. While the Vaccine Riot marked a transformative period in Brazilian society, showcasing urbanization and bourgeois trends, the COVID-19 pandemic illuminated unresolved issues, sparking controversies between science, institutions, and society.

The 'Doctors for Life' association, active during the health crisis, vehemently opposed vaccination and advocated for alternative treatments, prompting inquiries into the conditions facilitating their influence on medical practice and society. Pandemic uncertainties, spanning scientific challenges, knowledge production, information dissemination, and institutional responses, significantly contribute to shaping the anti-vaccination landscape.

Groups like 'Doctors for Life' strategically exploit these uncertainties to influence social behaviors, emphasizing the manipulation potential within a sanitary crisis. Analysis of historical and contemporary contexts draws from the literature on the Vaccine Riot, the WHO's concept of 'vaccine hesitancy,' and empirical research on Doctors for Life in Brazil since 2020. This comprehensive exploration underscores the intricate interplay between intentional actors and societal responses to vaccination, providing valuable insights for understanding and addressing vaccine hesitancy in the ongoing battle against infectious diseases.

Paper short abstract:

Under what circumstances does the emergence of a new technology lead to the fading out of existing competing technologies, and how does this take place across different countries? The paper seeks to answer this question by examining the development of vaccine technologies over the last century.

Paper long abstract:

The recent pandemic has exposed the effect of deep-rooted inequalities in access to health care. Low- and middle-income countries received significantly fewer doses of vaccines than their high-income counterparts. Typically, policy makers attribute the problem of vaccine inequality to matters of distribution, isolating it from linked processes of creation, production, and regulation. The proposed paper is an attempt to address this problem by examining the socio-technological relationships underlying vaccine innovation. The underlying hypothesis is that technological gaps between countries create distribution inequality, and this gap is largely a function of economic, legal, and political processes in a given space and time. Historically, technological progress in various fields is associated with a simultaneous fading out of ‘old’ technologies. Popular discourses explain these interrelated phenomena as a function of scientific advancement and technological determinism. The proposed paper problematizes such historically linear, technologically deterministic explanations and attempts to provide a critical understanding of technological progress and the concomitant obsoleteness. This approach examines the questions of why and how certain technologies become relevant in a given space and time by attending not only to the technological features which shape their interactions with the world but also to the underlying social conditions which determine their form and function.