From India to Indonesia, fake news, fear and conspiracy theories surrounding Covid-19 vaccinations are gathering momentum as governments embark on mass inoculation drives against the virus which has killed over 2.1 million and infected nearly 100 million worldwide. Attaining herd immunity through mass vaccination is crucial for the recovery of the devastated global economy. Governments are also racing to vaccinate their populations before the coronavirus mutates further – as has happened in Europe and elsewhere – which could potentially render current vaccines “ineffective”, say epidemiologists. “The anti-vaccine movement could have a negative impact on the handling of Covid-19 where the targets [number of people] for vaccination are not achieved to the point where the pandemic cannot be brought under control,” warned epidemiologist Iwan Ariawan of the University of Indonesia (UI). In India, political row erupts over home-grown coronavirus vaccine INDIA In India , the world’s largest vaccine producer, over 1.6 million frontline workers have been inoculated since its roll-out campaign on January 16, but segments of the population remain doubtful and fearful as hoaxes and manipulated videos are circulated on social media platforms. “I’m in no hurry to get vaccinated, unlike my colleagues who are queuing up. First, I might have already been infected and developed antibodies by now. Second, I do not have much trust in a vaccine developed in three to six months while the prevailing vaccines for other diseases exist for decades or years,” said a paediatrician in Bangalore who wanted to remain anonymous. India aims to vaccinate 300 million citizens by this summer. More than 300,000 people received jabs on January 22, making it the highest one-day figure. While the cumulative number of vaccinations remains about 57 per cent of the target and tens of thousands have not arrived for their vaccine appointments, authorities hope to boost turnout in the coming days. At least 1,200 cases of minor adverse effects have been registered following the immunisation, but this is said to be among the lowest in the world, according to India’s Health Ministry. India starts exporting vaccines as its own inoculation targets missed To address lingering doubts over the safety and efficacy of the vaccines, the state and central governments have launched a massive awareness campaign which includes deploying Bollywood resources such as songs, erecting posters and social media promotions. “The misinformation must be countered fiercely. States must do all they can to counter rumour-mongering against Covid-19 vaccines,” said Health Minister Harsh Vardhan, a doctor, while launching a series of awareness posters last week. To crack down on misinformation, New Delhi has asked states to take legal action against rumour-mongers. Top-level bureaucrats and health experts have also been brought in to inject confidence about the vaccination drive and to address any reluctance among recipients. VK Paul, chairman of the National Expert Group on Vaccine Administration for Covid-19, said it is “very sad” that some people are shunning vaccines in India when there is a “big clamour” for them globally. INDONESIA The country’s anti-vaxxer movement received a boost when an MP from the ruling Indonesian Democratic Party Struggle (PDIP) declared she “did not want to be vaccinated”. MP Ribka Tjiptaning told Parliament on January 12 she had her “doubts” about the vaccine, just a day before President Joko Widodo kicked off the country’s mass inoculation drive by receiving a dose of the Chinese-made CoronaVac vaccine. Ribka’s comments “could further strengthen the conviction of those who reject the vaccination”, said Pandu Riono, an epidemiologist from the University of Indonesia. “The anti-vaxxers’ voices will solidify as they now feel they have the support of Parliament.” As Widodo kicks off Indonesia’s vaccine drive, a shot for ‘influencer’ backfires Widodo has long pinned his hopes on a vaccination to rescue the country’s economy and restore his own popularity which took a beating over his handling of the pandemic, said Pandu. More than 27,000 Indonesians have died and over 965,000 have been infected. Indonesia has secured 18 million doses of the CoronaVac vaccine and 50 million doses each from Pfizer-BioNTech and AstraZeneca for delivery later this year. It hopes to inoculate around 70 per cent of its 270 million population to reach herd immunity by March 2022. The first phase of the vaccination programme will run from January to April, prioritising high-risk groups including 1.3 million health workers and 17.4 million public workers in all 34 provinces, followed by the general public. “The rejection of the vaccine, in general, is also linked to some people disliking Jokowi,” said Pandu, referring to the president by his nickname. Vaccine rejection was highest in Aceh, West Sumatra and South Sumatra – the provinces which voted against Widodo in the 2019 elections, Pandu added. Coronavirus: post-vaccination deaths are no cause for alarm, say experts A Ministry of Health survey in November 2020 found the vaccine acceptance rate was only 45-74 per cent, said Muhammad Habib Abiyan Dzakwan, a researcher from the Centre for Strategic and International Studies’ (CSIS) disaster management research unit. That same month, a Unicef survey found that Aceh had the lowest vaccine acceptance in the country at just 46 per cent, while 30 per cent of the population doubted Covid-19 vaccines. “It was never fully supported … this might add layers of homework for the government, as they not only [have to] convince people at the grass roots level but also national politicians,” said Habib. Indonesia has long had anti-vaxxers such as parents wary of measles vaccinations, but their numbers have grown with the advent of Covid-19, said epidemiologist Iwan. “Without good communication, people in this group have the potential to become people who refuse the Covid-19 vaccine,” said Iwan, adding that CoronaVac clinical trials showed it is “safe”. He believes at least 85 per cent of the population need to be vaccinated to achieve herd immunity. Indonesia’s Ulema Council (MUI) in early January gave its approval for the vaccine, deeming it to be permissible under Islam. This approval was critical as over 90 per cent of the country’s population is Muslim, but still, many doubters remain fuelled by fake news. As Philippines seeks Covid-19 vaccines, ghost of Dengvaxia scandal lingers Hoaxes and misinformation against vaccination circulated on social media at the start of the pandemic last year but accelerated in December before exploding in January, according to Mafindo, an Indonesian civil anti-fake-news organisation. The number of anti-vaccine hoaxes in December was 22.9 per cent of total social media output and accelerated to 35.7 per cent by January 18, said Aribowo Sasmito, who heads the Mafindo fact-checking team. Among the hoaxes was the fake news that the president had suffered seizures after his vaccination and died. MALAYSIA In neighbouring Malaysia , which expects to receive its first batch of vaccines in February, disinformation came from anti-vaxxers and sceptics who do not believe Covid-19 exists, said Professor Awang Bulgiba Awang Mahmud of the Centre for Epidemiology and Evidence-Based Practice at the University of Malaya. In recent months, Covid-19 cases in Malaysia spiked to over 186,000 infections and 680 deaths after its initial success in bringing the pandemic under control through strict lockdowns. A Ministry of Health online survey in December found 17 per cent of the 212,000 respondents were unsure of the Covid-19 vaccines’ efficacy, while 16 per cent said they would reject the vaccine. “The problem … is that the minority who reject the vaccine could potentially influence the fence-sitters … [and] others to reject the vaccine. Then the number of those against the vaccine could increase and this will cause problems for the country to achieve herd immunity,” said Awang. Malaysia’s rubber glove Covid-19 boom loses shine amid rights abuses The government needs to convince anti-vaxxers through clear, objective explanations which are backed by credible scientific experts, he said. “I would seek the advice of the best behavioural scientists and communication specialists in the country to make this happen. The messages need to be professionally crafted, in clear language and be delivered continuously to make sure that people understand the rationale behind the vaccination.” Awang admitted that it is not easy to convince anti-vaxxers and doubters. “However, it can and needs to be done as we do not have many options if we want to exit this pandemic and see some return to normalcy.”