Need for Transparent Public Health Communication
Published on June 6, 2024
AstraZeneca recently admitted in a court case filed in the United Kingdom that in “very rare cases”, its COVID-19 vaccine can cause reduced platelet count and cause a blood clot-related side effect—thrombosis Thrombocytopenia Syndrome (TTS). Although this risk has long been acknowledged by AstraZeneca to medical regulators in Europe, the recent admission has rejuvenated anxiety about the use of vaccines. This development was concomitant with AstraZeneca withdrawing their vaccine from global markets - a decision made in response to falling demand and independent of the controversy around its side effects. Mis-reporting such events can lead to misinformation, particularly when vaccine safety and risk data is not adequately shared during deployment.
Vaccines are crucial for public health, preventing individual illness and reducing disease spread through herd immunity. Over the last few decades, vaccinations have led to the eradication of smallpox and reduced incidence of diseases such as polio and measles. Vaccinations reduce healthcare costs, impede the evolution of the disease, and improve the health outcomes of the target population. Vaccines for bacterial disease are also a key tool for reducing antibiotic resistance by lowering infection rates. However, vaccines must enjoy public confidence to ensure their sustained adoption. Loss of public trust in vaccines because of misinformation can hamper the adoption of this important public health tool.
The Oxford-AstraZeneca’s Covid vaccine was marketed as Covishield in India and Vaxzevria in Europe and few other countries. The vaccine was manufactured and marketed in India in partnership with the Serum Institute of India in Pune and contributed to the country’s fight against the deadly COVID-19 pandemic.
India, in general, does not have a high incidence of vaccine hesitancy. However, the lack of risk communication around COVID-19 vaccines at the time of deployment can erode public confidence going forward. Other governments, such as the US and the UK, have implemented mechanisms for understanding adverse events in addition to the vaccine company’s monitoring efforts. This allowed the governments to make informed decisions around vaccine deployment - for example, the UK offered alternatives to the Astra Zeneca vaccine in younger age groups where the risk of TTS was more apparent. To achieve this, an easily accessible portal for reporting adverse events, such as the Vaccine Adverse Event Reporting System (VAERS) of the United States or the yellow card reporting system of the UK, is crucial. India’s system of monitoring adverse effects of vaccinations needs to be strengthened and be able to communicate with necessary decision-making agencies to be quickly respond to public health concerns arising from vaccine use. This would help disseminate information to the public and empower policymakers with the necessary data to make informed decisions on vaccine safety and deployment strategies.
During the COVID-19 pandemic, the Takshashila Institution highlighted the importance of public engagement in effectively communicating the risks and benefits of vaccination at the time of deployment. The document emphasised that public health officials play a crucial role in this process, and their efforts are integral to building public confidence and fighting misinformation and disinformation.
Furthermore, transparency in data helps policymakers to address concerns raised by others. Recently, ICMR rejected claims from a Banaras Hindu University (BHU) study that suggested that nearly one-third of the individuals who received Bharat Biotech’s anti-COVID vaccine Covaxin reported ‘adverse events of special interest’. Several medical practitioners have also cautioned not to draw significant conclusions from the paper given limitations with methodology, particularly an absence of a control group and nuanced observations from the study being sensationalised in the media, leading to misinformation being spread about the safety of vaccines. The poor scientific method used in this paper aside, the controversy created here could have been averted if the side effects of vaccines had been systematically studied and transparently communicated by the government itself.
Recent controversies over vaccine side effects can erode public confidence in vaccinations. This can negatively impact public health outcomes in India, particularly for the poorer demographic. Hence, it is important that India continues to emphasise the importance and safety of vaccinations, acknowledge risks associated with the vaccines, set up mechanisms to assess such risks and communicate these to the public at the time of deployment.
You can read more about Takshashila’s work on COVID-19, Vaccines and Public Health in general here:
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