Rumours and crises

Case study:
How fear of oral polio vaccine was overcome in India

Allegations regarding vaccine-related adverse events that are not rapidly and effectively dealt with can undermine confidence in a vaccine and ultimately have dramatic consequences for immunization coverage and disease incidence.

Some situations that encourage rumour include:

Serious social conflict,
Economic and political uncertainty,
Social transition and clashes of culture and beliefs,
A history of discrimination and manipulation,
Lack of transparency in a distant or authoritarian organization.

What is a vaccine safety crisis?

You may not be able to define it, but you certainly know when you are in one!

Crises in vaccine safety are characterized by an unexpected series of events that initially seem to be out of control. The outcome is usually uncertain when the crisis is first identified, and there is a threat to the success of a vaccine or immunization programme.

A crisis may have a "real" basis arising from genuine vaccine reactions or immunization errors, or it may have no foundation in reality and be triggered entirely by mistaken rumours. Often a crisis in vaccine safety originates in the identification of AEFIs, but is aggravated by negative rumours.

Whether a rumour triggers a series of events that build into a crisis depends on the nature of the rumour, how fast it spreads and whether prompt and effective action is taken to address it.

When approaching a crisis, keep in mind that this may not only be a challenge, but also an opportunity to improve the communication on immunization issues. You have the opportunity to dispel negative rumours, to take action to upgrade policies and procedures if required, and to correct any errors or lapses in best practice.

Question

Consider the following scenarios. A new vaccine is introduced in a country and a cluster of serious AEFIs occurs, including the death of a child.

Which of the following statements address(es) failures in communication that could increase the risk of these adverse events "exploding" into a national crisis and putting the immunization programme at risk?

Several answers possible.

	A. No one took responsibility for managing the event locally - the correct actions were not taken, or not taken quickly enough.
	B. Local communication about the event was poor, adding to the uncertainty and insecurity about what actually went wrong and whether it was being addressed. The parents of the dead child were not counselled, nor was empathy shown to them.
	C. The event was inaccurately reported in the media before you could deal with it.
	D. Rumours started circulating on social media sites.
	E. Someone involved in the original event was not truthful when interviewed about it and the lie was later exposed, adding to the perception that there was a conspiracy to hide the problem and that the health authorities could not be trusted.

Answer

All of the statements above are correct.

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