On 8 October 2020 at Gurei Health Care Centre in Juba, South Sudan, Elisabeth Abraham Loro, nurse and vaccinator, collects vaccines from a cold box. UNICEF is a main actor in immunization in South Sudan. It works in close collaboration with the Ministry of Health and with funding from various donors, including Gavi, the Vaccine Alliance (GAVI), on routine immunization and specific vaccination campaigns to protect children and women in the country against vaccines preventable diseases. UNICEF is the main supplier of the vaccines, re-use preventing (RUPs) and auto-disposable (AD) syringes used during vaccination activities, as well as the safety boxes for disposal of the used syringes. Gurei Primary Health Care Centre located in the capital city Juba is one of the health facilities supported by UNICEF.

According to new research published by the Social Science in Humanitarian Action Platform (SSHAP), a partnership with IDS, Anthrologica and the London School of Hygiene and Tropical Medicine, successful take up of the Covid-19 vaccine relies on transparency and trust, not just combatting misinformation. Researchers are calling on governments and others to invest in building public trust for vaccination so that communities are involved, understand and feel confident to ensure successful vaccine deployment. According to the Royal Society and British Academy (2020), 80-90% of the population require the vaccine for it to stem the pandemic.

The SSHAP research is based on a review of previous vaccine deployments and suggests that if governments try to coerce people into receiving vaccines, it could backfire, damage trust, induce hesitancy and entrench resolve against vaccination. It found that successful widespread deployment of vaccines is largely dependent on whether populations have trust in their governments.

This means that while providing consistent and scientifically accurate information can mediate some vaccine hesitancy, vaccine confidence may not improve unless clear efforts are made to increase public trust. Research shows that chances of a successful rollout are greater if governments ensure vaccines are administered by trusted local actors such as local healthcare providers, and even nonbiomedical health practitioners.

Vaccine hesitancy is not just about fringe groups such as ‘anti-vaxxers’ but varies nationally and by social groups. Studies show there is lower Covid-19 vaccine confidence amongst ethnic minorities such as Black US Americans who have faced historic and systemic oppression and have consequential mistrust in state intentions. Misinformation is more likely to have traction among communities that have experienced discrimination, neglect and abuse.

Many people have real concerns about the safety of Covid-19 vaccines. Without transparent, clear and compelling communication about what they are, how they are being tested, why they are important, and what the public can expect from them, rumours will continue to emerge as people strive to fill in knowledge gaps. Publics must be meaningfully engaged in decision-making and planning. This will be critical for improving vaccine confidence and trust in the government and overall public health response.

Commenting on the findings, Professor Melissa Leach, Director of IDS and co-principal investigator of Social Science in Humanitarian Action Platform said: “It is very welcome news that at last vaccines have been identified that have impact in containing Covid-19. However, the success of the vaccines in stopping this global pandemic rely on governments investing as much in vaccine confidence as deployment. As our research shows, building trust in government and the public health response will be critical components to the take-up of the Covid-19 vaccine.”

SSHAP (the Social Science in Humanitarian Action Platform) is a programme of work focusing on the social dimensions of emergency responses. It currently focuses on the social dimensions of the responses globally to Covid-19. SSHAP is a partnership between the Institute of Development Studies, Anthrologica and the London School of Hygiene and Tropical Medicine and is funded by the UK Foreign, Commonwealth and Development Office and the Wellcome Trust.