Vaccine Hesitancy in the Post-Soviet Space

COVID-19 vaccine distribution has recently been ramping up worldwide with more than 150 million doses administered at the time of writing (February 13). However, this significant breakthrough now encounters a new obstacle in the form of vaccine hesitancy. Skepticism of vaccines had mostly existed only on the fringe of mainstream society as the scientific community continually and overwhelmingly contradicts arguments against vaccination. This issue nevertheless managed to develop into becoming one of the World Health Organization’s top ten global threats to public health in 2019 prior to the onset of the pandemic. 

Fighting against the phenomenon of vaccine hesitancy must be considered among the most crucial components in the plan to eradicate COVID-19 worldwide. In order to reach herd immunity and prevent further spread of the disease, a significant proportion of individuals must be willing and able to get vaccinated. Recent outbreaks of various preventable diseases such as measles demonstrate this need as they have flared up due to a sharp decline in immunization levels below their respective herd immunity thresholds. However, convincing vaccine skeptics of the efficacy of this new vaccine remains a grueling challenge, as hesitancy towards vaccines is often deeply rooted in valid concerns relating to political realities and cultural phenomena. 

Nowhere in the world is this more prevalent than in the post-Soviet space—an especially concerning fact given the high regional incidence of COVID-19 numbering in the millions. Approximately a quarter of the population of most countries located in the region share this belief in vaccine hesitancy—more than double the population of vaccine skeptics in the United States. A distrust in government which is often tied to healthcare run by the state, difficulty determining source credibility, and a lack of individual connections to knowledgable healthcare workers often serve as the sources of hesitation towards vaccines in the post-Soviet space. By understanding these root causes, here are solutions on how to address vaccine hesitancy in the post-Soviet space while being mindful of the local context. 

Root Cause #1: Rampant Distrust 

While not solely an issue endemic to the post-Soviet space, distrust in local authorities is particularly prevalent in this region. Following the dissolution of the Soviet Union, governments across the region have been unable to establish social cohesion and provide economic stability. However, as topical as these issues sound, a fundamental distrust of outsiders has been rooted in the culture for generations relating to the wide-reaching effects of government corruption and cannot be eliminated overnight. So how can the issue of distrust be adequately addressed? 

Perhaps, the simplest answer is an improvement in transparency and accountability. In countries such as Russia and Ukraine, the lack of these pillars of good governance has led to a significant increase in government distrust spurred from this already present cultural phenomenon of distrusting those outside one’s personal circles. This is exemplified by polling from the Levada Center showing that a stark majority of Russians distrust any media information about COVID-19, and only half have confidence in the healthcare system to handle the pandemic. To decrease this high level of distrust, knowledgeable individuals should work to engage with communities to develop a personal connection and share important information. While this seems like a very slow-build and exhaustive effort, this remains an effective means of outreach where outreach might not exist otherwise. For instance, take the outreach being conducted by Dr. Anthony Fauci, Director of the U.S. National Institute of Allergy and Infectious Diseases, including media appearances, local panels, and even celebrity collaborations in the United States. His dedicated outreach effort is a great example of how to engage individuals and make them feel more at ease. 

Root Cause #2: Source Credibility 

Unfortunately, fake news is a widespread phenomenon whose dissemination has stirred up controversy in determining source credibility for the layperson. The common feature of bias in mainstream news severely worsens the problem as political skew can dissuade individuals from trusting even the most accurate information. Furthermore, the culture of distrust prevalent in the post-Soviet space encourages individuals to trust information shared by those within their personal circles. Vaccine hesitancy is then so pervasive in this region due to the anti-vaccine movement’s particular ability to take a foothold in communities that rely on social media for information. 

Determining source credibility is a simple process that requires a few short steps. To work around this issue, local civil society organizations (CSOs) would serve an excellent role in filling this gap between a lack of transparency from governments that seem intangible and communities who are more likely to place trust in personal connections. Similar to the suggestion mentioned earlier, knowledgeable individuals at CSOs can effectively and meaningfully engage communities while providing a needed sensitivity for community concerns. For example, developing virtual and in-person community-based workshops that teach fact-checking as a skill can successfully counter how individuals treat news. 

Conclusion: Increase Access to Experts 

As mentioned before, the lack of personal connections between most individuals and field experts remains a daunting issue in the post-Soviet space. Confidence in medical professionals cannot exist unless the concern of accessibility is addressed. Misinformation continues to be rampant as experts in the field seem untouchable and individuals prefer to trust their inner circles. While the solution remains the same—expert engagement and CSO work to develop personal connections—this issue must be reiterated to emphasize its severity. Given the cultural context of the post-Soviet space, vaccine hesitancy is able to thrive and prevent significant COVID-19 reductions in the region. Increasing access to experts, especially medical professionals and vaccine scientists from the region, who can establish personal connections at an individual level, as exhaustive as the process may appear, serves as the best solution to change course.