Vaccine Hesitancy in Low- and Middle-income Countries: Potential Implications for the COVID-19 Response

British Medical Journal

This article deals with potential issues surrounding the COVID-19 vaccine in low and middle income countries.

The authors state that researchers, governments and global agencies should proceed with particular care in the evaluation of candidate SARS-CoV-2 vaccines in LMICs, with effective communication to build trust and avoid generation of vaccine hesitancy. Vaccine efficacy is often highly variable between high-resource and low-resource settings.

The transmission dynamics of SARS-CoV-2 in countries with predominately young populations, which is true of many LMICs, are largely unknown. To be accepted, it is vital that any vaccine intended for use in LMIC is shown to be safe and effective in the settings in which its use is intended. Recent remarks from French researchers that candidate vaccines should be tested first in Africa were met with widespread outrage and accusations of racism. The scientists subsequently apologised, yet the damage to confidence in COVID-19 research on the continent may be difficult to repair. Inadequate attention to communication and perceived secrecy, particularly in the context of the heightened fear of an epidemic, can be disastrous.