Introduction:

Individuals who refuse or postpone vaccinations are referred to as vaccine-hesitant, while the
broader issue is known as vaccine hesitancy. This phenomenon arises from a variety of social,
cultural, and psychological factors, making it one of the significant challenges facing the
healthcare sector. Vaccine hesitancy can facilitate the spread of diseases during pandemics
and epidemics, as evidenced during the COVID-19 crisis. According to the World Health
Organization, one in five children do not receive essential vaccinations, resulting in deaths
from diseases that could have been prevented with appropriate vaccines. Addressing this
complex issue requires a multifaceted approach. One effective strategy is the application of
behavioural economics tools. Vaccine hesitancy patterns can vary based on factors such as
age, gender, and income, necessitating comprehensive study and research to develop effective
methods for reducing this hesitancy.

Literature Review:

One of the main reasons for vaccine hesitancy is the misinformation that is spread from the
hands of social media. A significant portion of U.S. adults expressed hesitation regarding the
COVID-19 vaccine, citing concerns over its effectiveness, side effects, and the rapid
development process. Social media is essential in spreading global information, which is
more wrong than right and increases hesitancy. A lack of scientific literacy and declining trust
in authorities contribute to susceptibility to misinformation. People who turn towards the
internet for health and vaccine information usually have a lesser and more inaccurate idea of
what that vaccine does. Studies link increased misinformation with decreased vaccination
rates. Another study investigated the role of fake news and online misinformation on
immunization rates and found decreased rates after the proliferation of false information
online (Garett & Young, 2021). The health departments are responsible for lessening the
misinformation or directing the people towards the correct information if this problem ever
has to be solved. However, public health campaigns are also crucial in addressing vaccine
hesitancy. These campaigns can provide accurate information, debunk myths, and promote
the importance of vaccination. The wrong information can be spread through the news,
websites, social media and other platforms. The COVID vaccine had some reports online,
some accusing the vaccine producer and complaints against its effectiveness, claims of new
diseases stemming from the vaccine, and assumptions that natural immunity was enough to
defeat the virus. Facebook, YouTube, Reddit, Twitter, and Instagram are the culprits in the
above cases. Hence, this is a pressing issue that is amplified by the existence of social media
and other unreliable resources.

FLWs are instrumental in addressing hesitancy through direct interaction, allowing them to
uncover citizen concerns and uncertainties (Krishnamurthy et al., 2023). This paper is a study
to identify the barriers to vaccinations. Fear of side effects, doubts about vaccines, and
religious beliefs are some barriers to vaccines. There should be targeted communication
placed towards the fewer opportunities as there is a possibility that most resources will not
reach them. Communication strategies should address fears about vaccine side effects rather
than peripheral concerns. The frontline workers must be trained as current training
emphasises clinical protocols but should also effectively equip FLWs to address vaccine-
related fears. The findings suggest that fears regarding vaccine side effects may apply to all
vaccines, highlighting a worrying trend of declining routine immunisations post-pandemic
and during any pandemic that might hit in the future. Studies regarding this must be
conducted according to access to healthcare, financial welfare, socio-demographics, class,
and availability of resources. Fear of adverse effects from the vaccine was identified as the
most significant factor of vaccine hesitancy. Fear of side effects consistently predicted lower
vaccination odds, disabled individuals had lower vaccination rates, and healthcare access was
a significant barrier. The findings suggest a need for targeted health marketing programs that
address specific barriers within identified subgroups. Training for frontline workers should
emphasise understanding and addressing fears related to vaccine side effects, particularly in
vulnerable populations.

On average across countries, one in five adults reported being hesitant to take the COVID-19
vaccine, with the most cited reasons for hesitancy being concerns about the safety of the
vaccine, followed by concerns about its efficacy (Eberwein et al., 2023). Europe and Central
Asia had the highest hesitancy, while Latin America and the Caribbean showed the lowest.
the lower income groups, rural areas, females, lower education levels and younger
respondents showed higher hesitancy rates. There was little change in hesitancy levels across
the surveyed countries from October 2020 to August 2021, with variations in Iraq, Malawi,
and Uzbekistan, where hesitancy increased significantly. Safety was the primary concern
again, and distrust in the government and the pharmaceutical industries. Vaccine hesitancy is
notably higher for COVID-19 than for childhood vaccines, which are influenced by new
vaccine technologies and rapid development. The behaviour that is followed in a societal
environment is one of the significant causes of vaccine hesitancy and the manipulation by the
information that is published on social media. There needs to be a change in the thought
process of the people, and there is a need for a more formal spread of information about the
vaccine, its ingredients and its uses.

Objectives:

1. To understand the reasons behind vaccine hesitancy.

2. To understand the impact of the multi-dimensional poverty index, access to the
internet through a gendered lens, and vaccine wastage on vaccine hesitancy.
3. To explore the previously written literature and discover a gap.
4. To understand the significance of the problem of vaccine hesitancy from a
behavioural economics perspective.
5. To explore empirical evidence on vaccine hesitancy and find the limitations in the
path to reduce the problem.
6. To suggest changes to the policies in the hope of reducing the problem.

Research Gap

1. There are minimal studies on vaccine hesitancy based on state and cultural
differences. As India is the most populous and diverse country, it is an arduous task to
take on but an essential one as it will help find a way to reduce the problem.
2. There is a chance to explore how the formal agencies and the government are trying
to eradicate misinformation and publish legitimate news. The framing, the nudges and
the type of advertising are essential.
3. Studies on the effectiveness or ineffectiveness of vaccination drives, campaigns and
other educational undertakings from the government, hospitals or vaccine producers.
4. Comparisons of policies undertaken by other countries and the application of those
policies in India.
5. Examining and discovering the limitations in the policies implemented in India.
6. A gendered outlook on vaccine hesitancy: the problems women face and the disregard
of those problems by medical professionals.
7. Household surveillance on vaccine hesitancy: the impact of parenting, education,
income and access to healthcare.
References:

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Kant, R., & Chaturvedi, H. K. (2024). COVID-19 vaccine hesitancy among adults in

India: A primary study based on health behavior theories and 5C psychological

antecedents model. Plos One. https://doi.org/10.1371/journal.pone.0294480

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Vaccine Hesitancy and Vaccination Coverage in India: An Exploratory Analysis.

https://doi.org/10.3390/vaccines10050739

3. Garett, R., & Young, S. D. (2021). Online misinformation and vaccine hesitancy.

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