COVID vaccine hesitancy leads to child health concerns in PNG

Widespread distrust and refusal of the COVID-19 vaccine in Papua New Guinea (PNG) is being linked to a rising number of mothers choosing not to bring their children forward for other vaccinations.

And as immunity levels decline in the most populous Pacific Island nation, it is only a matter of time before a devastating disease outbreak occurs, health experts say.

The nation successfully held the COVID pandemic at bay with strict measures, including border closures, until March 2021 when cases began to surge. Now, PNG has recorded a total of 46,427 cases, including 909 in the past one and a half months.

Yet the COVID vaccination rate in the large Pacific Island nation remains dramatically low at just 7 percent of the population for the first dose and 5 percent for the second dose. In comparison, Fiji’s COVID vaccine uptake is at 99 percent for the first and 89 percent for the second dose.

Distrust of the COVID vaccine in PNG has spread to a general distrust of all vaccinations, according to local health professionals.

“COVID vaccine resistance has translated into the hesitancy of mothers and families to have their babies vaccinated,” said Professor Glen Mola, head of obstetrics, gynaecology and reproductive health at the School of Medicine and Health Science at the University of Papua New Guinea in Port Moresby.

The hesitancy is based on “the mistaken fear that the nurses in the baby clinics might covertly vaccinate the baby against COVID-19,” Mola told Al Jazeera.

While PNG’s health services have been under severe strain with the demands of the pandemic, a high level of public distrust of the vaccine is a leading factor in the low uptake.

Woman with grey hair sits on chair, looking at the camera while a man bends over to administer the vaccine. He is wearing a cap, blue t-shirt and blue gloves. There are some people waiting behind them, including children
A woman receives COVID-19 vaccination in Papua New Guinea [Photo courtesy of ChildFund]
Dr David Mills at the Kompiam Rural Hospital in the remote Enga Province, located in the mountainous highlands of the PNG mainland, said there will be serious health implications as infant vaccinations decline.

According to the United Nations Children’s Fund (UNICEF), the uptake of a third dose of the vital DTP (diphtheria, tetanus and pertussis) vaccine in PNG infants, for instance, plummeted from 64 percent in 2009 to 31 percent last year.

“Trust in the health system generally has deteriorated due to the poor information being disseminated,” said Dr Mills, referring to “the persistence of conspiracy thinking” around COVID as well as the overplaying of the level of threat it posed to PNG and a perception that COVID health messaging was only being disseminated for financial incentives.

“We are expecting epidemics of measles, pertussis [whooping cough] or polio to emerge at any time due to the chronically low vaccine coverage – particularly measles is a concern,” he said.

Even before COVID-19, a number of challenges plagued the rollout of the routine infant immunisation programme in PNG, where more than 80 percent of people live in rural and remote areas.

Three mothers with four children stand against the backdrop of a wooden fence and a hut with a straw roof. Two more children lean against what looks to be a corrugated iron shed on the other side of the fence
Families living in the rural and remote highlands of PNG suffer due to poor roads, transport and health services. Hela Provice, PNG [Catherine Wilson/Al Jazeera]
In the highlands, health services have very limited reach beyond the main urban centres. Nationwide, there is a lack of qualified health and medical professionals in PNG. The country has fewer than 1,000 doctors for a population of nearly 9 million.

While the country’s child mortality rate has fallen over the past 15 years, neonatal and infant mortality rates remain the highest in the region – at 22 and 35 per 1,000 live births respectively.