(a) “On April 12, 2009, the Government of Mexico responded to a request by the World Health Organization (WHO)for verification of an outbreak of acute respiratory infections in the small rural community of La Gloria, Veracruz. During April 22–24, 2009, a new influenza A (H1N1) virus infection, commonly called “swine flu,” was confirmed in several patients. On June 11, 2009, the pandemic H1N1 2009 was declared by the WHO. All countries were advised to be on high alert and to strengthen infection control measures in health facilities. In September 2009, over 254,206 laboratory-confirmed cases of pandemic H1N1 and at least 2,837 deaths were reported by the WHO (Pandemic H1N1 2009, update 64, 2009). As a consequence, fears were rising that, during the winter months in 2009, a second wave of pandemic spread would occur, and many countries were planning national vaccination campaigns. At the same time, many citizens were not convinced that the new influenza A (H1N1) virus posed a serious health threat to them (Reuter & Renner, 2011 ). A survey conducted by the German news magazine Spiegel (August 29, 2009) showed that only 38% of German citizens stated that they will “definitely” or “likely” take part in the upcoming immunization program. This raised great concern in public health authorities that the planned immunization program might suffer the same fate as the National Influenza Immunization Program (NIIP), launched on October 1, 1976, as a reaction to a swine flu outbreak in the United States. After only 3 months, the NIIP was effectively halted since public reactions were highly negative. By that time, only 22% of the U.S. population had been immunized. Luckily, the virus did not develop the feared deadly potential of the 1918–1920 [so- called Spanish] flu pandemic. The examples of the new influenza A [in 2009] and the swine flu outbreak in 1976 reveal that a key to the impact that public health intervention programs can achieve depends greatly on how individuals perceive health risks. This holds true not only for preventive efforts in the case of infectious diseases but also in cases of non-infectious diseases caused by behavior-related risk factors such as tobacco and alcohol consumption, being overweight, high blood pressure, high cholesterol, and unprotected sexual intercourse, behaviors that are responsible for more than 60% of all deaths worldwide (World Health Organization [WHO], 2002). Given the global burden of health risks, the question is: How can we implement more effective risk avoidance and reduction in the future?”
Renner & Schupp (2011, pp. 637-638)
(b) In 2019, just months before the outbreak of the COVID-19 pandemic, Steven Taylor published a book titled,
The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease.
In Chapter 10 of his book, Taylor (2019) describes the challenge of what he calls “vaccination hesitancy,” and
discusses a number of interventions that might reduce vaccination hesitancy and improve vaccination rates.
(c) “The health belief model (HBM)… was one of the first models that adapted theory from the behavioural sciences to understand health problems… It was developed with the specific purpose of helping to understand why people did not participate in public health programmes that were on offer; in other words, it was interested in preventive health behaviours (Rosenstock, 1974 in DiMatteo & Martin, 2002).”
Govender, Petersen, & Pillay (2016, p. 421/ p. 616)
Context: 2022/2023 Measles outbreak and vaccination campaign in South Africa
A measles outbreak has been declared across all provinces of South Africa, with the exception of the Eastern Cape (NICD, April 2023). The age group currently most affected by the outbreak is children between five and nine years (43% of cases), with a total of 67% of cases occurring in children between the ages of one and nine years old. A measles vaccination campaign has been rolled out targeting all children up to the age of 14.
The 2022/2023 measles outbreak and vaccination campaign come in the wake a three-year COVID-19 pandemic in which vaccine hesitancy amongst many South Africans of diverse circumstances and backgrounds emerged as a major healthcare challenge to efforts to contain the SARS-CoV-2 virus via a nationwide COVID-19 vaccination programme.
Reports in the popular press have suggested that some parents are sceptical and mistrustful of National Department of Health efforts to contain the measles outbreak by way of vaccinations. One parent commented via social media that, “You are no longer trustworthy. You always tell us a fairy tale. They shut down the whole country to force people to get vaccinated and destroyed the economy in the process.” Another protested, “Don’t come kill our children.”
In the face of such potential opposition, even hostility, towards mass immunisation efforts, it is important to assess the extent to which healthcare authorities and the healthcare profession in South Africa have learnt lessons from years of growing vaccine hesitancy, and especially from the COVID-19 pandemic and vaccine programme, in order to be address and respond to vaccine hesitancy that may be shown towards the 2023/2023 measles outbreak and vaccine campaign.
Essay Topic – Topic Statement
Critically discuss and evaluate the extent to which official communications regarding the 2022/2023 measles outbreak and vaccination campaign in South Africa reflect sufficient awareness of and proactive responses to issues of vaccine hesitancy that might undermine the effectiveness of the campaign.
The target communications to be evaluated in your essay include statements, press releases, and online posts relating to measles outbreak, measles vaccines, and the measles vaccine campaign, originating from official sources such as the national and provincial Departments of Health, and the National Institute of Communicable Diseases (NICD). As a minimum, your essay will need to engage with the following communications/ posts by the NICD:
Your essay should include*:
• A brief outline of the context of this discussion, in terms of the history of measles vaccination and vaccine hesitancy, as well as vaccine hesitancy in SA in the wake of the COVID-19 pandemic, supported by at least two references.
• Relevant use of/ reference to the constructs of the Health Belief Model (HBM) described by Govender, Petersen, & Pillay (2021, pp.468-469).
• Relevant use of/ reference to Taylor’s (2019) recommendations for reducing vaccine hesitancy.
• Relevant use of/ reference to relevant findings in Cooper et al.’s (2021) study of factors influencing routine childhood vaccination.
• A clear conclusion about the topic statement – that is, a clear conclusion about the adequacy of these official communications for addressing concerns about vaccine hesitancy in the 2022/2023 measles vaccine campaign, based on the analysis and critical evaluation developed in your essay.
Answer to Above Question on Health Management
Hesitancy towards applying vaccines is a major problem within South Africans, as it is identified in the 2022/2023 measles outbreak whereby there is a significant challenge identified in the form of vaccine hesitancy. However there are measures undertaken in order to reduce the level of residency among South Africans towards the vaccines, and this is aimed at identifying the effectiveness of official communication regarding the measles outbreak and vaccination campaign in South Africa.
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