Addressing the resistance to the Covid-19 vaccine

The number of daily Covid-19 cases in the Philippines may jump to 10,000 to 11,000 by the end of March, the OCTA Research Group warned in an interview on the ABS-CBN News Channel. This prognostication came amid new strains of the coronavirus and many Filipinos’ laxity in following health protocols. On March 15, the Department of Health (DoH) reported 5,404 new Covid-19 cases, pushing the number of active cases to 53,479 and of total cases to 626,893.

These statistics show why our country needs to step up its vaccination efforts. As of March 16, the government has vaccinated 215,997 health care workers, according to reports.
Carlito Galvez Jr., the country’s vaccine czar, said the government’s mass vaccination program would begin by May, even with limited supply.

Even though the current global vaccine demand outpaces supply, there a is significant percentage of the population that resists vaccination. In the latest World Economic Forum-Ipsos survey, vaccine confidence has dropped in most of the countries surveyed.

Since October, the percentage of respondents who strongly or somewhat agreed with the statement “if a vaccine for Covid-19 were available, I would get it” has dropped across all countries surveyed, except in the United Kingdom and the United States. The most notable declines are in South Africa (-15 points), France (-14), Japan (-9) and South Korea (-8). Also, December marked the first time since August that overall vaccination confidence was below 50 percent in any country.

The top two reasons for this resistance? Concerns about side effects and the vaccines’ effectiveness.


In the Philippines, a whopping 46 percent of adult Filipinos are still unwilling to get vaccinated as of February, an OCTA survey found. Conversely, only 19 percent of Filipinos say they are willing to have themselves vaccinated.

Resistance to vaccination is nothing new. History is littered with examples of it. From the hesitancy of Americans to take the polio vaccine in the 1960s to the resistance of Filipino mothers against the measles vaccine in 2019, vaccination has encountered considerable public opposition.

Why, then, is it so challenging to increase the number of vaccinated people?


A 2019 study by Dartmouth College, published in Science Daily, “shows that past problems with vaccines can cause a phenomenon known as hysteresis, creating a negative history that stiffens public resolve against vaccination.”

“A hysteresis loop causes the impact of a force to be observed, even after the force itself has been eliminated; it’s why unemployment rates can sometimes remain high in a recovering economy,” the study explained. “It’s why physical objects resist returning to their original state after being acted on by an outside force.”

Consequently, this is “why the public resists vaccination campaigns for ailments like the common flu” — and by extension, the Covid-19 vaccine.

The country’s response to Dengvaxia a few yeas ago and the latest reported side effects of the AstraZeneca vaccine only strengthened the effect of hysteresis.

So how can people’s resistance to the Covid-19 vaccine be addressed? There are already a lot of successful case studies in the many parts of the world that applied behavioral science and design thinking.

At the core of the solution is identifying and understanding different personas. Health care workers make up one persona, but we can have others, like mothers, seniors and those based on geography. Then communication is customized for each persona to effectively nudge the vaccine recipient.


A study by Rupali Limaye, a health communication scientist at the Johns Hopkins Bloomberg School of Public Health, reveals some dos and don’ts about nudging the somewhat wary. “One thing that we’ve learned very clearly is not to correct misperceptions because people feel as though we are being dismissive,” said the study, which was published in the Scientific American.

Instead of dismissing and contradicting negative perceptions about the vaccine, it is better for government communication managers and vaccination centers to respond with empathy, a key tenet of design thinking.

Limaye suggests responding to misinformation “by saying something like, ‘There’s a lot of information out there, and some of it is true, and some of it is not true. Let me tell you what I know.’” That kind of reply, she says, “helps people feel that they are being listened to.”

Moreover, medical personnel can also build rapport by framing the decision in a personal way: “Let me tell you why I vaccinated my own children.” The study says “such statements leverage the single most trusted source of health information for most Americans: their own health care providers; the fact that health care workers are first in line for the coronavirus vaccines gives them a crucial opportunity to set an example and offer first-person validation for worried individuals.”

Resistance to the Covid-19 vaccine can be addressed through empathy, demonstrated through how government officials communicate to the public, how public information is delivered, and how healthcare workers on the ground communicate to the public.

The author is the chief executive officer of Hungry Workhorse Consulting, a digital and culture transformation consulting firm. He is a fellow at the US-based Institute for Digital Transformation. He teaches strategic management in the MBA program of De La Salle University. He may be reached at