Determinants of COVID-19 Vaccine Hesitancy in Fiji

"To effectively address the issue of vaccine hesitancy, understanding the reasons for hesitancy, the sources of misinformation about the vaccine, and how Fijians accessed their COVID vaccine related information and processed it, becomes critical. This is especially important not just to implement measures to improve vaccine uptake, but to also ensure that legitimate concerns of the people are not disregarded."- Nilesh Lal, Executive Director of Dialogue Fiji

Fiji, whose economy largely depends on the tourism industry, has suffered significant setbacks to development gains due to the COVID-19 pandemic, which arrived at the archipelago in March 2020. Hopes of economic recovery rested, in large part, on the successful rollout of a safe and effective vaccination programme. In this context, the non-governmental organisation (NGO) Dialogue Fiji conducted a survey to explore determinants of vaccine hesitancy. The goal was to understand COVID-19-vaccine-related public perception, knowledge, concerns, and acceptance among Fijians in order to help guide the government and relevant agencies in rolling out the vaccination programme.

Carried out as part of the Commonwealth-Foundation-funded project "Strengthening Citizen Engagement in COVID-19 Policy and Decision Making", the online study (June 25 to July 10 2021) found that only 53.9% of the 1,047 Fijian adults surveyed believed the COVID-19 vaccine was "very safe". The study also found that 76.8% had reported their intention to get vaccinated, 13.1% were hesitant, and 10.1% were undecided. Within the hesitant group, 50% reported a fear of vaccine side effects as a reason for their refusal. Other reasons they cited include vaccines that aren't safe (36%), vaccines that have metal chips and are connected to 5G or are magnetic (17%), and religious reasons (10%).

Among particular demographic groups, those more likely to agree to get vaccinated against COVID-19 included females (74.9%), Fijians of Indian descent (84.1%), and followers of Islam (88.6%). The latter figure is in contrast to Christians, who were most vaccine hesitant (14.8%) and had the lowest levels of acceptance (59.2%). Dialogue Fiji indicates that Fijian Christian influencers, including religious leaders, have shared vaccine-related conspiracy theories through social media platforms (Facebook, TikTok, Instagram, and YouTube). For instance, they have associated COVID-19 vaccines with demonic potions and a "mark of the beast".

When Dialogue Fiji asked respondents how much information they were receiving about COVID-19 vaccines, 81% indicated they were getting enough. Survey data also show that 68% of respondents report having seen or heard at least some information about COVID-19 vaccines of whose veracity they were uncertain. Of this subgroup, 73.6% cited social media as their primary source of COVID-19-vaccine-related information; Facebook (90.7%) was the most widely used social media platform amongst this group.

Of the 1,047 respondents, only 52.2% showed high confidence in the public health agencies that recommended getting a COVID-19 vaccine in Fiji. In contrast, 77% said they trusted the World Health Organization (WHO) as a source of information about COVID-19 vaccines (vs. 29.6% trusting local health officials).

In conclusion: "Misinformation...can have a considerable effect on the acceptance of the COVID-19 vaccine therefore, government, public health officials and advocacy groups must address hesitancy and build vaccine literacy to increase vaccine acceptance and achieve the greater goal of herd immunity."