COVID-19 vaccine brand hesitancy and other challenges to vaccination in the Philippines (preprint)

Abstract Background: COVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus, and prevent hospitalisations and deaths. However, there are a series of events and factors that create barriers to vaccination. In this paper, we explore vaccination narratives and challenges experienced and observed by Filipinos during the early vaccination period in the Philippines. Material and methods: We conducted 35 interviews from a subsample of 1,599 survey respondents ages 18 and older in the Philippines. The interviews were conducted in Filipino, Cebuano, and/or English via online platforms such as Zoom or via phone call. All interviews were recorded, transcribed verbatim, translated, and analysed using inductive content analysis. To highlight the complex reasons for delaying and/or refusing COVID-19 vaccines, we embedded our findings within the social ecological model. Results: Our analysis showed that individual perceptions play a major role on the decision to vaccinate. Such perceptions are shaped by exposure to (mis)information amplified by the media, the community, and the health system. Social networks may either positively or negatively impact vaccination uptake, depending on their views on vaccines. Political issues contribute to vaccine brand hesitancy, resulting to vaccination delays and refusals. Perceived inefficiencies and inflexibility of the system also create additional barriers to the vaccine rollout in the country, especially among vulnerable and marginalised groups. Conclusions: Challenges to COVID-19 vaccination may be individual, interpersonal, and structural, which work individually and collectively. Among these barriers, our results suggest that many concerns regarding vaccination operate at the individual level. Vaccine brand hesitancy and misinformation are growing public health challenges in the country that need to be addressed. Recognising and addressing concerns at all levels are critical to solutions aimed at improving COVID-19 vaccination uptake and reach.

Tracking changes in reporting of epidemiological data during the COVID-19 pandemic in Southeast Asia: an observational study during the first wave (preprint)

Background When a new pathogen emerges, consistent case reporting is critical for public health surveillance. Tracking cases geographically and over time is key for understanding the spread of an infectious disease and how to effectively design interventions to contain and mitigate an epidemic. In this paper we describe the reporting systems on COVID-19 in Southeast Asia during the first wave in 2020, and highlight the impact of specific reporting methods. Methods We reviewed key epidemiological variables from various sources including a regionally comprehensive dataset, national trackers, dashboards, and case bulletins for 11 countries during the first wave of the epidemic in Southeast Asia. We recorded timelines of shifts in epidemiological reporting systems. We further described the differences in how epidemiological data are reported across countries and timepoints, and the accessibility of epidemiological data. Findings Our findings suggest that countries in Southeast Asia generally reported precise and detailed epidemiological data during the first wave of the COVID-19 pandemic. However, changes in reporting were frequent and varied across data and countries. Changes in reporting rarely occurred for demographic data such as age and sex, while reporting shifts for geographic and temporal data were frequent. We also found that most countries provided COVID-19 individual-level data daily using HTML and PDF, necessitating scraping and extraction before data could be used in analyses. Interpretation Countries have different reporting systems and different capacities for maintaining consistent reporting of epidemiological data. As the pandemic progresses, governments may also change their priorities in data sharing. Our study thus highlights the importance of more nuanced analyses of epidemiological data of COVID-19 within and across countries because of the frequent shifts in reporting. Further, most countries provide data on a daily basis but not always in a readily usable format. As governments continue to respond to the impacts of COVID-19 on health and the economy, data sharing also needs to be prioritised given its foundational role in policymaking, and the implementation and evaluation of interventions. Funding The work was supported through an Engineering and Physical Sciences Research Council (EPSRC) (https://epsrc.ukri.org/) Systems Biology studentship award (EP/G03706X/1) to TR. This project was also supported in part by the Oxford Martin School. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.