Publications The COVID-19 pandemic has caused upheaval in not only healthcare but also social and economic systems, turning attention to the resilience of societies, economies,...
The COVID-19 pandemic has revealed the challenges of promoting population-wide vaccine uptake. Vaccine hesitancy, defined by the World Health Organization’s Strategic Advisory Group of Experts on Immunization as the “delay in acceptance or refusal of vaccines despite availability of vaccination services,” has the potential to undermine the effectiveness of health policy interventions and threaten population health. Historical and contemporary studies in the West have identified misinformation and disinformation as major concerns that reduce people’s confidence in vaccines, thereby slowing vaccine uptake. Recent experiences from the Asia-Pacific region in vaccine rollout have also highlighted the importance of cultural values, personal privacy, and communication in the design and implementation of public health policy. How do people perceive information about vaccination campaigns, and how can public acceptance of vaccines be enhanced in the long term? Answering these questions is crucial for policymakers, health communicators, and community leaders seeking to safeguard public health.
CAPRI is developing reports on how different countries in the Asia Pacific experience vaccine hesitancy and the role of misinformation and disinformation in government and civil society efforts to promote vaccination and public health. As the world exits the emergency stage of the pandemic, continued vaccination efforts are on the horizon—potentially for COVID-19 and certainly for future disease outbreaks. What lessons can Asia-Pacific societies offer each other and the world before the next outbreak? Drawing insights from experts in fields including public health policy, communication, social psychology, and cultural anthropology, as well as leaders and decisionmakers in local and national government, civil society, and the scientific community, these reports will examine:
In 2023, CAPRI is developing the first two reports in this series on Japan and Taiwan, which both have unique cultural, historical, and political contexts but could offer insights and best practices for the region.
Taiwan spent 2020 and the first months of 2021 largely free of COVID-19 thanks to strict border controls and nonpharmaceutical measures that eliminated community spread of the disease. In May 2021, local cases began to increase, and the government implemented tighter restrictions on movement and social life. Only limited numbers of the AstraZeneca vaccine were available in Taiwan at this time when demand for them increased rapidly, creating an environment of uncertainty in which misinformation and disinformation could thrive.
Throughout the pandemic, both Taiwan’s government and civil society have dedicated considerable attention to reducing the spread of misinformation and disinformation relating to COVID-19. From May 20 to July 27, 2021, the Central Epidemic Command Center held an additional press conference every morning to address misconceptions about the pandemic and vaccines. Furthermore, Taiwan’s Ministry of Health and Welfare and Centers for Disease Control established clarification sections on their websites to help the public verify the accuracy of claims about COVID-19 and the vaccines. The Taiwanese government has also partnered with social media platforms such as Google, Facebook, and LINE to combat COVID-19 misinformation.
In addition, Taiwan’s civil society boasts robust fact-checking organizations, including the Taiwan FactCheck Center, Cofacts, and MyGoPen, which have worked closely with the government. In February 2020, Taiwan enacted the “Special Act on COVID-19 Prevention, Relief, and Restoration,” which included a provision penalizing the dissemination of rumors or misinformation about COVID-19. However, determining what constitutes a rumor or misinformation is not clear cut.
Although common factors such as age, gender, level of trust in the government, and education level affect vaccine hesitancy in Taiwan, the information landscape during the pandemic contributed to people’s attitudes toward the COVID-19 vaccines, especially when their supplies were limited. Speculation that Mainland Chinese agents were spreading misinformation online and perceptions that Taiwan’s government was prematurely promoting a domestically developed vaccine contributed to the politicization of discussions on COVID-19 vaccines. Given this experience during the pandemic and robust ecosystem of civil society organizations researching misinformation, Taiwan can establish best practices for health literacy education and science communication to prepare for future health emergencies.
Vaccine hesitancy in Japan before the COVID-19 pandemic is well documented due to a unique history with various vaccines, in which misinformation plays a role. For example, early in the development of vaccines for polio and cholera, contaminated doses and improper administration resulted in people contracting the diseases, contributing to a persistent belief that vaccines can give people the diseases they protect against. In addition, extensive media coverage of adverse side effects in young women who received the human papillomavirus (HPV) vaccine led to widespread wariness of vaccine side effects. Although the reports were based on anecdotal evidence that was later debunked, the HPV vaccination rate in Japan remains low. In both cases, misinformation about vaccines was based in true events, highlighting that collective memories are difficult to overcome.
Despite this history, vaccine hesitancy has decreased in Japan over time and during the COVID-19 pandemic. Although a substantial portion of the population did not initially plan to get vaccinated against COVID-19, by May 2023 approximately 83% of Japan’s population had received at least two doses of a COVID-19 vaccine; this coverage is comparable to other high-income Asian countries. People who changed their minds to get vaccinated tended to perceive the benefits of vaccination, recognize the safety of the COVID-19 vaccines and the actual risks of adverse side effects, and acknowledge that vaccination is effective in preventing viral spread. In Japan’s cultural and political context, while government messaging and scientific communication have effectively encouraged COVID-19 vaccination, social connections and forging a social norm of vaccination have been key to increasing vaccine uptake in hesitant groups.
Misinformation and the role of social media in the information landscape remain concerns; studies in Japan have found that the more people use social media as a primary source of COVID-19 information, the more likely they are to be vaccine hesitant. In fact, use of social media as a primary information source has been linked to people who originally intended to get vaccinated becoming more hesitant. Japan’s government has taken steps to combat this misinformation, including providing accurate information on their own websites, encouraging citizens to consult their doctors about vaccination, and debunking false claims that vaccinations are linked to infertility. Going forward, the effectiveness of these interventions in the Japanese context can be evaluated to identify best practices for other societies.
Publications The COVID-19 pandemic has caused upheaval in not only healthcare but also social and economic systems, turning attention to the resilience of societies, economies,...
Publications The COVID-19 pandemic has revealed the challenges of promoting population-wide vaccine uptake. Vaccine hesitancy, defined by the World Health Organization’s Strategic Advisory Group of...
The Democracy in Asia project was launched by the Brookings Foreign Policy program in 2020 to explore the state of democracy in the Indo-Pacific region...