Executive Summary MAIN ARGUMENT As the U.S. and Chinese economies decouple, Taiwan is navigating challenges posed by strategic competition between two great powers. In an...
The COVID-19 pandemic has magnified many governance challenges that predated the health crisis. From the necessity of swiftly formulating responses to combat an unknown virus to the development of economic relief packages to support affected families and businesses, governments were confronted with amplified challenges to health, economic, and social resilience. Promoting vaccination, a long-standing challenge, became a critical testing ground during the COVID-19 pandemic, revealing the dynamics of how health information—both true and false—spreads and how the media landscape can shape health behavior.
Historical and contemporary studies in the West have identified misinformation and disinformation as factors that reduce people’s confidence in vaccines. 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. As this health emergency wanes and future crises loom on the horizon, the issue of vaccine hesitancy will become more crucial, amplified by the ever-expanding array of information and media channels. How can governments understand public attitudes toward vaccines and leverage communication strategies to protect population health? With distinctive cultural, political, and social systems, Asia-Pacific societies can offer compelling lessons for the world in navigating misinformation and disinformation to promote public health.
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.
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