Most people welcomed the opportunity to get vaccinated against covid-19, yet a non-trivial minority did not. Vaccine-resistant people tend to hold strong views and assertively reject conventional medical or public health recommendations.

This is puzzling to many, and the issue has become a flashpoint in several countries.

It has resulted in strained relationships, even within families, and at a macro-level has threatened social cohesion, such as during the month-long protest on Parliament grounds in Wellington, New Zealand.

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This raises the question: where do these strong, often visceral anti-vaccination sentiments spring from? As lifecourse researchers we know that many adult attitudes, traits and behaviours have their roots in childhood.

This insight prompted us to enquire about vaccine resistance among members of the long-running Dunedin Study, which marks 50 years this month.

Specifically, we surveyed study members about their vaccination intentions between April and July 2021, just prior to the national vaccine roll out which began in New Zealand in August 2021. Our findings support the idea that anti-vaccination views stem from childhood experiences.

The Dunedin Study, which has followed a 1972-73 birth cohort, has amassed a wealth of information on many aspects of the lives of its 1037 participants, including their physical health and personal experiences as well as long-standing values, motives, lifestyles, information-processing capacities and emotional tendencies, going right back to childhood.

Almost 90 percent of the Dunedin Study members responded to our 2021 survey about vaccination intent. We found 13 pecent of our cohort did not plan to be vaccinated (with similar numbers of men and women).

When we compared the early life histories of those who were vaccine resistant to those who were not we found many vaccine-resistant adults had histories of adverse experiences during childhood, including abuse, maltreatment, deprivation or neglect, or having an alcoholic parent.

These experiences would have made their childhood unpredictable and contributed to a lifelong legacy of mistrust in authorities, as well as seeding the belief that “when the proverbial hits the fan you’re on your own”.

Our findings are summarised in this figure.

Personality tests at age 18 showed people in the vaccine-resistant group were vulnerable to frequent extreme emotions of fear and anger. They tended to shut down mentally when under stress.

They also felt fatalistic about health matters, reporting at age 15 on a scale called “health locus of control” that there is nothing people can do to improve their health. As teens they often misinterpreted situations by unnecessarily jumping to the conclusion they were being threatened.

The resistant group also described themselves as non-conformists who valued personal freedom and self-reliance over following social norms. As they grew older, many experienced mental health problems characterised by apathy, faulty decision-making and susceptibility to conspiracy theories.

Negative emotions combine with cognitive difficulties
To compound matters further, some vaccine-resistant study members had cognitive difficulties since childhood, along with their early-life adversities and emotional vulnerabilities. They had been poor readers in high school and scored low on the study’s tests of verbal comprehension and processing speed.

These tests measure the amount of effort and time a person requires to decode incoming information.

Such longstanding cognitive difficulties would certainly make it difficult for anyone to comprehend complicated health information under the calmest of conditions. But when comprehension difficulties combine with the extreme negative emotions more common among vaccine-resistant people, this can lead to vaccination decisions that seem inexplicable to health professionals.

Today, New Zealand has achieved a very high vaccination rate (95 percent of those eligible above the age of 12), which is approximately 10 percent higher than in England, Wales, Scotland or Ireland and 20 percent higher than in the US.

More starkly, the New Zealand death rate per million population is currently 71. This compares favourably to other democracies such as the US with 2,949 deaths per million (40 times New Zealand’s rate), UK at 2,423 per million (34 times) and Canada at 991 per million (14 times).

How to overcome vaccine resistance
How then do we reconcile our finding that 13 percent of our cohort were vaccine resistant and the national vaccination rate now sits at 95 percent? There are a number of factors that helped drive the rate this high.

They include:

• Good leadership and clear communication from both the prime minster and director-general of health
• leveraging initial fear about the arrival of new variants, delta and omicron
• widespread implementation of vaccine mandates and border closure, both of which have become increasingly controversial
• the devolution by government of vaccination responsibilities to community groups, particularly those at highest risk such as Māori, Pasifika and those with mental health challenges.

A distinct advantage of the community-driven approach is that it harnesses more intimate knowledge about people and their needs, thereby creating high(er) trust for decision-making about vaccination.

This is consistent with our findings which highlight the importance of understanding individual life histories and different ways of thinking about the world – which are both attributable to adversities experienced by some people early in life. This has the added benefit of encouraging a more compassionate view towards vaccine resistance, which might ultimately translate into higher rates of vaccine preparedness.

For many, the move from a one-size-fits-all approach occurred too slowly and this is an important lesson for the future. Another lesson is that achieving high vaccination rates has not been free of “cost” to individuals, families and communities. It has been a struggle to persuade many citizens to get vaccinated and it would be unrealistic not to expect some residual resentment or anger among those most heavily affected by these decisions.

Preparing for the next pandemic
Covid-19 is unlikely to be the last pandemic. Recommendations about how governments should prepare for future pandemics often involve medical technology solutions such as improvements in testing, vaccine delivery and treatments, as well as better-prepared hospitals.

Other recommendations emphasise economic solutions such as a world pandemic fund, more resilient supply chains and global coordination of vaccine distribution. The contribution of our research is the appreciation that citizens’ vaccine resistance is a lifelong psychological style of misinterpreting information during crisis situations that is laid down before high school age.

We recommend that national preparation for future pandemics should include preventive education to teach school children about virus epidemiology, mechanisms of infection, infection-mitigating behaviours and vaccines. Early education can prepare the public to appreciate the need for hand-washing, mask-wearing, social distancing and vaccination.

Early education about viruses and vaccines could provide citizens with a pre-existing knowledge framework, reduce citizens’ level of uncertainty in a future pandemic, prevent emotional stress reactions and enhance openness to health messaging. Technology and money are two key tools in a pandemic-preparedness strategy, but the third vital tool should be a prepared citizenry.

The takeaway messages are twofold. First, do not scorn or belittle vaccine-resistant people, but rather attempt to glean a deeper understanding on “where they’re coming from” and try to address their concerns without judgement. This is best achieved by empowering the local communities that vaccine resisters are most likely to trust.

The second key insight points to a longer-term strategy that involves education about pandemics and the value of vaccinations in protecting the community. This needs to begin when children are young, and of course it must be delivered in an age-appropriate way. This would be wise simply because, when it comes to future pandemics, it’s not a matter of if, but when.

Dr Richie Poulton, CNZM FRSNZ, director of the Dunedin Multidisciplinary Health & Development Research Unit (DMHDRU), University of Otago; Dr Avshalom Caspi, professor, Duke University, and Dr Terrie Moffitt, Nannerl O. Keohane University Professor of Psychology, Duke University. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

New Zealand’s leading daily newspaper has warned the country against complacency over the covid-19 pandemic and to look to Fiji for an example of how things can easily go wrong.

In an editorial today, The New Zealand Herald has also criticised the government over its communication strategy and failure to counter a disinformation campaign threatening the national vaccination rollout.

“Complacency is our greatest enemy, particularly while the director-general of health continues to report no community transmissions in his regular briefings and with just 5 percent of the population having received a second vaccine shot,” said the Herald.

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“Fiji has discovered geographical isolation is not enough to avoid the increased transmissible variants of covid. Vigilance and adherence to official advice remains crucial as the best mechanism we have to the defeating this damned thing.

“Raising our prevention and contact tracing game after it has arrived is too late.”

From early on in the covid-19 pandemic, it was obvious that consistent communication was essential for New Zealanders to maintain compliance with key measures to limit transmission of the virus, said the newspaper.

“Now we know ‘influencers’ were deployed in Auckland’s March [2020] lockdown to push messages into social media as the government fretted about online posts undermining the pandemic response,” the Herald said.

Jeopardising NZ’s response
“It appears it was thought overly harsh critics condemning infected people for not self-isolating could truly jeopardise the country’s response. A newly released Cabinet paper said ‘social licence’ was crucial to a strong covid-19 response.

“Such hostility could undermine the overall pandemic response, wrote covid-19 Response Minister Chris Hipkins. ‘Public reaction to particular individuals who have not used the covid-19 Tracer app or otherwise failed to follow good practices suggests a possible erosion of this.’

“So, the Government sought help from social media figures who were deemed to have sway in Māori, Pacific, Indian and youth communities. Hosts from radio stations Tarana, Flava, The Edge and Hauraki subsequently posted reassuring photos and messages, using the campaign’s hashtag #stayinforit.

“Contrast this social media influencing tactic with the lack of action around countering misinformation on the vaccine.

“Most will have by now seen or heard of the leaflets put in mailboxes in a concerted campaign to raise unfounded fears about the vaccine and undermine the protection offered by mass immunity.

“The flyer was produced and distributed by a group called Voices for Freedom. Co-founder Claire Deeks ran as a candidate for Advance New Zealand at the last election, and was third on the party list.

“The group claimed to be putting out two million flyers to coincide with the government’s vaccine campaign.”

Information investigation
The Herald noted how investigative journalist David Fisher had sought any communications about what government agencies might do to address the false claims being disseminated about the vaccine and was told “the information does not exist”.

“For all its efforts and expense, Voices for Freedom failed to register as a threat.”

The government itself had not always been clear in all its communications, with some “casual contacts” of positive cases being upgraded to “casual plus” without announcement or explanation in March this year, the newspaper said.

“The Prime Minister was also accused of neglecting her own advice to ‘be kind’ when she publicly criticised a covid-infected person who continued to work at a KFC store.

“Ultimately, the government is well aware the greatest risk is the public passively drifting off the necessary precautions rather than active resistance.”

• Read the full New Zealand Herald editorial

A PNG member of Parliament died from covid-19 this week but it still wasn’t enough to convince many Papua New Guineans that the virus is real and is probably out of control in their country.

Misinformation and lack of trust in authority is so widespread in PNG that social media questions and vilifies the country’s most experienced doctors and scientists.

Even the PNG National Pandemic Controller, David Manning, was accused of peddling a hoax when he confirmed the MP for Open Kerema, 53-year old Richard Mendani, had died from covid-19 at the weekend.

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Twenty doctors at Port Moresby Hospital have tested positive but on social media they are blamed for not properly wearing PPE gear.

Conspiracy theories are spreading faster than covid-19 on PNG social media.

Posts claim covid-19 is an invention of the West to control population, that Papua New Guineans are guinea pigs for vaccines and that God is protecting Melanesians from catching the disease.

The senior consultant specialist clinician at Port Moresby General Hospital, Professor Glen Mola, called it the “bullshit of social media” in a Facebook post this week. He wrote:

“Sorry, getting a bit frustrated here with some of my compatriots. Health workers are risking their lives to continue to provide health services and many people are just spending their time on screens accusing us of unethical practice, criminal and corrupt misuse of government funds and putting forward false, ridiculous, unfounded conspiracy theories for which there is no evidence.”

Women scientists and journalists in particular have been singled out for vile misogynistic abuse on Facebook.

ABC Tok Pisin journalist Hilda Wayne turned off comments on her Facebook posts at the weekend. She said she was quoting direct sources on covid-19 and turning off comments to stop the toxic responses and interactions.

She wrote “so many people on [an] emotional rollercoaster with covid-19 on Facebook. Panic and misinformation just recipes of disaster”.

“Ignoring PNG for too long,” she added.

Read that again, ignoring “PNG for too long”.

If you don’t talk to your neighbours, how can you know what is going on in your own backyard? That there is endemic corruption and a breakdown in health care, education, law and order in the family.

Our family is the term adopted by Australia’s Prime Minister Scott Morrison.

PNG covid situation not a surprise
That the detection of covid-19 cases in PNG has tripled in the past month is not a surprise to those aware of the healthcare situation in PNG.

Two thousand mothers die in childbirth every year. TB, pneumonia and malaria are rifle but they are diseases that can be treated.

New restrictions, including the wearing of masks take effect this week [yesterday] but these will be almost impossible to enforce in PNG.

The majority of the population of 9 million live closely together either at home or when they travel on public transport. Ninety percent live in rural areas and just 15 percent has access to grid electricity.

While Australians look on in blind horror and surprise at the disaster unfolding in our nearest neighbour, we are also watching a failure in communication and education.

Australia used to play a major role in providing independent and trusted news to the Pacific but importantly also providing news about the Pacific to Australians.

The ABC’s international broadcasting to the Pacific was cut drastically in 2014 following the Abbott government’s decision to cancel the Australia Network contract. Around 80 staff, many of them with years of specialist experience in covering the Pacific were made redundant including members of the Tok Pisin (PNG) and French language teams.

Media voice reduced to whisper
Since then, Australia’s media voice in the region has been reduced to a whisper. The ABC does not have the resources by itself to provide a comprehensive international multi-platform media service.

The small specialist Pacific team that is left, provides an excellent service but is stretched.

The ABC’s PNG correspondent Natalie Whiting provides outstanding coverage but she is the only full-time Australian journalist based in the Pacific.

Technology has given the Pacific a voice to the rest of the world and people are able to share information instantly. That includes misinformation.

Mobile phones come loaded with Facebook as part of prepaid data plans in many Pacific countries. Most people cannot afford to pay for internet browsing. Affordable mobile data plans offer cheap access to Facebook.

There are varied figures for the percentage of population on Facebook … it’s highest In French Polynesia (59 percent), Tonga 49 percent, and Cook Islands 49 pecent and lowest in PNG 7 percent, Kiribati 25 percent and Solomon Islands 11 percent.

Aggregated site of independent news
I noticed the gap in independent and factual information about three years ago when I founded the Pacific Newsroom on Facebook. (Also on Twitter but with a smaller presence).

It’s an aggregated site of verified and independent news about the region – from journalists, academics, analysts, bloggers and citizen journalists.

The Pacific Newsroom has become the town square of the Pacific where people can share stories. Facebook has allowed this to happen because it is the internet in the Pacific.

We have more than 22,000 members, not just from the region but Fijians based in South Sudan and Afghanistan, seasonal workers in Australia and Tongans in Utah.

We fill a role that should be publicly funded. New Zealand journalist Michael Field and I work as volunteers, sharing a long term commitment to public interest journalism.

While traditional media, radio, TV and newspapers, retain an important role, distribution is not always reliable. We know that in the absence of accurate and trusted information, rumour, speculation and innuendo fill the vacuum.

The Pacific had a tragic example of this in Samoa in 2019, when 83 children died because of a drop in measles vaccinations and misinformation by anti-vaxxer groups.

Accurate and trusted news
That is why the dissemination of accurate and trusted news is vital to countering misinformation about the covid-19 pandemic.

Australia and New Zealand are providing support in the way of vaccines but people won’t get vaccinated if they believe conspiracy theories.

Profossor Mola says the propagation of this misinformation has the potential to lead to thousands of deaths in PNG if people pretend covid-19 does not exist.

Australia and New Zealand should be working with PNG on rolling out a national multi-media information campaign to help fight the “social media bullshit” as part of their assistance package.

This pandemic has shone a light on what works and what doesn’t. Things aren’t working in Papua New Guinea and it’s time for Australia to take a closer look at its relationship with the neighbours.

Republished from The Pacific Newsroom.

• The Pacific Newsroom