Survey of Haitians’ Perceptions of COVID Vaccination Reveals Some Surprises
As of July 2021, less than 1% of the population of Haiti was fully vaccinated against COVID-19. Researchers conducted an on-the-ground survey to understand why. They discovered that vaccine availability, access, misinformation and distrust of Western medicine each figured into the lack of vaccine uptake.
In contrast to the actual 1%, 27% of 1,071 Haitians surveyed in three rural communities in September 2021 said they intended to get vaccinated, said Maurice Junior Chery, M.D., M.P.H., lead author of the survey study and a Ph.D. graduate student in prevention science and community health at the University of Miami Miller School of Medicine.
What accounts for the difference between the 1% and the 27%?
“The COVID vaccines were available but not necessarily accessible to everyone, especially in rural areas,” Dr. Chery said. He and colleagues chose to focus on rural Haitian populations because they tend to be the most vulnerable to health challenges, including COVID-19. The study results were published online in the journal Human Vaccines & Immunotherapeutics.
The 26 percentage point difference revealed by the survey “is a huge discrepancy,” said Judite Blanc, Ph.D., assistant professor of psychiatry and behavioral sciences at the Miller School. Dr. Blanc mentors Dr. Chery in her Holistic Families Lab within the Department of Psychiatry and Behavioral Sciences.
“This is not surprising. This reflects the reality that I knew when I was growing up in Haiti,” Dr. Blanc said. “The biggest problem when it comes to implementing health care policy and health programs in low-income countries — including Haiti — is that people are scared.”
Concerns about vaccine side effects were the leading reason for vaccine hesitancy, reported by 67% of respondents. A close second, 65%, said they hesitated because they believe they could catch COVID-19 from the vaccine. This finding surprised Dr. Chery. Traditionally, the Haitian population has been receptive to receiving vaccines against polio, measles and other preventable diseases. On the other hand, he added, “I wasn’t totally surprised because of the global climate around COVID-19 vaccination.”
Countering Vaccine Misinformation
Haiti is not immune to vaccine misinformation. The rapid development and the distribution of this vaccine, although scientifically sound, helped to spread fear in less developed countries, Dr. Chery said. Also, “correct information can really take a while to arrive in rural areas, but false information is quick to get into this population.”
In terms of solutions, more education, awareness and communication about COVID-19 vaccination are needed to overtake this misinformation. “We have to address all those all those concerns, such as side effects. We also need to provide the good information regarding vaccination efficacy,” Dr. Chery said.
“What is super surprising to me is the fact that three quarters of [respondents] identified their health care workers as their most trusted source of information with regard to the vaccine,” Dr. Blanc said. The fact that the majority of this population trusts health care workers “is great news,” she said.
Health care workers can be engaged in direct education. “I am a physician in Haiti, and we do that all the time,” Dr. Chery said. Training community leaders and members to provide accurate information and increasing the number of doctors and nurses involved in community outreach are additional strategies.
Other Challenges Divert Attention from Vaccination
People in Haiti are facing a range of other day-to-day challenges, making it more difficult to call attention to the benefits of COVID-19 vaccination. The political situation in the country is unstable. Also, other diseases like HIV and tuberculosis remain prevalent, and the country is experiencing outbreaks of cholera.
Nonetheless, Dr. Chery remains undeterred, with his efforts to increase vaccine uptake as part of his commitment to promoting health equity overall in Haiti.
Miller School’s Support
Dr. Chery cites the support from Dr. Blanc, the Holistic Families Lab and the Miller School as essential to his completing his work and allowing his research to find a wider audience. “We are really close to the Haitian diaspora in South Florida. It’s also important that the Black population knows about what is happening in Haiti,” he said.
In addition, Dr. Chery acknowledges support from study senior author Dr. Bethany L. Hedt-Gauthier and the research team at Zanmi Lasante for their assistance in conducting the survey and writing the paper.
Moving forward, Dr. Chery will continue to work with Dr. Blanc and other colleagues on separate research into sleep health and gynecologic cancers in the Haitian community. He is also involved in the ongoing Haitian Well-Being Study, which looks at population stressors and overall mental health.