Vaccine in Society: From Matters of “Fact” to Matters of “Concern”
Jakkrit Sangkhamanee and Abhirat Supthanasup
In the previous article, we wrote about the development of covid-19 vaccines as well as how to ensure their efficacy, not only of providing immunity against the viruses but also of responding to social needs and confidence. We called the latter issue the “society-oriented immunity” of the vaccines. This is a dimension of great importance if we wish to understand how the vaccines work and how they are distributed amid the spread of information, expectations, and the virus.
We pointed out that the essential aspect of the debate over “good” vaccines was not limited to the efficacy against the diseases, but it involved the contexts of the timing, the value, the acquisition process, and the trustworthiness of the producing and procuring agencies. In other words, whether a product of science will be widely recognised and accepted into people’s lives does not stem only from the fact that said technology or product is technically effective but also from the fact that it is publicly accessible — with people being involved in the acceptance process — and well-placed in accordance with the social, cultural, and economic standpoints as well as different attitudes of diverse populations.
In this article, we will point out another important process, which follows the technical and social processes of vaccine development already discussed. It is the process of disseminating vaccines widely into society. Vaccine dissemination is an important process that transforms a matter of fact from scientific research and experiments, a collaboration of specific groups of people and agencies, into a matter of concern for a broader society, which includes people of diverse ideas and backgrounds.[1] Dissemination of vaccines is therefore a process necessary to connect institutional dimensions and diverse relationships, including medical specialties, political institutes, digital technologies, social networking, mass communication, systematic population grouping, and emphasis on multiculturalism. This article will cite Australia as a case study for Thai people to contemplate on and compare it with what has happened in Thailand.
From Scientific Facts to Vaccine Dissemination in Society
In late 2020, or about a year after the onset of the COVID-19 pandemic, many countries around the world began planning to use vaccines to mitigate the spread of the diseases. In November 2020, the Australian Parliament endorsed the Australian COVID-19 Vaccination Policy,[2] which set out key principles for the rollout of COVID-19 vaccines in Australia and the key priority of which was making safe and effective COVID-19 vaccines available to all Australians. The policy established a communication strategy for providing timely, transparent, and credible information to the public and stakeholders with the focus on regular and transparent communication via Australian government channels and media, with the following messages.
1) Covid vaccine was the best method to protect Australians.
2) The goal was access to safe and effective vaccines for all Australians.
3) The government would closely monitor the tracking and tracing systems for Covid vaccines to ensure the vaccines used were effective and safe.
4) Priority populations would have access to vaccines before others.
5) Vaccine characteristics, results of vaccine trials and pandemic situations would determine priority populations.
6) Australians would be encouraged to get vaccinated as more vaccines became available.
7) Australians were encouraged to acquire credible information for informed decision-making and to keep themselves well updated.
The Australian Parliament endorsed the Australian COVID-19 Vaccination Policy, which set out key principles for the rollout of COVID-19 vaccines in Australia and the key priority of which was making safe and effective COVID-19 vaccines available to all Australians.
A few months later, on 7 January 2021, Australia’s COVID-19 vaccine national roll-out strategy was published.[3] This strategy outlines priority populations for vaccination and the phases in which vaccines would be provided. There were 16 populations and five phases. In the first phase, the priority populations were aged care residents and residential aged care workers, disability care residents and residential disability care workers, priority frontline healthcare workers, and priority quarantine and border workers. Vaccination would be provided at 30-50 hospitals nationwide.
Prime Minister Scott Morrison said Australia's first coronavirus vaccinations for most at-risk groups could commence around mid-February. They would be given Pfizer shots after the vaccine was approved by the Therapeutic Goods Administration (TGA). The review was expected to be complete by the end of January 2021. The Pfizer vaccine would be imported from overseas. Large-scale vaccination of the general population would use the AstraZeneca vaccine, which would be produced onshore[4].
Around end of January 2021, the federal government launched a A$23.9 million COVID-19 vaccine public information campaign after the Therapeutic Goods Administration (TGA) approved the Pfizer vaccine, Australia’s first COVID-19 vaccine, with the objectives of widely ensuring people of the safety and effectiveness of COVID-19 vaccines and the vaccination rollout plan as well as access to vaccines. The campaign would run across a variety of mediums, including television, radio, press, social and digital.[5] The campaign would be in three phases:
1) To reaffirm that COVID-19 vaccines were put through Australian government agencies’ approval process, ensuring both the safety and efficacy of vaccines
2) To provide information on how the vaccine would be rolled out, particularly to priority groups, and dosage requirements.
3) To inform the public about how and where to get vaccinated, dosage requirements, and to support vaccine uptake.
From Policies on “Fact” to Policies on “Concern”
Vaccine rollouts not only to at-risk populations and main relevant personnel such as healthcare and frontline workers but also to the general public inevitably faced a challenge of promoting confidence and acceptance. During this process, scientific and technological inventions had to work with political institutions on policy, taking into account social networking and other dimensions including economic, political and cultural dimensions in order to change scientific “facts” to become socially shared “awareness”. This will increasingly affect collaboration between vaccines and other actors. During this process, it has become clear that technical information has been used and connected with various social dimensions and relationships.
Scientific and technological inventions had to work with political institutions on policy, taking into account social networking and other dimensions including economic, political and cultural dimensions in order to change scientific “facts” to become socially shared “awareness”.
In the case of Australia, we can explore said process in different dimensions. Though unlikely to cover all aspects, this deliberation should provide sufficient information to show how this change process works.
Promoting Awareness of Safety
The first phase of the COVID-19 vaccine information campaign focused on communication to ascertain
that the vaccines had gone through the approval process to ensure their safety and efficacy via such different mediums as videos, posters, and social media. Main essences include:
1) How COVID-19 vaccines work. For example, the video demonstrates how COVID-19 vaccines work inside our body after vaccination.[6] It is a simple animated explainer video with an easy-to-understand explanation, which includes several repetitions of the important message “Safe. Effective. Free”.
2) How vaccines are tested and approved. For example, an animated explainer video describes all the 6 steps of the Therapeutic Goods Administration’s approval process for Covid-19 vaccines. The main message to convey is ‘Safety. Quality. Effectiveness’.[7]
Apart from animated explainer videos, videos with presenters to explain the effects of Covid-19, vaccine approval processes, and vaccine rollout approaches were disseminated.[8] For example, the following video features Professor John Skerritt, a representative of the Therapeutic Goods Administration, TGA assuring: “A vaccine will be approved only after we have enough data that the vaccine is effective and safe”. There are also other videos featuring Dr Nick Coatsworth, an infectious disease physician, and Chief Nursing and Midwifery Officer Alison McMillan. Those people are medical specialists having credibility as spokespeople to convey information about vaccines. However, it might be questioned if those people are enough to reach out to all walks of life, as Australia is very diverse. Representatives of different groups may be needed, including religious and cultural leaders.[9] Also, as the safety of vaccines was the public’s main issue of concern, the communication of messages confirming the safety was crucial. Nonetheless, providing information on the side effects, as well as transparent and regular communication on the safety information, contributed to creating trust among people.
In addition to videos, still images on social media platforms were used during the first phase of the campaign on 28 January 2021 to promote the vaccination program, with the following key messages: 1) Stay up to date 2) Vaccine protect, 3) TGA approval process, and 4) Vaccines free.[10]
Along with the messages from the federal government, state governments also communicated to the public about the safety of the vaccines to boost their confidence in the vaccines. For example, ACT Health’s Facebook page posted a fact check message on 3 October 2021, reading: “COVID-19 vaccine development and approvals were not rushed.” The statement was given the following supporting facts: the urgency of the COVID-19 pandemic meant that researchers and developers from around the world prioritised the progress of COVID-19 vaccines; there was huge investment in research and new technologies to help researchers understand the virus; and coronaviruses were a well-known family of viruses back from the severe acute respiratory syndrome (SARS) epidemic in 2003 and Middle East respiratory syndrome (MERS) outbreak in 2012, so it meant that researchers and scientists already understood the virus’s biology.
In Australia, TGA is the only agency to approve vaccine safety and effectiveness. TGA always has access to clinical trial data so that the investigation and approval process can be done in a short time. Said post got high Facebook engagement, with over 14,000 reactions, more than 449 shares and comments that read that the information posted was interesting, especially for those hesitant to get vaccinated. Such a comment includes: “This is a very good to read. Excellent information. Helping those who hesitate to make an informed decision- yes or no. Giving those who made the decision to have the vaccine to know there was a lot of research done before the Jan….”[11]
Building “Community Spirit” Awareness
Building awareness of the safety closely involves technical facts, but the next part of awareness involves more elements or dimensions to enhance information on the vaccines and the outbreak, such as
1) Campaign on “Arm yourself against COVID-19”
The federal government launched the “Arm yourself against COVID-19” campaign to encourage eligible Australians to be vaccinated against COVID-19 to protect themselves, their loved ones, the people they care about, and the wider community.[12] The campaign features people from various backgrounds: races, genders, and ages. Their shirt sleeve was rolled up showing a band aid to indicate that those people had been vaccinated. The images were placed on pastel colours and next to the text that read: A COVID-19 vaccine is your best defence, and our only way forward. Now's the time to protect yourself, and encourage your family, your friends, your workmates, your community, someone you love to do the same. Find out when you can book your vaccination.”[13]
The federal government launched the “Arm yourself against COVID-19” campaign to encourage eligible Australians to be vaccinated against COVID-19 to protect themselves, their loved ones, the people they care about, and the wider community.[14] The campaign features people from various backgrounds: races, genders, and ages. Their shirt sleeve was rolled up showing a band aid to indicate that those people had been vaccinated.
However, Dr Tom van Laer, Associate Professor of Narratology at the University of Sydney, said that trust and motivation were needed for adopting a behaviour. This advertisement created trust in the vaccines but failed to motivate people to get vaccinated.[15] Even though the campaign was rolled out across a range of channels, including television, radio, print, social and digital media, and the material was adapted for culturally and linguistically diverse and Aboriginal and Torres Strait Islander audiences, comments were made that the campaign may not have reached the culturally and linguistically diverse audiences as intended, and whether the phrase “Arm yourself” could be translated well into other languages, and if so, how.
In conjunction with the federal government’s “Arm yourself against COVID-19” campaign, the state governments encouraged people to get vaccinated with community-spirit-promoting messages; for instance, ACT Health’s Facebook page changed its profile picture to an image with the text that read “I’ve had the COVID-19 vaccine. Keep CBR safe & strong.” The page also sent similar messages in other posts, such as a post giving an update on the number of people who have been vaccinated, together with a text that read “Thank you for keeping Canberra safe and strong,” which demonstrated people’s participation in taking care of the community by getting Covid-19 vaccine. [16]
Building Awareness with Lure of Social Freedom”
“Spread freedom” campaign?
เOn 24 October 2021, the federal government launched the Spread Freedom campaign to encourage eligible Australians to get vaccinated.[17] This campaign was launched when over 73% of eligible Australians had got two shots. The government wanted to encourage more Australians to be vaccinated by using the tag line “Spread freedom”. This campaign featured living life in freedom by showing people going to the pub, having family get-togethers, and travelling so as to communicate to those who hadn’t got vaccinated that they might miss all those pleasures. The campaign ended with a closing message of encouragement “We’re almost there Australia. Book your COVID-19 vaccination at Australia.gov.au” to encourage those who hadn’t got vaccinated to book their vaccination. [18]
The federal government launched the Spread Freedom campaign to encourage eligible Australians to get vaccinated. This campaign was launched when over 73% of eligible Australians had got two shots. The government wanted to encourage more Australians to be vaccinated by using the tag line “Spread freedom”. This campaign featured living life infreedom by showing people going to the pub, having family get-togethers, and travelling so as to communicate to those who hadn’t got vaccinated that they might miss all those pleasures.
Roll up for WA campaign
Queensland and Western Australia had lowest rates of vaccination probably because the outbreaks there were not as severe as those in New South Wales, Victoria, and ACT. The situation prompted the governments to encourage vaccine uptake there. For instance, Western Australian government invested over A$3.6 million on the Roll up for WA campaign to encourage their people to get vaccinated. This campaign particularly targeted a younger demographic by saying that those who had been vaccinated were able to enjoy sport, concerts, and family events — not only in WA but interstate and overseas. [19] The advertisement was screened during the Australian Football League (AFL) grand final and appeared on social media, in print and on radio, and on billboards around WA. [20]
Building “Fear-Based” Awareness
Don’t be complacent
The ‘Don't be complacent’ advertisement was first screened on 11 July 2021 in Sydney during the Delta outbreak and the third week of a lockdown. It showed the possible impact of the virus on health by using an image of a hospitalised patient with respiratory problems who needed a ventilator.[21] Chief Medical Officer Paul Kelly said that the important message was that they wanted Australians to get vaccinated as quickly as possible, and “This is not a time for complacency, it is not a time for frustration, it is a time for actually recognising that and taking that responsibility for yourself, your family and the community.”[22]
It can be seen that the process and practice of transforming technical facts about vaccines into social awareness could not have been implemented if the focus had been solely on presenting technical facts. The placement, distribution, and acceptance of vaccine in society was the result of the ability to connect such facts to other dimensions and social concerns, such as safety, community spirit, freedom, and fear. We do not wish to support or propose that scientific facts are insignificant. Rather, the aim of the article is to point out that the successful performance of scientific and technological products in society is entirely the result of connecting such technicality to political, cultural, and ideological contexts as well as social expectations. This is because in actuality scientific and technological products have never existed in a vacuum, but they are outcomes of social inventions.
This article is part of the Comparative Assessment of the Pandemic Responses in Australia and Thailand, supported by the Australia-ASEAN Council under Australia-ASEAN Council COVID-19 Special Grants Round, the Australian Department of Foreign Affairs and Trade.
This article is part of the Comparative Assessment of the Pandemic Responses in Australia and Thailand, supported by the Australia-ASEAN Council under Australia-ASEAN Council COVID-19 Special Grants Round, the Australian Department of Foreign Affairs and Trade.
References
[1] Latour, Bruno. 2004. “Why Has Critique Run Out of Steam” From Matters of Fact to Matters of Concern” Critical Inquiry 30: 225-248.
[2] Australian Government. https://www.health.gov.au/sites/default/files/documents/2020/12/covid-19-vaccination-australian-covid-19-vaccination-policy.pdf
[3] COVID-19 vaccination – Australia's COVID-19 vaccine national roll-out strategy. Australian Government, Department of Health; 27 January 2021. https://www.health.gov.au/resources/publications/covid-19-vaccination-australias-covid-19-vaccine-national-roll-out-strategy
[4] Lara Pearce. Four million Australians to be vaccinated for coronavirus by end of March; 7 January 2021. https://www.9news.com.au/national/coronavirus-vaccine-update-four-million-australians-by-end-march-scott-morrison/45f2fdba-66ca-4ea5-bea9-b0356c0b9e4c
[5] Australia’s COVID-19 vaccine information campaign begins, Department of Health; 27 January 2021. https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/australias-covid-19-vaccine-information-campaign-begins
[6] COVID-19 vaccines-How vaccine work. Australian Government, Department of Health; 25 January 2021. https://www.youtube.com/watch?v=0AssZJ0N2Ls&t=1s
[7] COVID-19 Vaccines- TGA approval process (animation). Australian Government, Department of Health; 3 February 2021. https://www.youtube.com/watch?v=XxJ7dnltvtI
[8] COVID-19 Vaccines – Live action montage (30 seconds). Australian Government, Department of Health; 27 January 2021. https://www.youtube.com/watch?v=BL62mNLOdzQ
[9] Jessica Kaufman. The government is spending almost A$24m to convince us to accept a COVID vaccine. But will its new campaign actually work?; 28 January 2021. https://theconversation.com/the-government-is-spending-almost-a-24m-to-convince-us-to-accept-a-covid-vaccine-but-will-its-new-campaign-actually-work-154062
[10] COVID-19 vaccines campaign social media. Australian Government, Department of Health, https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/covid-19-vaccination-campaign-materials/covid-19-vaccination-campaign-other-resources/covid-19-vaccines-campaign-social-media
[11] COVID-19 Vaccine fact. ACT Health’s Post. 3 Oct 2011
[12] Arm yourself against COVID-19. Australian Government, Department of Health. https://www.health.gov.au/news/arm-yourself-against-covid-19
[13] Now is the time to protect yourself (30 second ad for Aboriginal and Torres Strait Islander peoples. Australian Government, Department of Health; 14 July 2021. https://www.youtube.com/watch?v=TrW932Ga_Mg
[14] Arm yourself against COVID-19. Australian Government, Department of Health. https://www.health.gov.au/news/arm-yourself-against-covid-19
[15] Chris Pash. Vaccine arm yourself commercial as exciting as a 'bowl of cereal'. https://www.adnews.com.au/news/vaccine-arm-yourself-commercial-as-exciting-as-a-bowl-of-cereal
[16] ACT COVID-19 vaccination tracker. ACT Health’s Post. 24 September 2011.
[17] Spread Freedom. Australian Government, Department of Health; 24 October 2021. https://www.health.gov.au/news/spread-freedom
[18] Spread Freedom (30 second TVC). Australian Government, Department of Health; 24 October 2021. https://www.youtube.com/watch?v=RBZFhZMGupQ
[19] Roll up for WA. Government of Western Australia. https://rollup.wa.gov.au/
[20] Pip Christmass. New $3.6 million Roll Up for WA advertising campaign encourages vaccine uptake; 21 September 2021. https://7news.com.au/lifestyle/health-wellbeing/new-36-million-roll-up-for-wa-advertising-campaign-encourages-vaccine-uptake-c-4028034
[21] COVID-19 Health Campaign - Don’t be complacent. Australian Government, Department of Health; 12 July 2021. https://www.youtube.com/watch?v=5v0Xc4dWYH4
[22] Karen Barlow. Graphic COVID-19 scare campaign under way while Australians are urged to 'arm' themselves; 11 July 2021. https://www.canberratimes.com.au/story/7335447/graphic-scare-and-care-in-public-covid-19-campaign/