Rapid Qualitative Research in Public Health Emergencies: COVID–19 Vaccine Hesitancy in Taiwan
Regarding the COVID–19 pandemic, massive vaccination has become the primary public health approach for human society to return to its normal function. However, considering the emergency situation and the unprecedented speed of vaccine development, hesitancy toward COVID–19 vaccination is foreseeable. Global organizations have prepared for the necessary risk communication for COVID–19 vaccination from the very beginning.
In Taiwan, the COVID–19 vaccines roll-out started at late March 2021. At the beginning, people appeared to be hesitant to receive COVID–19 vaccination. The overall vaccination rates remained low until significant increases of COVID–19 cases occurred in Taiwan. However, it is dangerous to rely on merely the rise of infection cases to motivate people for vaccination. Without clear and effective risk communication about the uncertainty surrounding both the pandemic and COVID–19 vaccines, people may not be able to build up long-term confidence toward the vaccines. Meanwhile, there appears relatively strong COVID–19 vaccine hesitancy among certain communities, including vulnerable groups such as the elderly. As such, a thorough investigation into people’s concerns about COVID–19 vaccines and potential factors influencing decision-making is needed.
This study is the first “rapid qualitative research” conducted locally in Taiwan to investigate people’s hesitancy toward COVID–19 vaccination. This research approach has been developed and promoted by a group of applied anthropologists. It has been used in public health emergencies, and its ability to measure people’s concerns quickly so as to guide pandemic control interventions has been demonstrated. This study presents an approach particularly suitable for public health emergencies which is based on filling practical needs and providing timely feedback for policy formulation, although it can also be applied to development and evaluation of policy interventions in non-emergency situations.
Considering the importance of this newly emerging method, this article presents a detailed description of the process of this rapid qualitative investigation method step by step, as well as visualization of the whole process. In so doing, the authors hope to introduce this very important method to a Taiwanese audience.
The findings are as follows: (1) People are highly aware of the uncertainty of COVID–19 vaccination, and they need comprehensive and well-translated information. Conventional information campaigns are insufficient to allay people’s concerns over safety in a situation involving emergency-use authorization. (2) There has been scant attention paid to the important emotional aspects in health-related decision-making, yet these were found to be crucial in people’s final decision on whether to be vaccinated against COVID–19, and should thus be given serious weight in future risk communication. (3) A labeling effect can emerge, possibly hindering communication. People feel unable to express their different concerns and ideas while considering whether or not to vaccinate themselves for COVID–19. Due to feelings of being misunderstood and pressured, people who remain hesitant may shut down their communication with the outside world. (4) Explanations of vaccine policy details affect the overall trust in vaccine policy. A lack of clear explanation of the time arrangement of vaccine roll-out and availability of boosters directly leads to people’s concerns about whether they should receive any vaccine in such an uncertain situation.
Based on the findings, this study suggests that the government should pay serious attention to people’s concerns on COVID–19 vaccination, provide comprehensive and lay-friendly information and avoid labeling unvaccinated people. Effective and well-designed communication can help people build long-term, solid confidence in COVID–19 vaccination.