Social Vaccine

• 21 Apr 2020

Why in News

The Union Health Minister has recently asserted that lockdowns and social distancing are the most effective “social vaccines” available to fight the pandemic (Covid-19).

Key Points

• Social Vaccine
  
  • It is a metaphor for a series of social and behavioural measures that governments can use to raise public consciousness about unhealthy situations.
  • This is made possible through social mobilisation.
    
    • Social mobilisation is a process whereby people are organized in order to enable them to collectively think and act upon their development.
    • It can empower populations to resist unhealthy practices, increase resilience, and foster advocacy for change. This can ultimately drive political will to take action in the interests of society.
  • A social vaccine addresses barriers and facilitators of behaviour change (attitudinal, social, cultural, or economic) and supplements Information, Education, and Communication (IEC) with targeted Social and Behaviour Change Communication (SBCC) strategies.
    
    • SBCC is the strategic use of communication approaches to promote changes in knowledge, attitudes, norms, beliefs and behaviors.
• Effectiveness of a social vaccine during Pandemic
  
  • When applied to pandemics, the effectiveness of a social vaccine is determined by the extent of dissemination and uptake of accurate information about personal infection risk and methods to reduce the risk.
  • Uganda and Thailand used SBCC strategies effectively during the HIV/AIDS pandemic to bring down the incidence of HIV infection, before Highly Active Antiretroviral Treatment (HAART) was introduced in 1995. 
  • These countries demonstrated how an effective social vaccine helped “flatten the curve” till effective treatments were discovered that dramatically reduced mortality, viral loads and infection transmission.
• Social Vaccine amidst Covid-19
  
  • The skills and experiences from controlling HIV/AIDS pandemic can be innovatively adapted for the current pandemic.
  • Use of IEC and SBCC strategies:
    
    • Maintaining physical distancing in social situations and wearing cloth masks or facial coverings in public by 100% of people is key to preventing infection along with regular disinfection of oneself and one’s surroundings.
    • People are more likely to practise these behaviours if all leaders (without exception) promote them publicly and consistently, the whole community believes in their importance, and if proper information, support, and materials are available and accessible.
    • Building trust is key if government-imposed mitigation strategies are to be embraced by the population.
• Practising Social Mobilisation
  
  • This will make people to hold leaders accountable to invest in: rapidly scaling-up testing; meeting the basic needs of vulnerable sections; not communalising or politicising the pandemic; providing adequate Personal Protective Equipment (PPE) to front-line workers in health, etc. and not compromising the privacy and dignity of infected individuals.

Role of Social Vaccine in Controlling HIV/AIDS Pandemic

• Outbreak of the Disease: The Human Immunodeficiency Virus (HIV) that causes the Acquired Immune Deficiency Syndrome (AIDS) is believed to have made the zoonotic jump through chimpanzees on humans in Africa as early as the 1920s, but the HIV/AIDS epidemic was detected in 1981 and was a pandemic by 1985.
• Panic Situation: The cause was unknown (till 1984) and diagnostic tests were unavailable (till 1985). Since there was no treatment, a diagnosis of HIV infection was a death sentence.
• Impact
  
  • Widespread fears of infection rendered many infected people homeless and unemployed. Many were denied access to care.
  • Stigma, discrimination and violence towards infected individuals, their families, social groups (sex-workers, gay men, drug users, truck drivers, migrants), and even health workers, were common.
  • Conspiracy theories, misinformation and unproven remedies were widely propagated.
  • The unpreparedness of health systems, societal prejudices and socio-economic inequities were starkly exposed.
• Use of Social Vaccine
  
  • Reducing HIV transmission centred on acknowledging that everybody was potentially infected — even those apparently healthy — and that infection occurred predominantly through sexual transmission and intravenous drug use.
  • The core preventive messages involved being faithful to one sexual partner or having safe sex, etc.These measures conflicted with prevailing cultural, social, religious, behavioural and legal norms.
  • However, IEC and SBCC activities targeted (and partnered) individuals, families, community leaders, and social and health systems to change attitudes and behaviours. Religious and community leaders were key change agents.
    
    • Thailand used humour to defuse social taboos about publicly discussing sex.
    • Coercive or punitive methods acted counter-productive in controlling HIV/AIDS.
  • These strategies and advocacy against stigma and discrimination were also successfully adapted in India.

Way Forward

• There is still no biomedical vaccine for HIV/AIDS. Considering the limited efficacy and uptake of influenza vaccines, vaccines for SARS-CoV-2/Covid-19 may not provide a panacea.
• Effective treatments to reduce deaths with Covid-19 may emerge, but till then, and even afterwards, a social vaccine is needed.
• A social vaccine can build societal immunity to the devastating effects of future pandemics by the lessons learned about addressing the root causes, and our responses to the current one.

Source: TH