Mind the "Vaccine Fatigue"

"[E]ffective and empathetic vaccine communications hold great promise in eliminating preventable vaccine fatigue across sectors in society."

Vaccine fatigue can be described as people's inertia or inaction towards vaccine information or instruction due to perceived burden and burnout. The phenomenon may be particularly pronounced amid large infectious disease outbreaks, such as COVID-19, when people can become overwhelmed by a deluge of communication on the importance and imperative of vaccination - particularly as new variants (e.g., Omicron) emerge. Because vaccine fatigue may compromise people's vaccination intention, this study explores the antecedents to vaccine fatigue in the context of the COVID-19 pandemic. The goal is to help government and health officials address the issue and to prevent vaccine fatigue from progressing into more permanent forms of vaccination non-adoption, such as vaccine hesitancy or hostility.

A literature review was conducted in PubMed, Scopus, and PsycINFO to identify factors that introduce or intensify vaccine fatigue in society. The preliminary search, which was conducted on December 2 2021 and December 6 2021, led to 37 articles for inclusion in the final review and analysis.

Overall, a wide range of antecedents to vaccine fatigue was identified, ranging from the frequency of immunisation demands, vaccine side effects, misconceptions about the severity of the diseases and the need for vaccination, to lack of trust in the government and the media. For example:

• The findings show that many antecedents of vaccine fatigue are rooted in flaws in vaccine science, as well as too many vaccination demands in a relatively short period of time. In countries such as Pakistan, many children may have already received 15 doses of vaccines (e.g., the oral polio vaccine), which could result in vaccine fatigue in both the children and the parents. Even before the identification of Omicron, many societies across the world had already demanded that the public take a 3-dose regime for additional protection, often with conflicting and confusing guidelines and recommendations. These insights highlight the need for greater investments in vaccine sciences and technologies, so that more user-friendly vaccines, in terms of the overall efficacy, duration of their protection, and the logistics associated with dose administration, could become available to the public. From the dose administration perspective, for instance, vaccines that are less invasive, such as inhalable vaccines, edible vaccines, and skin-based immunisation, could be developed.
• The literature indicates that a wide range of antecedents to people's vaccine fatigue is rooted in the lack of effective vaccine communications, which can lead to misconceptions about vaccine efficacy and effectiveness, poor understanding about the severity of the diseases or the urgency for vaccination, and/or erroneous or contradictory beliefs that hinder vaccination. As suggested here, the government and health officials should be more mindful about how vaccine communications are designed, developed, and deployed. For example: "Considering that compulsory interventions may result in potential consequences such as forcing the momentary vaccine fatigue into more aggressive and permanent forms of vaccine non-adoption, such as vaccine hostility, it is important that government and health officials adopt an empathetic approach to vaccine communications....The need for mindful and compassionate interactions with the public might be particularly pronounced in light of the potential unintended consequences vaccine communication could cause" - e.g., stigmatisation or discrimination.
• This study's findings show that a lack of trust in the government and the media is an antecedent to vaccine fatigue. For instance, due to the prevalence of the COVID-19 "infodemic" and the polarising role many media outlets have embraced, the public's trust in media reports on COVID-19, such as COVID-19 vaccines, has been deteriorating. Per the researchers, "It is possible that, to avoid potential or additional stress caused by the media reports on COVID-19 vaccines, people might develop a passive attitude towards news about the vaccines and the shots themselves, in the form of vaccine communication avoidance, and in turn, vaccine fatigue....[M]ore research and interventions are needed to ensure a healthy and symbiotic relationship can be formed between government and health officials, media professionals, citizen journalists, and the public in the context of vaccine communications."

In conclusion: "in light of the knowns and unknowns about COVID-19,...in order to effectively prevent vaccine fatigue from plaguing pandemic control and prevention efforts, more endeavors are needed to understand the causes and consequences of vaccine fatigue amid COVID-19 and beyond."