A recent World Bank survey showed that about 18% of Papua New Guineans were planning on being vaccinated, 26% were not, and 55% were unsure; 80% said they were worried about side effects, and about 50% said they don’t trust the vaccine.

So far, very few have actually come forward to be vaccinated.

From conversations I have had in and around where I live in Port Moresby, there are a variety of specific reasons that turn people against the vaccine. Many of these involve both a concern about side effects, and a lack of trust.

For example, some people I have talked to believe that COVID-19 vaccination is a preparatory activity for the digital economy, where there will be no cash in the form of notes and coins, but rather digital currency. This leads to resistance to vaccination on the grounds of it being an assault on freedom and privacy.

Others I have talked to believe that the COVID-19 vaccine will make their lives completely dependent on it. That is, they see the vaccine like other very addictive substances: betelnut, cigarettes, and alcohol. They believe that once they take the first dose, it will make their bodies addicted to it and they will ask for more doses. Again, this could be seen as a bad side effect or a lack of trust.

There is also a broader lack of understanding of COVID-19 itself, and this spills over into a lack of trust in the vaccine. When word of COVID-19 first came to PNG, almost the whole country entered a period of great fear, given the news they were hearing, especially about how COVID-19 was so deadly in China.

But from then until the time when COVID-19 vaccination was made available in PNG, the level of fear dropped due to the divergence between what people heard and saw in news from other countries, and what they actually experienced in PNG. They never saw people collapsing while walking; the disease didn’t seem that deadly. So, people say to themselves, “What is the point of getting the COVID-19 vaccine when life is as usual before COVID-19 came?”

Hotel quarantine has also led to confusion. When people go into a 14-day lockdown, and come out healthy, some people wonder where exactly the virus went. Why didn’t those suspected of having the disease die? Is the virus less effective in PNG than it is in other countries?

There were more deaths last year from COVID-19, and that has changed the minds of some. However, even today, the reality in PNG is that, apart from in major shops and workplaces, life continues as it was before COVID-19 began. People don’t wear masks, they gather in crowds, and public transport buses are full.

Although most Papua New Guineans remain anti-vax, as COVID-19 policies have become more stringent, some with anti-vax attitudes have got vaccinated. This is simply because most people need cash to buy the essentials on which they depend: rice, flour, sugar, tea, and tinned meats. You need money and therefore a job to purchase these goods, and if your job depends on getting the vaccine, then people will get vaccinated.

Anti-vax Papua New Guineans now living in urban areas are unlikely to return to their home villages and survive on fishing, hunting and gardening. Only a few would consider this.

However, we have also seen some anti-vax citizens protest. We saw this when the PNG government made a statement which suggested that domestic travel would only be possible for those who are vaccinated.

Recently, I got vaccinated. More people have been dying of COVID-19 lately, so when I thought through the health consequences I decided to get the vaccine. I also thought of my employment as well. I personally believe the “no jab no job” policy will be compulsory in the coming years.

It’s a decision I take responsibility for. Most people I know still don’t want to get vaccinated. It’s not enough to say that billions around the world are getting vaccinated. That is not going to convince Papua New Guineans. We need a lot more information and encouragement from all church leaders and health workers to get more people vaccinated. (The World Bank survey found that evidence from health workers was particularly effective in changing minds about the vaccination.) More stringent policies will also help, but risk a backlash.

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Disclosure: This article was written with the support of the ANU-UPNG Partnership, an initiative of the PNG-Australia Partnership, funded by the Department of Foreign Affairs and Trade. The views are those of the author only.

This article appeared first on Devpolicy Blog (devpolicy.org), from the Development Policy Centre at The Australian National University.

Anslem Manoka is a 2019 UPNG economics graduate. The views are those of the author only.