Role of traditional, religious leaders in upscaling COVID-19 vaccination

COVID-19 vaccination has already started to generate heated arguments following a hint that the Federal Government could start sanctioning anybody who refuses to be vaccinated.

Dr Faisal Shuaib, Executive Director, National Primary Healthcare Development Agency (NPHDA), disclosed this at a recent press conference in Abuja. He, however, said that implementation was dependent on availability of the vaccines.

“The Presidential Steering Committee and the Federal Ministry of Health are exploring ways of making vaccines more available to all Nigerians, including federal civil servants and corporate entities.

“Once these vaccines are made equitably available to all Nigerians, then we will need to have a frank discussion about justice, fairness and liberty that exist around vaccine hesitancy.

“So, you have a right to refuse vaccines, but you do not have the right to endanger the health of others,” he said.

Already, attempts are being made by two states – Ondo and Edo – to make COVID-19 vaccination compulsory, especially for public servants and members of the public who wish to gain access to certain places.

These places include religious worship centres, banks and public buildings.

However, those attempts and the suggestion that the Federal Government might sanction those who refuse vaccination have been criticised by some trade, professional and religious associations.

The Nigeria Medical Association (NMA) and Joint Health Sector Union (JOHESU) that kicked against the compulsory vaccination, said that government should rather embark on advocacy and persuasion, than coerce citizens into getting vaccinated.

The spokesman for JOHESU, Mr Olumide Akintayo,  said the policy would only be sensible if there were enough vaccines to inoculate eligible citizens.

Akintayo stated: “If you are thinking of it in terms of responsibility, it makes sense; but practically, we all know it is an impossible task.

“ If all the doses that have been sent to Nigeria since this outbreak is less than 10 million, how do you enforce that kind of policy in a country of over 200 million people?

“You don’t just come up with policies that are not backed by common sense; you don’t just say things because you want to talk. It would have made some sense if the vaccines are available for everyone.”

The General Secretary of the NMA, Philips Ekpe, said citizens could not be forced to be vaccinated against COVID-19 the same way they had the right to reject medical treatment.

Rather than being forced, he said Nigerians should be made to understand the need to be vaccinated.

According to him, although they cannot be forced, citizens who refuse vaccination should stay in their houses so that they don’t endanger others.

He said: “The Federal Government needs to make people understand the reason why they need to be vaccinated. They have the right to say no. You cannot force people. People have the right to say no to medical treatment.

“But you should let them understand the dangers of not getting vaccinated.

“For example, if you want to travel out of the country, if you are not vaccinated, you will not be let in. The reason is because the other country you are going to won’t want to endanger the lives of its citizens.

“Let them understand the importance, but then if they refuse, they should stay in their houses and not go out and endanger others.”

Experts believe that properly communicating the advantages of being vaccinated, through the use of existing structures, such as religious and cultural institutions, would yield better results than subtle threats.

Communication connotes persuasion, even on occasions when the purpose of a piece of communication is not to persuade, there is still the need to win over the audience to accept the message.

In this era of fake news, and when the social media is awash with conspiracy theories against vaccination, persuasion must first be deployed to get the attention of citizens.

The burden increases tremendously when there are cultural and religious stereotypes which could prevent many adherents from accepting that being vaccinated is safe.

This challenge is not peculiar to Nigeria. In the U.S. for instance, vaccine hesitancy is responsible for over 90 per cent of all COVID-19 related hospitalisation.

Getting some Americans vaccinated has been so challenging that many people have been offered monetary incentives to convince them to get vaccinated in an unusual case of persuasion.

In Nigeria, where religious and traditional leaders are custodians of faith and culture respectively, they wield great influence on devotees and those institutions can be deployed to boost vaccination drive.

Historically, religious and traditional rulers often employ the cognitive process of persuasive communication to change an entrenched social perception or public opinion hindering required public support for relevant people-oriented policies.

Leaders have the influence to subtly appeal to the target to listen, accept, comprehend and act.

Therefore, before considering the stick, government should first explore the use of carrot.

Religious and traditional leaders can help in giving correct messages on vaccination as well as being role models, making sure that they and their loved ones too are vaccinated.

Faith-based and culture-based organisations can also collaborate with other leaders to sensitise communities on the benefits of vaccination and to also dispel the many myths and disinformation about it.

King Bubaraye Dakolo of Epetiama Kingdom in Bayelsa has been putting this to practice to use, since vaccination was first rolled out in Nigeria in March.

“The arrival of the vaccine brought a huge relief to our kingdom. I mobilised my people to carry out awareness campaigns in the various communities to guard against apathy.

“My council chiefs and I led by example in being vaccinated early. When the people saw that, they were fully convinced that the vaccine is not harmful.

“We made it clear to our people through town hall meetings that the vaccine is safe and is designed to save humanity.

“We equally reminded them how some persons who refused to be vaccinated for poliomyelitis in the past are suffering the consequences of their actions today,” the traditional ruler said.

According the WHO COVID-19 Dashboard, Nigeria had administered 4.4 million COVID-19 vaccine doses as at Aug. 31, 2021. Out of that number, 2.9 million Nigerians have been fully vaccinated, according to the NPHDA.

With a fairly efficient vaccination structure, owing to many years of immunisation against polio, the Nigerian government should activate collaboration with religious and traditional bodies in its vaccination drive.

Experts, including health professionals and public administrators, believe that involving these leaders in advocacy and public enlightenment will lead to more people accepting to voluntarily get COVID-19 vaccination.

Of course, with just a paltry 0.7 per cent of the population vaccinated, the key indicator for any punitive measure for avoiding vaccination will be subject to availability of the vaccines.

However, to achieve the goal of vaccinating 40 per cent of its 200 million population before the end of 2021 and 70 per cent by the end of 2022, Nigeria will need more than availability of vaccines.

There has to be the acceptance and willingness of the majority of its population to be vaccinated.

One of the crucial and effective way to achieve that is to work with religious and traditional leaders.

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