Original Research

Barriers to the success of COVID-19 immunisation programs in New Ireland Province, Papua New Guinea


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Belinda Flanagan
1 (Australian) PhD, MPH, MMid, GradCertProfLearning, BApplSci (Nurs), AssocDipSci (Ambulance), Head of School - Paramedicine * ORCID logo

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Kay Nevill
2 Grad Dip Health Science (Primary Health Care), MPH

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Camilla Sabok
3 MMid, Dip General Nursing

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Mimi Zilliacus

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Jonathon Sward
5 MIDI, MPH, BParaPrac, Registered Paramedic


1, 5 School of Paramedicine, University of Tasmania, Locked Bag 5052, Alexandria, NSW 2015, Australia

2, 3, 4 Australian Doctors International

ACCEPTED: 26 May 2023

early abstract:

Background: Although guidance exists for the public health activities recommended for the management of Covid-19 in Papua New Guinea (PNG), community vaccine hesitancy has been identified as a major challenge. Vulnerable groups such as the elderly, children, people living in rural and remote communities, the socioeconomically disadvantaged and those with certain pre-existing medical conditions are disproportionally affected by Covid-19. This project aimed to address the reasons for community vaccine hesitancy in New Ireland Province, PNG.
Method: To understand the reasons for vaccine hesitancy and intent to vaccinate within the community, a mixed – methods approach was used in conjunction with two methods of data collection. First a survey was provided to community members. The survey was adapted from two pre-existing validated survey instruments, the Oxford Covid-19 hesitancy scale and Oxford Covid-19 vaccine confidence and complacency scale. Community leaders and healthcare workers were invited to participate in semi-structured interviews to provide a more detailed response of their experience of vaccine acceptance.
Results: 181 participants from the New Ireland Province were surveyed. Whilst vaccine awareness amongst the cohort was high (86.7%), overall uptake of vaccination was low (7.2%). Despite this, only 27.6% participants indicated they would receive the vaccine should it be made available to them. Participants had concerns regarding vaccine safety, vaccine advice, and the authenticity and origins of the Covid-19 virus itself. Religious and political influence compounded the mistrust community members had for vaccine recommendations. Some community members stated their community had suffered for many years with serious illness, expressing a fatalistic acceptance of the virus, as they do other illnesses.  
Conclusion: Vaccine hesitancy is a significant problem which has the potential to negatively impact population level health. An urgent focused effort to strengthen immunisation programs in PNG is evident. Preventative primary healthcare is a national priority, however, for the successful delivery of vaccination initiatives, well-formed immunisation programs which include education that will dispel myths and misinformation is required.

Keywords: COVID-19, Papua New Guinea, vaccination, vaccine hesitancy