Understanding COVID-19 Vaccine Hesitancy in Georgia: A sociological analysis

• Thesis title in Czech: Váhavý přístup k očkování COVID-19: Sociologická analýza
• Thesis title in English: Understanding COVID-19 Vaccine Hesitancy in Georgia: A sociological analysis
• Key words: COVID-19, váhání s očkováním, očkování, anti-vaxxer, náboženství, Gruzínská pravoslavná církev, Gruzie.
• English key words: COVID-19, vaccine-hesitancy, vaccination, anti-vaxxer, religion, the Georgian Orthodox Church, Georgia.
• Academic year of topic announcement: 2021/2022
• Thesis type: Bachelor's thesis
• Thesis language: angličtina
• Department: Department of Sociology (23-KS)
• Supervisor: doc. PhDr. Dino Numerato, Ph.D.
• Author: hidden - assigned by the advisor
• Date of registration: 05.06.2022
• Date of assignment: 05.06.2022
• Date and time of defence: 23.06.2023 09:00
• Venue of defence: Jinonice - Nový Kampus, B228, 228, seminární místnost ISS
• Date of electronic submission: 01.05.2023
• Date of proceeded defence: 23.06.2023
• Opponents: Ing. Zuzana Kotherová, Ph.D.

References

8. References

- Archard, D. (2021). Let’s Talk About Covid-19 Ethics. Democracy in a Pandemic: Participation in Response to Crisis, pp. 57-62. doi:10.2307/j.ctv1v3gqz6.12
Appel, C., Beltekian, D., Giattino, C., Hasell, J., Macdonald, B., Mathieu, E., Ortiz-Ospina, E., Ritchie, H., Rodés-Guirao, L., & Roser, M. (2020) - “Coronavirus Pandemic (COVID-19)”. Published online at OurWorldInData.org. Retrieved from https://ourworldindata.org/coronavirus [Online Resource]
- BBC. (July 2, 2013). Georgia’s Mighty Orthodox Church. Retrieved on March 15 from https://www.bbc.com/news/world-europe-23103853
- Borowy, I. (2021). Perspectives on COVID-19 Vaccine: The Incredible Success Versus the Incredible Failure. Historical Social Research/Historische Sozialforschung, 33, pp. 147-172. Retrieved from https://shibbolethsp.jstor.org/start?entityID=https%3A%2F%2Fcas.cuni.cz%2Fidp%2Fshibboleth&dest=https://www.jstor.org/stable/27087279&site=jstor
- Burki, T. (2020). The online anti-vaccine movement in the age of COVID-19. The Lancet Digital Health, 2(10), pp. 504-505. doi:10.1016/S2589-7500(20)30227-2
- Glassman, A., Kenny, C., & Yang, G. (2022). COVID-19 Vaccine Development and Rollout in Historical Perspective. Center for Global Development. Retrieved from http://www.jstor.org/stable/resrep39990
- Larson, H. J., Peretti-Watel, P., Schulz, W., Verger, P., & Ward, J. K. (2015). Vaccine hesitancy: clarifying a theoretical framework for an ambiguous notion. National Library of Medicine. doi:10.1371/currents.outbreaks.6844c80ff9f5b273f34c91f71b7fc289
- Lomsadze, G. (2022). Georgia’s doctors on the vanguard of vaccine hesitancy. Eurasianet. Retrieved from https://eurasianet.org/georgias-doctors-on-the-vanguard-of-vaccine-hesitancy [Online Resource]
- MacDonald, N. E. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine, 33(34), pp. 4161-4164. https://doi.org/10.1016/j.vaccine.2015.04.036
- Or, Z., Gandré, C., Durand Zaleski, I., & Steffen, M. (2022). France's response to the Covid-19 pandemic: between a rock and a hard place. Health economics, policy, and law, 17(1), pp. 14–26. https://doi.org/10.1017/S1744133121000165
- Our World in Data. (n.d.). Coronavirus (COVID-19) Vaccinations. Retrieved on May 29 from https://ourworldindata.org/covid-vaccinations?country=OWID_WRL
- The Moscow Times. (2020). Russian Communist Leader Links Coronavirus Vaccine to Microchip Conspiracy Theory. Retrieved on May 29 from https://www.themoscowtimes.com/2020/05/27/russian-communist-leader-links-coronavirus-vaccine-to-microchip-conspiracy-theory-a70391
- Zainul, H. (2020). Countering COVID-19 anti-vaccination propaganda. Institute of Strategic and International Studies. Retrieved from http://www.jstor.org/stable/resrep29702

Preliminary scope of work

1. Low COVID-19 vaccine uptake in Georgia

The COVID-19 pandemic has been an ongoing crisis since December of 2019 originating from Wuhan, China. It is an understatement to say that COVID-19 took the world by a surprise. Most countries quickly passed drastic measures to fight the unknown virus; most prevalent measures included lockdown of airways, restriction of movement, and stoppage of businesses such as restaurants, clubs, gyms, etc (Borowy, 2021). Concisely, everything that was not necessary and essential for ‘survival’ was closed for an indefinite period. Some countries, such as France even restricted movement in the streets without temporary passes; these passes were granted for several reasons, for example: going to the supermarket or pharmacy, walking a pet, emergency situations, etc (Or et al., 2022). Especially during the first year of the outbreak, the pandemic took a great toll on human life. Everything had to fit in the rules mentioned above, so jobs, schools, universities, and other institutions were forced to go online.

However, as the time passed and researchers throughout the world worked countless hours and gained more information about COVID-19 effects, variants, symptoms, etc, they started working on developing treatments and coping mechanisms - vaccines. The world’s number one priority right from the outbreak of the virus was to create an effective treatment - a vaccine to fight the virus successfully. Even though the first successful vaccine was developed in December of 2020 people started discussing the topic much earlier; people developed strong opinions and were grouped together in terms of looking forward to or opposing the idea of being vaccinated against Covid. The reasons behind this are various and the thesis will discuss the most prevalent ones in the next sections. Nonetheless, for the people who believe in modern medicine and vaccines, developing vaccines for Covid was the first spark of hope that the pandemic would have been defeated soon. After researchers announced that vaccines were effective and ready to use, countries started to order huge amounts of doses hoping that the majority of people would get vaccinated. According to the official website of Our World in Data, some countries such as Israel managed to vaccinate 66% of their population with all required doses (and additionally, 6.1% with at least 1 dose) and some, such as Georgia, could not manage it and only 32% of Georgians are fully vaccinated (additional 9% with at least 1 dose) (Our World in Data, n.d.).


2. Religiosity & education

COVID-19 is a hot and novel issue in the world, thus the literature on the different aspects of the pandemic is abundant. Nonetheless, the academic literature and research papers on COVID-19 vaccination obstacles and issues in Georgia are scarce, to say the least. In Georgia, only 32% of the population is vaccinated with sufficient doses and 9% have incomplete dosage (Our World in Data, n.d.). The main goal of the thesis is to find out, understand, and analyze a) the reasons behind the low rates (32%) of vaccination and b) attitudes and beliefs towards the practice in Georgia. Furthermore, the academic paper will cover and discuss various attitudes and opinions Georgian citizens have. There are many opinions on why the vaccination is ineffective, unnecessary, and fraud. Numerous controversial theories exist about vaccines and these theories have a wide range of followers (ref). Especially in the rural areas of Georgia, many people do not have a high educational level, do not have access to the Internet and/or information, and do not have time or wish to watch television and follow the national and international news. People started opposing vaccination because of the lack of information and widespread controversial theories, such as Western countries putting tracking devices via vaccine in the organism of patients to obtain information (The Moscow Times, 2020).

Another reason is that Georgia is an extremely religious country, with 80% of the population being Orthodox Christian believers and highly trusting the Georgian Orthodox Church as an institution (BBC, 2013), and people who do not get vaccinated often blame it on the Orthodox Church, even though religion and religious leader - Patriarch Ilia II has never stated that the vaccines are sacrilegious and that vaccination goes against the Orthodox Church. In the 21st century, religion has become vague for some; since the internet has become so prevalent, it has become easier to spread truthful as well as wrong information rapidly.
Some extremists or devotees come up with some rules and state that the religion calls upon it, then some internet users believe the statement without double-checking (Zainul, 2020). There have been countless different versions of why vaccination is against religion and all based on personal opinions. Some priests go against the fundamentals of the Orthodox Church and use their positions to speak out their opinions ‘in the name of religion’. Numerous Georgian anti-vaxxer priests preach against vaccination and teach their parish not to get a vaccine.
for instance, many priests have come out stating that the vaccine is a mark of the antichrist (Lomsadze, 2022). Nonetheless, these ideas and opinions are quickly spread and followed by the crowd.



3. Theories explaining low vaccine hesitancy

COVID-19 pandemic has caused crisis and panic throughout the world, yet the vaccine development for Covid has been the fastest in history (Glassman et al, 2022). Some of the underlying factors for vaccine hesitancy are the social media disinformation, the lack of interest for various reasons, and the fear of vaccines not being safe and reliable (Glassman et al, 2022). According to Dave Archard’s article following the first successful vaccination in December 2020, vaccine hesitancy existed long before COVID-19 vaccines were developed; the hesitancy was based on several different aspects such as futile controversial theories, such as the fast pace and procedures of developing vaccines (insufficient time for the testing of vaccines on humans), and fears of unknown and unexpected side effects (Archard, 2020).

The hesitancy of vaccination is frequent in a developing country - Georgia. According to Our World in Data only 41% of the population is vaccinated fully or at least with one dose in total in Georgia (Our World in Data, 2022). Even though empirical data on vaccination is lacking in terms of Georgia, there are many non-governmental organizations or media outlets that have published articles backed up with statistical data about vaccine hesitancy in Georgia; a Georgian author Giorgi Lomsadze (2022) discusses one of the anti-vaxxer groups (and plausibly most surprising) - health care workers. As Lomsadze underlines, the data published by the National Center for Disease Control (NCDC) concludes that almost a third of working medical personnel are not vaccinated. Certainly, the latter complicates the effectiveness of positive campaigns to boost and support vaccination in the country. Although, according to a study conducted prior to covid, communication can be one of the effective tools to support the vaccination and avoid the hesitancy (MacDonald, 2015) Lomsadze also highlights that medical personnel and generally, people from rural areas are more hesitant and strongly opinionated (2022); citizens who had been infected and had recovered are advocating for their rights not to get vaccinated, since they already have antibodies for Covid.


4. Research questions

As mentioned above, the academic paper will cover two important parts: a) Are the reasons for vaccine hesitancy drawing on Georgian or Global sources? and b) How is vaccine hesitancy related to social (social status & profession) and cultural (education & religion) factors? The paper aims to find out the main underlying factors and beliefs of Georgians who are hesitant to get vaccinated, what controversial theories exist - which are the most prevalent and why, and the attitudes and opinions of different categories of citizens, such as vaccinated people, people who are planning on getting the vaccine, anti-vaxxers…


5. Methods of data production & Methods of data analysis

The research paper will utilize empirical data from other similar developing countries undergoing more or less the same obstacles in terms of vaccination. Moreover, official Georgian websites and resources, such as the website of the Ministry of Health will be used to support the research paper with statistical data. Most importantly, the author will conduct oral interviews with Georgian citizens from urban and rural areas of Georgia to obtain more direct, rich, and raw data on this specific and hardly researched topic. The interviews will be semi-structured and will include biographical as well as specific, Covid-related questions to understand respondents’ background, religious affiliations, other, and probable underlying factors. The research sample will include Georgians who are vaccinated with insufficient doses (i.e. 1 or 2 without a booster), who were/are hesitant to get vaccinated, and anti-vaxxers.
The paper will utilize thematic analysis extensively. Obtained interviews will be coded using the free coding software ‘taguette’ (taguette.com). Coded transcripts will be analyzed and interpreted in the analysis part and the results will be discussed in the remainder of the paper. Moreover, the arguments and literature review will be supported by respondents’ answers and thoughts.


7. Ethical consideration

The author of this paper acknowledges that even though the treatment and the cure for COVID-19 already exists and the percentage of fully recovered infected patients increased compared to the beginning of the pandemic, some people are still suffering mentally and physically and/or have strong emotional responses to the topic due to the post-traumatic experiences or Covid related issues. The author will inform respondents about their rights and will ask for informed consent before starting the interview and will keep the respondents anonymous; he will take into consideration the sensitivity of the topic and will communicate with the respondents with respect and compassion nonetheless of their opinions and attitudes towards vaccination. The author will not be biased toward any positions and will not take respondents' words out of context; he will honor respondents' choices if they decide not to participate in the research. Additionally, the author understands the importance of honoring colleagues' work and will use academic resources coherently and will not use others’ work and words out of context.