UDC 027+351.774.7(599)

YAP J. M.

Eotvos Lorand University (Budapest, Hungary),

University of Perpetual Help System (Laguna, Philippines),

e-mail: joseph.yap@nu.edu.kz, ORCID 0000-0002-7852-1047

Tafalla D.

Magallanes Rural Health Unit (Magallanes, Cavite, Philippines)

e-mail: rylmanalo2327@gmail.com, ORCID 0000-0002-9052-0012

VACCINATION INFODEMIC AMONG CITIZENS OF MAGALLANES, CAVITE, PHILIPPINES

Objective. This survey research intends to understand how people from a fourth-class municipality of Cavite made their decision to be vaccinated in spite of false information circulating within family, friends, and neighbors. Methods. The study employed survey research and gathered data using voluntary sampling from a pool of citizens with an appointment schedule in the vaccination site located in Magallanes, Cavite. Results. The pandemic saw a rise in the spread of information disorders. The proliferation of fake news and misinformation affect our lives as they disrupt relationships with family members and friends. Trust is being questioned as people believe in contrasting medical opinions. The overload of information sharing is a challenge for individuals to evaluate news sources coming from multiple platforms. As the status of inoculation in the Philippines is ongoing, citizens who want protection took time to get vaccinated. The impact of traditional and social media continues to be powerful influencers in information dissemination. As we deal with overabundance of information, librarians have an emerging role to play. Conclusions. Librarians are seen as partners of a local government unit in promoting citizens' well-being, providing credible sources of health information vital for an individual to help them arrive at an informed decision, and showcase advantages of vaccines as evidenced by scientific publications.

Keywords: misinformation; disinformation; infodemic; vaccination hesitancy; COVID-19; Cavite, Philippines

Introduction

The pandemic saw a rise in the spread of information disorders. In research conducted by Islam et al. (2020), misinformation may lead to attack, stigma, and discrimination against healthcare workers. They see healthcare professionals as a threat when they visit public places or community spaces, including rented apartments where owners refuse to accept tenants who work at hospitals or healthcare facilities. Some people also believed in self-treatment. They rather pick up information shared by their social media friends instead of listening to the expert advice of healthcare professionals. What’s worse is when a medical practitioner is the purveyor of disinformation. This may cause more harm to the patient rather than helping them recover from infection caused by the virus.

Methods

The study employed survey research and gathered data using voluntary sampling from a pool of citizens with an appointment schedule in the vaccination site located in Magallanes, Cavite. Respondents answered a self-administered online questionnaire using Google forms with seven different questions translated into Filipino. The samples were all adult residents of Magallanes, Cavite.

Results and Discussion

The questionnaire consists of questions that seek to understand how they arrived at the decision to be vaccinated. Question one wants to find out their sources of information. Questions two and four give us an idea of their hesitancy and factors related to it. Questions three and five seek to understand their decision for vaccination and the factors related to it. Question six gives us an idea of their vaccine brand preference. Question seven asks them about their understanding of what will happen after being vaccinated.

Fig. 1. Administering the survey questionnaire

Status of Vaccination Program in the Philippines Against COVID-19

At the end of September 2021, the Philippines had an active COVID-19 cases of 138, 294 (Rappler, 2021). The nation recorded total deaths of 38, 294 and a total recovery of 2.3 million patients. In a report by VOA News (2021), The Philippines received its COVID-19 vaccines only on February 28, 2021, the last Southeast Asian country to receive such supplies. The first batch was donated by Sinovac Biotech Limited, a Chinese developed vaccine. On March 1, 2021, mass vaccination started in the Philippines. After which, AstraZeneca arrived on March 4, 2021. 487,200 doses arrived from COVAX Facility led by the World Health Organization.

According to McGill COVID-19 Vaccine Tracker Team (2021), there are 10 vaccines approved in the Philippines. It includes Pfizer, Moderna, Janssen, Sputnik, Oxford AstraZeneca, and SinoVac.

The Philippines developed a vaccine deployment plan. The lead agency responsible for policymaking and guidelines is the Inter-Agency Task Force on Emerging Infectious Diseases (IATF) which ensures that equal allocation of vaccines is achieved. Below them is the interim National Immunization Technical Advisory Group (NITAG) of health experts that provides recommendations to IATF.

Priority groups were established to address scarcity of vaccines.

Table 1

Priority Groups

Table 1 shows the most important priority groups that need immediate vaccines against COVID-19 in the Philippines. They are divided into five classes: workers in frontline health services including students in health and allied professions nursing aides and barangay health workers, senior citizens or those beyond 60 years old, persons with comorbidities or those with primary long-term illness such as diabetes or hypertension, uniformed personnel, and indigent population.

Status of Vaccination Program in Cavite and Municipality of Magallanes, Cavite

The municipality of Magallanes is known for their organized pandemic response. They were recognized to have one of the best practices in terms of providing immediate patient care. Their initiative on Empowered Team: Interconnected Teams focuses on strengthening their Incident Management Team. It is composed of the Swab Testing Team, Contact Tracing Team, Disinfection Team, and the Isolation and Monitoring Team, Checkpoint Team, and Information Team (PIO). This practice comes after joining a course conducted by the Jesse Robredo Institute for Leadership and Good Governance. The Rural Health Unit (RHU) of Magallanes participated in the course on Building Pandemic-Resilient Communities through Public Health Governance (Jesse Robredo Institute, 2021).

Being a 4th class municipality in the province of Cavite, Philippines does not hinder them in providing the best healthcare services. Magallanes is known for their production of rice and coffee. It consists of 16 barangays and has a population of 22, 727 (Province of Cavite, 2018).

In Magallanes, Cavite, the first dose of SinoVac was inoculated on 25 March 2021 to five A1 recipients. The inoculation was held in General Emilio Aguinaldo Memorial Hospital, Trece Martires City, capital of Cavite. One of the first facilities in Cavite to conduct vaccination roll-out. While Magallanes still have no place to conduct their vaccination roll-out that comply with the guidelines of the Department of Health, they decide to utilize the First Filipino Saint Hospital in Naic, Cavite as their temporary vaccination site. The first session of vaccination was held last April 13, 2021, and was then transferred at Magallanes Rural Health Unit Wellness Center last May 18, 2021.

Table 2 provides a description of priority groups and the number of fully vaccinated citizens of Magallanes as of September 30, 2021.

Table 2

Number of Fully Vaccinated Citizens of Magallanes as of September 30, 2021

Rise of Misinformation

O’Neil & Jensen (2020) emphasized the effects of social media platforms, especially during the time when people were quarantined at their own homes and were looking for a way to entertain themselves. The creation, production, and consumption of information gave rise to misleading messages wherein not everyone has the capacity to critically engage with it.

Fake news and false information continue to propagate overtime. It all starts when fake social media accounts are created (Affelt, 2019). These fake accounts are confident to spread false information as they think they can’t be traced. However, social media companies like Facebook detect accounts that are fraudulent.

There are various forms of fake news or misleading information. Among them are the following: purposely fabricated information, conspiracy theories, propaganda, and clickbait (Eberhart, 2019). The great concern about misinformation is the lack of credibility, trustworthiness, and deception (Cooke, 2018).

Vaccination Infodemic

Each one of us can be fooled by misleading information if we do not critically evaluate the source. There is an overabundance of information, and a lot of erroneous information is readily available online. This information often results in ambiguous forms of messages, rampantly known as fake news. At some point when critical thinking is neglected, post-truth and conspiracy theories occur, especially when one person agrees with its own bias.

The World Health Organization (2020) and its associates came up with a term called infodemic. It is the “overabundance of information, which entailed deliberate attempt to distribute wrong information.”

One concrete example of infodemic is that vaccines may cause autism and other health problems (Reñosa et al., 2021). Another one is application of tuob or steam inhalation, which is not recommended, as there is no confirmed scientific study in this traditional practice. There continues to be a lack of trust in health authorities and a strong influence from the church and religious orders (Germani & Biller-Andorno, 2021). These examples prove that those who receive this kind of information result in vaccine hesitancy despite vaccine availability.

Misinformation in the Philippines

In a study by Chua, Curato, and Ong (2021), 51% of Filipinos define fake news as untrue information. 46% believe it is unverified information. 37% think those are manipulated photos and videos. Others described it as incomplete information, and some as biased information. Respondents, most of them living in Manila, aged 18-34, find disinformation a serious problem.

Dismissed Anti-Fake News Bills

According to Poynter’s report by Funke and Flamini (2021), a bill that would hold government officials accountable for spreading false information was filed by the chair of the Senate’s Committee on Public Information and Mass Media in February 2018. Senator Grace Poe filed Senate Bill No. 1680 seeking accountability of public and government officials who publish and disseminate false information without reliability and accuracy. In the House of Representatives, Congressman Lray Villafuerte, Jr. introduced the Anti-Fake News Act which seeks to address responsible journalism but is seen as a threat to freedom of expression and suppression of free speech against the government and government officials. None of these bills became law, and they are deemed unconstitutional.

RA 11469: Bayanihan to Heal as One Act

In response to temporary measures that would authorize the president of the Philippines to exercise emergency powers during a national health crisis, the law on COVID-19 pandemic referred to as Bayanihan to Heal as One Act or Republic Act 11469 was signed by President Duterte in March 2020. Bayanihan in Filipino means doing communal work. One of its benefits is to ensure public health workers are protected and that they will be receiving a special risk allowance. A section of the law was introduced to penalize those who will break national government policies related to COVID-19 response. One of which is section 6 (f) which states that:

Individuals or groups creating, perpetrating, or spreading false information regarding the COVID-19 crisis on social media and other platforms, such information having no valid or beneficial effect on the population, and are clearly geared to promote chaos, panic, anarchy, fear, or confusion; and those participating in cyber incidents that make use or take advantage of the current crisis situation to prey on the public through scams, phishing, fraudulent emails, or other similar acts.

While anti-fake news bills were both dismissed, RA 11469 stressed that any means of COVID-19 misinformation/disinformation is punishable by law.

Survey Results and Discussion

Table 3

Number of respondents

As seen in Table 3, a total of 157 respondents participated in the study. While the master list contains a total of 9, 564 residents, we can’t assume that everyone will appear in the vaccination site. The number of respondents is only 2% of the total vaccinated citizens of Magallanes. Based on the days when the samples were drawn, the survey team gathered at least 20% of those who appeared at the vaccination site and were willing to answer the survey questionnaire.

Fig. 2. Where do you get your news/information?

Almost all the respondents, 96.8% (Fig. 2), access Facebook as their primary source of news and information. We can expect that these users have mobile devices and are connected to internet services to be able to gather information from the social media giant. With a small town that is interconnected with each other, 68.8% depend on the information coming from their family, friends, and neighbors. We can interpret that there is a strong bond and influence among these people as they believe the information coming from their trusted allies. 67.5% of the respondents still watch television. This is an indication that television newscasts are still alive and are a source of reliable information. Other sources of information come from YouTube, newspapers, and radio.

Fig. 3. Before you came to the vaccination site, did you think twice or more before getting vaccinated?

Majority of the respondents, 82.8% (Fig. 3), thought multiple times before they decided to receive the first dose of vaccine. We can infer that they are not convinced about the effectiveness of the vaccines, but their final decision is to be vaccinated due to multiple reasons presented in Figure 4.

Fig. 4. What made you finally decide to take the COVID-19 vaccine?

More than half of the respondents, 51% (fig. 4), mentioned that they wanted to take the vaccines but had no time to take it, or probably they were not yet scheduled to take it as there are priority groups. 28.7% shared that they took the vaccines because their family members and friends encouraged them. Another 24.2% said that they took the vaccines because it was a work or school requirement and that they can’t be allowed to enter their work/school premises if they did not receive at least one dose. Some 15.9% said that they received the vaccines because of a local and/or foreign travel requirement. Others are afraid to get the infection again, thus 18.5% waited to take the vaccine. Again, because of fear, 6.4% admitted they took the vaccine because unvaccinated citizens will not get or at least will have a difficult time receiving aid from the government.

Fig. 5. It took a while for me to get vaccinated because I read/learned from social media and/or TV/radio that vaccines were not safe and effective

Social media and traditional media like television and radio have a wide reach and influence, thus 90.4% (Fig. 5) of the respondents delayed their time to get vaccines because they received information that COVID-19 vaccines were not safe and effective.

Fig. 6. I took the vaccine regardless of the vaccine brand

According to the respondents, taking any vaccine brand is not an issue. The majority of them, 86.6% (Fig. 6), will just take the shot regardless of the brand.

Fig. 7. Preferred vaccine brand

But, if they are given the chance to choose the brand, they would select Moderna as their top choice of vaccine brand. 39.5% (Fig. 7) believes that Moderna is the best option followed by Pfizer (24.2%), Sinovac (18.5%), and fourth is Sinopharm (12.1%).

Fig. 8. I believe that once I am vaccinated, I won’t be infected with COVID-19

There is a good indication after taking the vaccines. Contrary to their previous answers, 77.1% (Fig. 8) believe that once they are fully vaccinated, they won’t be infected by COVID-19. Although not a guarantee that a person will be completely protected from the virus, at least there is a strong sense of the importance of being vaccinated. Yet, this is something the respondents should understand that they still must follow health protocols after being vaccinated.

Strategy to Encourage Senior Citizens to Take Vaccines

Since some senior citizens are still apprehensive about taking the vaccines, the province of Cavite launched a campaign to take the vaccines in exchange for two kilos of rice. Basic commodities like rice will entice the residents to grab the opportunity of getting a rice subsidy. Meanwhile, the local government hits two birds by encouraging the locals to take the jab at the same time helping them with what the constituents needed the most - food for the families.

Functions of Public Libraries

Since the pandemic resulted to infodemic, public libraries have a major role to play as advocates of authentic and authoritative information. In the Philippines, there is a law that supports the establishment of public libraries. Republic Act No. 7743 or the Act establishing congressional, city, and municipal libraries, and barangay reading centers throughout the country. The act enumerated the functions of public libraries including the mission of increasing the literacy rate of every citizen.

Status of Public Libraries in the Philippines

The National Library of the Philippines (NLP) assists over 1,455 public libraries throughout the Philippines in terms of training, staff development and partial book allocations (National Library of the Philippines, 2018). 50% of the established libraries are found in municipalities, while 19% are found in the cities.

Public Libraries as Partners in Combating Infodemic

According to Coward (2018), “civic engagement means working to make a difference in the civic life of our communities and developing the combination of knowledge, skills, values and motivation to make that difference.” It is the duty of public libraries to educate its community about current events which are free from bias and false information. The library should be able to provide multiple resources for the community to arrive at an informed decision bound by truth.

As mentioned by Kranich (2012), it is the library’s duty to protect the democratic ideals of society by strengthening and exercising its fundamental rights. Libraries can always be content providers and be publishers of quality information. They can provide evidence-based data and information that can verify facts, encourage, and strengthen diversity and bring people together with mutual interest to have a dialogue and conversation. By these acts, seeking for truth is the core function of the library.

Cavite Provincial Library

In the absence of a municipal library in Magallanes, the researchers reached out to the provincial library. The provincial library caters to the information needs of all citizens of Cavite including those residing from Magallanes. The Cavite Provincial Library maximized the use of social media, particularly Facebook, a very popular site in the Philippines, to reach out to their citizens and provide them with the latest authoritative medical and health information. In their own simple way of communicating to their online users, they teach and inform users by posting and sharing credible sources of information about COVID-19 and the huge benefit of being vaccinated. By doing so, they help their users to be informed and become critical thinkers.

Recommendations

As citizens continue to enjoy the advantages of technology and utilization of social media in the digital era, the researchers believe that there are better ways to ensure that we get appropriate information in knowledge sharing.

The local government unit’s (LGU) primary role is to protect and safeguard its people. They should also provide effective services and programs for the benefit of everyone. In this regard, with the threats posed by infodemic and fake news, the LGU may conduct the following activities:

1. Strengthen its public awareness campaign against false information and promoting factual content in all platforms to all sectors (governance, education, healthcare, professional industries, labor and business groups, marginalized sectors);

2. Collaborate with information professionals, communication experts, or tap public libraries in providing training on how to critically evaluate information and how to spot fake news;

3. Reinforce media and information literacy programs in public schools;

4. Advocate for a responsible use of social media by highlighting existing codes of conduct, ethics, and integrity in school, work, and social life.

   Conclusions

   As revealed by the study, the people of Magallanes, use social media, particularly Facebook, as their primary source of news and information. It poses challenges and threats for those who are deceived by fake health information. As suggested by scholars Demuyakor, Nyatuame, and Obiri (2021) governments and stakeholders must carry out massive public education on fact checking. It will reduce the level of panic, fear, and mistrust that false information on social media has brought to the public.

   The influence of family members and friends are also strong to help them decide on taking the vaccines. Hence, the same people also access the same platform that is available to all. One way to combat fake news is for the libraries to take an active role in their communities. Libraries are here to help their users to navigate, decipher, and evaluate which information to trust and which sources are credible. As Cooke (2018) mentioned, “libraries help knowledge communities to seek, differentiate, and select quality information and apply them in our daily lives.” It is hoped that medical practitioners and library professionals collaborate with each other to counter all kinds of infodemic – misinformation, disinformation, fake news.

   
   

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   YAP J. M.

   Університет імені Лоранда Етвеша (Будапешт, Угорщина),

   Університет системи постійної допомоги (Лагуна, Філіппіни),

   e-mail: joseph.yap@nu.edu.kz, ORCID 0000-0002-7852-1047

   TAFALLA D.

   Відділ охорони здоров’я сільських районів Магалланес (Магалланес, Кавіте, Філіппіни),

   e-mail: rylmanalo2327@gmail.com, ORCID 0000-0002-9052-0012

   
   

   ІНФОДЕМІЯ ЩОДО ВАКЦИНАЦІЇ СЕРЕД ГРОМАДЯН МАГАЛЛАНЕСУ В ПРОВІНЦІЇЇ КАВІТЕ, ФІЛІППІНИ

   _{Мета. Це дослідження має на меті дізнатися, як люди з міського муніципалітету четвертого класу провінціїї Кавіте прийняли рішення про вакцинацію, незважаючи на дезінформацію, що поширюється, починаючи від їх кола спілкування (родина, друзі та сусіди) і закінчуючи потужним впливом традиційних медіа та соціальних мереж. Методика. У дослідженні використовувалися опитування та збиралися дані за допомогою добровільного відбору з групи громадян із розкладом прийомів у місці вакцинації, розташованому в Магалланесі, Кавіте. Результати. Пандемія стала причиною зростання поширення дезінформації. Поширення фейкових новин та інформації впливає на наше життя, оскільки порушує наші стосунки з членами сім’ї та друзями. Довіра один до одного піддається сумніву, оскільки різні люди вірять у різну інформацію, яку вони чують, читають або бачать у традиційних медіа та соціальних мережах. Оскільки статус щеплення на Філіппінах змінюється повільно через багато факторів, громадянам, які хочуть захисту, знадобиться час на вакцинацію. Бібліотекарі відіграють нову роль. Так, вони можуть бути партнерами підрозділу місцевого самоврядування для покращення здоров’я громадян. Вони можуть надати джерела інформації про здоров’я, необхідної для людини, щоб допомогти їй прийняти обґрунтоване рішення. Висновки. Бібліотекарі можуть продемонструвати переваги вакцинації, про що свідчать наукові публікації та інформація, схвалена Всесвітньою організацією охорони здоров’я.}

   _{Ключові слова: неправильна інформація; дезінформація; інфодемія; вагання щодо щеплення; COVID-19; Кавіте, Філіппіни}

   
   

   _{Received: 02.08.2021}

   _{Accepted: 28.11.2021}

   _{Creative Commons Attribution 4.0 International
   © J. Yap, D. Tafalla, 2021}

   _{https://doi.org/10.15802/unilib/2021_248965}