To assist in addressing the rising number of cases, PNG received its first shipment of COVID-19 vaccines through the COVAX Facility in April. This consisted of 132,000 doses of the AstraZeneca vaccine that were licensed and manufactured by Serum Institute of India. Additional doses of the AstraZeneca vaccine were provided by the Australian government and in May doses of the Sinopharm vaccine (primarily being made available to Chinese citizens) that were provided by the Chinese government began to be administrated (both vaccines require two doses). It is estimated that tens of thousands of doses of the AstraZeneca vaccine provided through COVAX and by the Australian government expired at the end of July and were not used (ABC News, 2021a). Vaccines are not mandatory, but are free of charge (National Control Centre for COVID-19, 2021). In instances, employers in some urban centers have been offering workers small incentives to promote vaccination (ABC News, 2021b).

Throughout the first four months since they have become available, the number of vaccinations administered daily has generally grown, but the overall vaccination rate remains low. Less than 1 percent of the population had received at least one dose of a COVID-19 vaccine as of August 2, 2021. Around 86,000 people had received at least one dose and 18,000 have been fully vaccinated. In April and May, priority was given to health and other essential workers. In late May, the general population was able to gain access to the COVID-19 vaccine, primarily in the Southern region where there had been a greater number of cases and more access points were available (particularly in the largest city of Port Moresby). However there are over 100 vaccination sites located across Papua New Guinea, with vaccination sites situated in all of the country’s provinces (National Control Centre for COVID-19, 2021). The bulk of vaccination sites are located in hospitals or local health centers. Although vaccination sites are located across the country, Papua New Guinea’s geography is such that accessibility is less than ideal. By the end of July, around 61,000 of the people who had been vaccinated were either health or other essential workers, with the remaining around 25,000 people being from the broader population.

# <u>3.2 Existing evidence about vaccine hesitancy in PNG</u>

The limited existing evidence on attitudes to COVID-19 vaccines in Papua New Guinea points to very high vaccine hesitancy rates by international standards. A nationwide study of health care workers conducted in 2021 found that only 56 percent were willing to be vaccinated against COVID-19. When the same survey was extended to a convenience sample drawn from the public, it found only 39 percent of people were willing to take the vaccine (Pogo et al., 2021, p. 17). Among both survey groups combined (data are not provided in which health care workers are separated), concerns about vaccine safety were very prevalent (Pogo et al., 2021, p. 18). Social media was found to be the most common source of information on the vaccine, although local health authorities and health workers were the most trusted (Pogo et al., 2021, p. 23). Belief in vaccine misinformation and misunderstandings were common, even among health care workers (Pogo et al., 2021, p. 20). The role of social media as a source of information, and misinformation, on COVID-19, has been noted by health care practitioners and journalists working in PNG as a major concern, with high-profile examples of existing misinformation being spread by social media (Ahearn, 2021).

Similar findings have emerged from the other two surveys conducted on attitudes to COVID-19 in Papua New Guinea thus far. A survey of 281 University of Papua New Guinea students found that 48 percent of respondents would not take a vaccine while a further 46 percent were unsure (Fox, 2021, p. 1). An online survey conducted by one of PNG’s largest newspapers found only 22 percent of participants were willing to be vaccinated, although the survey involved self-selection, meaning its utility as a gauge of 9