Impact Canada led the implementation of the World Health Organization`s (WHO) Behavioural Insights Data Collection Tool, which was applied in several waves and surveyed approximately 2,000 Canadians on key behavioural domains, including public perception of risk, sources of information, and confidence in vaccines. The results showed that citizens who trust the government match those who trust vaccines. An advisory body or expert group means any committee, body, commission, board, conference, working group or similar group, subcommittee or other sub-group thereof, that provides advice, expertise or recommendations to governments. They are composed of members of the public and/or private sector and/or representatives of civil society and may be established by the executive, legislative or judiciary, or by subdivisions of the State. Consultation and participation of citizens and local communities will also help develop the vaccination strategy best suited to the local context, overcoming some of the logistical challenges and vaccine hesitancy. For example, the COVID-19 vaccination schedule in Canada involves collaboration between the federal government; provinces; territories; First Nations, Inuit and Métis leaders; and local governments, among others.43 The UK`s COVID-19 vaccine distribution plan has taken a community-led local approach with partnerships between national government, local authorities, the national health system, local public health directors, local health and welfare agencies, the voluntary and community and faith-based sectors.44 Since the beginning of the COVID crisis, Governments have had to make quick decisions and implement many unforeseen measures to protect vulnerable communities. In the first few months, the widespread use of direct procurement as an exceptional measure for the procurement of goods, services and works has drawn attention to potential integrity risks, in particular fraud and corruption, which could seriously undermine the effectiveness of public policies if not properly mitigated. Some cases of irregularities and allegations of corruption in the procurement and supply of medicines have been reported, as well as other types of misconduct such as the accumulation of medicines by health professionals and various online scams (OECD, 2020). Yet there has been little discussion about the specific integrity risks associated with vaccine development and distribution10 and how these might affect people`s confidence in and effectiveness of government immunization strategies. Open government refers to a culture of governance that promotes the principles of transparency, integrity, accountability and stakeholder participation in support of democracy and inclusive growth (OECD, 2017). Previous studies show that in countries where low levels of openness were widely perceived by the public, increased openness was a key driver of institutional trust (OECD/KDI, 2018).
In the context of the COVID-19 pandemic and vaccination campaigns, four measures are identified to ensure that government measures are publicly visible and that public institutions are working with the population, especially the segments most reluctant to be vaccinated. To ensure timely delivery, governments need to establish policies and infrastructure for the distribution, storage and administration of vaccines in their countries. A recent report to the European Economic Area (EEA) shows that most EEA countries intend to use existing vaccination infrastructure, while few planned to purchase additional equipment to ensure proper vaccine storage (ECDC, 2020). However, in many jurisdictions, the current infrastructure and supply may not be sufficient to ensure a rapid vaccination campaign, especially given the specific transport and storage requirements of some vaccines (e.g. strict cold chain compliance). Indeed, there are already signs that some countries are struggling to meet their planned schedules. Trust in vaccines must also be complemented by trust in the institutions responsible for immunization. Lack of acceptance of immunization may be due to the past failure of health systems and public institutions to serve effectively and build trust in certain populations. In general, trust in institutions is crucial for the proper functioning of society and the acceptance of public policies, especially in times of crisis. Trust is defined as the belief that another person or institution will act in accordance with their own expectations of the positive behaviour of others (OECD, 2017), and institutional trust is recognized as a key measure of government performance (OECD, 2019). The OECD has developed a trust framework to guide governments in developing specific policies to enhance public trust, based on the five dimensions of government mandates, which research has shown largely explain citizens` trust (see Box 1). The more involved the public in decisions about vaccine approval and delivery, the more likely it is to be.
Deliberative democracy41 is gaining importance in addressing pressing policy issues in areas such as urban planning, health and the environment (OECD, 2020). These processes are usually successful when asked to resolve moral dilemmas (such as introducing “vaccine passports”) and given sufficient time to weigh arguments and evidence. In the case of Scotland, for example, a citizens` panel was set up to assess governments` response to COVID-19, assess evidence from experts ranging from epidemiology to law and economics, and submit a report to Parliament`s COVID-19 Committee.42 During the pandemic, Korea`s Ministry of Health and Welfare launched the “Thanks Challenge” on Instagram. with the aim of expanding the scope of awareness-raising activities around COVID-19 measures. The initiative invited citizens to share a photo of themselves at home to promote social distancing and lockdown measures. Celebrities and influencers also participated in the campaign, helping the government spread official information about the disease and its symptoms. The development of several effective COVID-19 vaccines in less than a year is a powerful demonstration of the authorities` ability to promote scientific R&D efforts for the common good, and an example of the benefits of international cooperation between public and private actors. Trust in immunization and in the ability of governments to communicate and carry out a vaccination program crucially depends on: If the 10-day period extends beyond the date of the final adjournment of Congress, the President may approve and sign the bill within that period, which thus becomes law. However, in such a case, if the President does not approve and sign the law before the expiry of the ten-day period, it will not become law.