JAMSOTI, India -- In Jamsoti, a village tucked deep inside India's most populous state of Uttar Pradesh, the common refrain among the villagers is that the coronavirus spreads only in cities. The virus, they believe, does not exist in villages.
So when a team of health workers recently approached Manju Kol to get vaccinated, she locked up her house, gathered her children and ran to the nearby forest.
The family hid there for hours and returned only when the workers left in the evening.
"I would rather die than take the vaccine," said Kol.
A virus surge that ripped through India in April and May, killing more than 180,000 people, has tapered off, and new cases have declined. But the relief could be fleeting as a significant amount of the population is still reluctant to get shots. This has alarmed health experts who say vaccine hesitancy, particularly in India's vast hinterlands, could put the country's fragile gains at risk.
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"Vaccine hesitancy poses a risk to ending the pandemic in India," said retired virologist and pediatrician Dr. T. Jacob John. "The more the virus circulates, the more it can mutate into dangerous new variants that can undermine vaccines."
Delivering vaccine doses in the world's second-most-populous country was always going to be challenging. Even though India did relatively well at the beginning of its mammoth vaccination drive, the campaign soon hit a snag because of shortages and a complicated vaccine policy, exacerbating inequalities.
Less than 5% of India's population is fully immunized. Experts caution that by the end of the year, vaccination rates must rise significantly to protect most Indians from the virus that has killed more than 388,000 people, according to Johns Hopkins University -- a figure considered to be a vast undercount.
As of Monday, every adult in India was eligible for a vaccination paid for by the federal government. The policy, announced last week, ends a complex system of buying and distributing vaccine doses that overburdened states and led to inequities in how the shots were handed out.
There is still widespread hesitancy fueled by misinformation and mistrust, particularly in rural areas, where two-thirds of the country's nearly 1.4 billion people live.
Health workers face stiff resistance from people who believe that vaccines cause impotence, serious side effects and could even kill. And some say they do not need the shots because they're immune to the virus.
Rumors about shots disrupting menstruation cycles and reducing fertility have also contributed to fear and have skewed the data in favor of men. In almost every Indian state, more men are getting vaccinated than women -- and that gap is widening each day.
Quashing such rumors and conspiracy theories is a tough order for many, particularly in India's tribal-dominated districts that have recorded disproportionately lower vaccine coverage in comparison with other districts, according to official data.
Yogesh Kalkonde, a public health doctor in Gadchiroli, a tribal area in the western state of Maharashtra, said his district was overrun with the belief that the vaccines are more dangerous than the virus.
Some in the area have raised the claim that the shots can cause infertility, Kalkonde said. Others simply question its effectiveness.
"We have to convince people, go door to door, and rely on people who have taken the vaccine to spread the word," he said. "It's an extremely slow process."
For months, Vibha Singh, a government-appointed nurse, has gone door to door in the villages of Uttar Pradesh.
"People tell us to leave or they would beat us," said Singh. "Sometimes they also throw stones and bricks at us."
"We need to explain it clearly to people, ideally through local trusted networks," said K. Srinath Reddy, president of the Public Health Foundation of India. He said state governments should bolster local self-help groups and village councils and ask local religious leaders to step in.
"It requires a conversation, not just top-down messaging," he said.
VACCINATIONS IN JAPAN
In Japan, thousands of companies began getting vaccine doses to workers and their families Monday in an employer-led drive aimed at more than 13 million people to rev up the nation's slow rollout.
Yuka Daimaru, among the Suntory workers getting shots on a sprawling office floor, was visibly relieved after spending more than a year worrying about the coronavirus.
"I was nervous, but it didn't hurt as much as I thought it would," she said. "Now I don't have to worry as much on commuter trains or at meetings."
The Tokyo-based beverage-maker plans to inoculate 51,500 people, including part-time workers and employees' families, with the Moderna vaccine.
About 3,500 companies have signed up for the free vaccine doses, and the number is growing. The companies must present plans to inoculate at least 1,000 people per site. But they decide whom to include, such as families, affiliate companies and suppliers.
Universities are also eligible. Smaller companies can apply through organizations, such as the local merchant association, so ideally no one falls through the cracks, according to the Health Ministry.
Among those taking part is the automaker Toyota, which plans to vaccinate 80,000 people at its plants and offices.
Fast Retailing, behind the Uniqlo clothing chain, plans to inoculate 18,500 people, including part-timers and cleaning and cafeteria staffers, starting July 1.
The online retailer Rakuten said it's vaccinating 60,000 workers and their families.
Japan is relying totally on imported vaccines for a campaign that started in February with medical professionals. Only about 6% of Japanese citizens are fully vaccinated. The country has had more than 14,000 deaths, according to Johns Hopkins.
Vaccinations have been slowed by bungled reservation procedures, unclear distribution plans and shortages of medical staffs to give shots.
Local governments and Japan's Self-Defense Forces are also leading the vaccination campaign, but the employer-led efforts are helping accelerate the pace.
Daisuke Sen, a human resources senior general manager at Suntory Holdings, said the vaccinations at his company will be completed by the end of August.
The first day came after weeks of work, especially scrambling to find doctors and nurses to carry out the shots, he said.
"Getting here means so much for me," he said.
CANADA'S MEASURES
In Canada, fully vaccinated citizens who test negative will be exempt from two weeks of quarantine when returning to the country as of July 5, officials said Monday.
Canadians and permanent residents who return will have to be fully vaccinated 14 days or more before their arrival.
Officials said those travelers must have two doses of a vaccine approved by Canada, provide a negative covid-19 test from 72 hours before arrival, take a second test upon arrival and have a quarantine plan in the event the test comes back positive.
Public Safety Minister Bill Blair said the first phase of easing border measures will continue to restrict entry to Canada for foreign citizens who want to enter for nonessential reasons.
Transport Minister Omar Alghabra said a flight ban between Canada and India will remain in place until July 21, but a ban with Pakistan will be removed.
Officials have said they would like 75% of eligible Canadians to be fully vaccinated before advising that border restrictions be loosened for tourists and business travelers who aren't citizens or permanent residents.
The government expects to have enough vaccine delivered for 80% of eligible Canadians to be fully vaccinated by the end of July.
"We need to make sure that a substantial majority of Canadians are fully vaccinated," Blair said.
The border between Canada and the U.S. remains closed to all nonessential travel.
Prime Minister Justin Trudeau's government announced Friday that border restrictions on nonessential travel with the United States have been extended until July 21 in coordination with the U.S. There are growing calls in the U.S. to open the border for nonessential travel such as tourism, but less than 25% of Canadians are fully vaccinated.
Information for this article was contributed by Rajesh Kumar Singh, Yuri Kageyama, Rob Gillies, Sheikh Saaliq and Krutika Pathi of The Associated Press.
