By Professor Manaf Al Qahtani, Head of Microbiology Department At the World Health Expo (WHX) Dubai 2026, I had the privilege of moderating and contributing to a strategic discussion titled “From Infodemic to Immunisation Impact: Behavioural Leadership Strategies for Communicable Disease Control,” reflecting the growing challenge posed by an infodemic, the rapid and widespread circulation of both accurate information and misinformation to the public.

The session brought together global and regional immunisation leaders to address one of the defining challenges of our time: vaccine hesitancy.

The discussion began with a simple but uncomfortable truth: vaccines can be safe, effective, and freely available, yet remain underused. The barrier is not always misinformation alone; more often, it lies in system design. For decades, immunisation programmes have invested heavily in logistics: procurement, cold chains, digital registries and coverage targets, which are essential. But trust, the factor that ultimately determines uptake, has rarely been treated as infrastructure.

If trust were managed like cold-chain capacity, it would have clear ownership, dedicated resources, measurable indicators and continuous monitoring. Instead of reacting to confidence crises, systems would anticipate them.

One of the central insights from the discussion was that much of what we label as hesitancy is not vocal refusal but quiet delay, such as missed appointments and postponed visits. In many cases, these are not ideological objections but signals of friction: limited clinic hours, complex booking systems, rushed consultations, or inconsistent messaging. When vaccination pathways are inconvenient or impersonal, delay becomes predictable.

This reframing is important, as it shifts the narrative from blaming communities to examining system architecture. Are immunisation services designed around logistics or around people’s daily lives?

Leadership during uncertainty emerged as another central theme. Public health decisions often evolve as scientific evidence develops. Changes in guidance are not a weakness of science; they are a reflection of learning. However, trust is influenced not by the change itself, but by how it is communicated.

Transparent explanations, acknowledgement of uncertainty, and clear rationale protect credibility. By contrast, overconfidence followed by reversals can undermine it. 
The panel emphasised the need to embed behavioural science into routine operations, beyond crises. This includes equipping healthcare workers to manage vaccine conversations with empathy, monitoring early warning signals such as appointment patterns and community feedback, and measuring patient experience alongside coverage rates, or the proportion of the target population that receives recommended vaccines. 

Looking forward, the next infodemic will likely spread faster; therefore, immunisation systems must evolve from reactive communication to proactive design. Confidence must be engineered, not assumed.

The lesson from WHX Dubai 2026 is clear: trust is not a soft concept; it is critical infrastructure. Just as a compromised cold chain weakens a vaccine, a fractured chain of trust weakens an entire immunisation effort.

Addressing vaccine hesitancy, therefore, requires more than countering misinformation. It requires redesigning systems so that confidence is built into every interaction, from policy decisions, credible rationale to clinic encounters.

I believe that is how we move from infodemic to immunisation impact.