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JAMSOTI, India (AP) — India’s vaccination efforts are being undermined by widespread hesitancy and fear of the jabs, fueled by misinformation and mistrust. That’s especially true in rural India, where two-thirds of the country’s nearly 1.4 billion people live.

Health workers are facing stiff resistance in villages, where some flee their homes until the workers are gone. Vaccine workers have been physically attacked by people who believe the shots can cause infertility and even death.

To allay the fear and confusion, state governments have mounted aggressive awareness campaigns through posters and radio announcements. But India already has struggled with low vaccination rates and will have to get many millions more people vaccinated to end the pandemic.