Almost daily, President Trump and leaders around the world say they are struggling to develop a coronavirus vaccine, perhaps the most urgent mission in the history of medical science. But repeated guarantees of near-miraculous speed exacerbate a problem that has been largely overlooked and that public health experts say needs to be addressed now: persuading people to really get vaccinated.
A growing number of surveys find so many people saying they would not receive a coronavirus vaccine that their potential to stop the pandemic could be jeopardized. Mistrust is particularly pronounced in African American communities, which have been disproportionately devastated by the virus. But even many staunch supporters of immunization say they are wary of this vaccine.
“The bottom line is that I have absolutely no faith in the FDA and the Trump administration,” said Joanne Barnes, a retired fourth-grade teacher from Fairbanks, Alaska, who said otherwise she was always scrupulously up to date on getting it. . vaccines, including herpes zoster, flu, and pneumonia. “I feel like there is a rush to get a vaccine, so I very much doubt.”
Mistrust of vaccines has been on the rise in the US in recent years, a sentiment that resists categorization by political party, academic background, or socioeconomic demographics. It has been promoted by a handful of celebrities. But now, anti-vaccine groups are attracting a whole new type of clientele.
Jackie Schlegel, founder of Texans for Vaccine Choice, which lobbies for school vaccine exemptions, said her group’s membership had skyrocketed since April. “Our phones are ringing with people saying, ‘I’ve been vaccinated, but I’m not getting this,'” she said. “‘How do I exclude myself?'” She said she often has to assure callers, “‘
The tedious process of developing a safe and effective vaccine generally takes a decade; some have taken much longer. But the Trump administration, himself once skeptical of the open vaccine, has recently been saying that a coronavirus vaccine could be ready this fall. While it has removed certain conventional barriers, such as financing, many experts still believe that the proposed timeline could be overly optimistic.
But every time a coronavirus vaccine is approved, the initial demand is supposed to far exceed the supply. The need to establish a foundation of trust in it has been overlooked and has not been addressed.
Earlier this month, a nationwide working group of 23 epidemiologists and vaccine behavior specialists released a detailed report, which received little attention, saying that work was urgent. Operation Warp Speed, the $ 10 billion public-private partnership that is driving much of the vaccine research, they wrote, “is based on the compelling but unfounded assumption that ‘if we build it, they will come.'”
In fact, the group, led by researchers from the Johns Hopkins Center for Health Safety and the Department of Anthropology at Texas State University, wrote: “If poorly designed and executed, a Covid-19 vaccination campaign in the The US could undermine the increasingly tenuous belief in vaccines and the public health authorities that recommend them, especially among people at increased risk for Covid-19 impacts. “
The researchers noted that although billions of federal dollars were being invested in biomedical research for a vaccine, it appeared that there was virtually no funding for social scientists to investigate vacillation around vaccines. Focus groups to help identify the most effective messages to counter opposition, the authors said, should be launched immediately.
The current political and cultural turmoil, fueled by the Trump administration’s frequent disregard for scientific expertise, only amplifies the various foundations of skeptical positions on vaccines. They include the terrible legacy of federal medical experiments on African Americans and other disadvantaged groups; a distrust of Big Pharma; resistance to government mandates, such as school immunization requirements; adherence to homeopathy and other “natural” medications; and a group of apocalyptic beliefs and conspiracy theories, particularly around Covid-19, sometimes perpetuated by celebrities, most recently Kanye West.
“So many of our children are being vaccinated and paralyzed,” he told Forbes this month. “So when they say we are going to fix Covid with a vaccine, I am extremely cautious. That is the mark of the beast.
A May poll by The Associated Press-NORC Center for Public Affairs Research found that only half of Americans said they would be willing to receive a coronavirus vaccine. One in five said they would refuse, and 31 percent were unsure. A survey conducted in late June by researchers at the University of Miami found that 22 percent of white and Latino respondents and 42 percent of black respondents said they agreed with this statement: “The coronavirus is being used to force a dangerous and unnecessary vaccine on Americans. ” “
“Confidence issues are tremendous in the black community,” said Edith Perry, a member of the Maryland Community Research Advisory Board, which seeks to ensure that the benefits of health research span black and Latino communities.
The solution, he said, is not just employing the conventional strategy of meeting with black church congregations, especially if the government and vaccine producers want to reach the millennial generation.
“The pharmaceutical industry would have to convince some of the young people from Black Lives Matter to join,” said Ms. Perry. “Raise your hands and say, ‘I apologize. I know we did it wrong and I need your help to get it right. Because we need a vaccine and we need the participation of blacks and Hispanics. “
The talk at The Shop Spa, a large barber shop with a black and Latino clientele in Hyattsville, Maryland, underscores the challenges. Mike Brown, the manager, whose staff members have been trained to discuss wellness with clients, referred to Tuskegee’s notorious experiments and said, “I hope they won’t sabotage us again.”
Her clients and families are still suspicious of pharmaceutical companies, she said. “It is difficult to trust that they are taking care of our well-being,” he continued. “I am very skeptical about that shot. I have my popcorn and my soda and I’m looking at it very carefully. “
The new report on vaccine confidence includes contributions from epidemiologists and experts in health and communication inequities. The general recommendation is that public health agencies should listen to community concerns early in the process, rather than issuing directives from above after the fact. They should seek out trusted community leaders to convey people’s uncertainties about the transparency, access, allocation, and cost of research. Those representatives could, in turn, become respected providers of updates, to combat what the World Health Organization calls the “infodemic” of vaccine disinformation.
The strongest recommendations were on communities of color. The authors urged that vaccines be provided free of charge and made available in easily accessible locations: churches, pharmacies, hair salons, schools. Noting that the vaccine would emerge at a time when protests about systemic racism, especially in healthcare, have erupted, the researchers cautioned that if accessibility was perceived to be unfair, the vaccine could become a critical point of continuing unrest. And that perception could increase mistrust of the vaccine.
At a recent Senate hearing, Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, was repeatedly asked about plans to address the growing vacillation of vaccines. He replied that the discussions had been ongoing for “10 to 12 weeks.” A CDC spokesman declined to elaborate after the New York Times repeatedly asked him to do so.
Emily Brunson, a medical anthropologist at Texas State University, said the myriad of reasons people may be skeptical of this vaccine, combined with the vast reach of Covid-19, meant that creating a campaign for the acceptance of the vaccine would be much more difficult than one for a more defined group: herpes zoster vaccine for older people, HPV vaccine for preteens. The researchers said that a national advocacy strategy should be in the planning stages as soon as possible.
Above all, the concern that is constantly invoked by those who doubt this vaccine is haste. When health authorities repeatedly promote speed of development, an idea underlined by the name Operation Warp Speed, they inadvertently compound public safety concerns.
“If you’re smart, you’re concerned that we don’t have a vaccine, and if you’re smart, you’re concerned that we may have moved so fast that we accept a level of risk that we might not normally accept,” said Sandra Crouse Quinn, professor of public health at the University of Maryland.
Health communication experts say those who try to persuade the vaccinated to get vaccinated should not dismiss them as “anti-vaxxers,” which has become an insult and closes the talks.
“You should always listen to their concerns,” said Dr. Quinn, senior associate director of the Maryland Center for Health Equity, which studies issues related to trust in healthcare in communities of color.
Last week, a nonprofit public health initiative, Public Good Projects, launched Stronger, a campaign to combat vaccine disinformation, with a wealth of advice, including lists of established scientists to follow on Twitter.
Dr. Quinn said that one way to increase vaccine acceptance is to appeal to people’s innate altruism: “that getting a vaccine, when it is available, is not just about you. It’s about protecting your grandmother who has diabetes and Uncle Sean, who is immunocompromised, “he said.
And when people respond by listing their objections to the vaccine, ask them, she said, “If that’s what you think, how do you protect your community?”
