Spreading the Cure

Boosting confidence in a COVID-19 vaccine might prove to be one of the most consequential tasks for governments and public health experts in 2021.

Source: https://www.nbcnews.com/news/us-news/many-parents-are-hesitant-give-their-kids-covid-19-vaccine-n1240741

There is hope that the world is rounding the corner on a global pandemic that has so far claimed the lives of over 1.8 million people.

On Dec. 11, 2020, the U.S. Food and Drug Administration (FDA) issued a nationwide emergency use authorization for the Pfizer-BioNTech COVID-19 vaccine. A week later, the FDA authorized Moderna’s vaccine. There are ten vaccines currently being distributed in several countries after being greenlit for emergency, limited, or approved use (though Russia’s Sputnik V and China’s Sinovac are still awaiting results from phase III testing). As of Jan. 8, 2021, 17.33 million doses have been administered worldwide and a further 20 vaccines are in the final stages of testing.  

While a triumph for the scientific community, the speed with which these vaccines are being developed is also a testament to the crucial role of government programs. In the United States, for instance, the early breakthroughs made by Pfeizer-BioNTech and Moderna would have been impossible without Operation Warp Speed.

Vaccine production, however, is one side of the equation. As we roll into 2021, an unprecedented immunization campaign is underway with governments around the world focusing on securing, shipping, storing, and administering doses to millions of their citizens.

Such an undertaking involves substantial logistical challenges, many of which are already delaying distribution. But convincing people to accept a COVID-19 vaccine might prove to be one of the most consequential tasks for government officials and public health experts in the days to come.

In the United States, a staggering 21% of adults claim they will refuse a COVID-19 vaccine while a further 18% remain uncertain about whether they will get immunized. In Russia, roughly 55% of respondents claimed they would accept a dose when several vaccines were still in human trials. Meanwhile, news reports from countries like France, Japan, and Indonesia suggest that people across the world continue to have misgivings about accepting a cure.

If left unaddressed, such “vaccine hesitancy” may well make the 60%-70% inoculation threshold for herd immunity against COVID-19 a difficult target to achieve in 2021.

Addressing COVID-19 vaccine hesitancy.

News outlets have been sounding the alarm for months that coronavirus conspiracy theories may cause people to reject a COVID-19 vaccine. Certainly, there is an avalanche of disinformation that warns people against getting vaccinated for fear of being microchipped or otherwise socially controlled in some obtuse way. But individuals that refuse to get immunized as a result of such beliefs are on the extreme end of vaccine skepticism.

“Vaccine hesitancy is usually defined as ‘delay in acceptance or refusal of vaccination despite availability of vaccination services,”” said Dr. Devon Greyson, an assistant professor of communication at the University of Massachusetts-Amherst who studies families’ practices around health-related information, in an email communication. “Setting aside the small number of anti-vaccine activists and focusing on the vast majority of vaccine hesitant people, the reasons for hesitancy are diverse and sometimes complex.”

Greyson explained that people could be reluctant to accept vaccines for various reasons including a lack of scientific information; experiences with medical sexism or racism; or ideologies promoting “natural” treatments. Even distrust in governments – usually a hallmark of coronavirus conspiracy theories – can lead to vaccine hesitancy stemming “from awareness of specific drug approval missteps in the past to general anti-government sentiment.”

Because scientists are still learning about the disease and its cure, vaccine hesitancy might be harder to address in the case of COVID-19. For instance, there is still uncertainty about the long-term effects of coronavirus vaccines and this might exacerbate legitimate (if ultimately inaccurate) immunization concerns in undecided communities. Early, if rare allergic reactions among healthcare workers given the Pfizer and Moderna vaccines, meanwhile, are likely to further muddy the waters.

As a complex, multilayered, and highly social phenomenon, vaccine hesitancy cannot be countered simply by increasing access to scientific information according to Greyson, though this remains integral in an overall immunization strategy.  

“Most people aren’t trained to read and interpret scientific research, and even those who are can’t be experts in everything” said Greyson. This is why there are various factors involved when people do change their minds about getting vaccinated (in the case of other diseases, for example). In addition to positive past immunization experiences, it is important that “trusted sources” support getting adults and children vaccinated.

These sources can be family doctors, midwives, and pediatricians. But they might also include non-expert individuals with little or no knowledge of, or experience in, medicine. Because vaccine hesitancy can stem from a multitude of overlapping cultural, religious, or personal reasons, individuals who possess social or cultural capital in their communities can become critical in convincing immunization skeptics. For instance, imams, clergymen, and priests can make getting vaccinated acceptable, thereby countering any distrust grounded in religion. Trusted messengers can also play a crucial role boosting vaccine confidence in communities subjected to ill-conceived public health experiments in the past.

The good news, then, is that despite still learning about the disease, there are clear and proactive communicative steps that public health experts and government officials can take to address vaccine hesitancy in the case of COVID-19. For Greyson, researchers, scientists, and medical librarians can all help by arming frontline healthcare providers with the means to answer patient questions, keeping track of vaccine misinformation, and clearly communicating the reality of COVID-19 – the disease, its risks, prevention, and vaccine. 

Communication without politicization.

These actionable steps, while clear, might prove to be a lot harder to execute if COVID-19 becomes too deeply politicized. This is because adding a partisan spin to any aspect of the virus in any part of the world can directly increase vaccine hesitancy by further spreading  blatantly false information. But, equally important, politicizing the virus might depress confidence in public health messaging and cause those skeptics, who might otherwise change their minds, to continue believing in well-meaning but scientifically incorrect cures and prevention strategies. Such an indirect effect would be a far greater setback in eradicating the pandemic in 2021.  

When it comes to the nitty-gritty of distributing vaccines in local communities, then, one of the most important things officials and health experts can do is ensure that the correct information gets to the right people at the right time and through a trusted source. In short, addressing vaccine hesitancy around COVID-19 will involve keeping politics out of the pandemic.

As Greyson explained, communicating health information is most effective when actors across the political spectrum avoid ideological or partisan divides. “We never want public health to be associated with a particular party or politician—public health is for everybody.”