Skepticism Spreads Like a Virus
Combatting It Likely Will Determine Whether Vaccines and Other Tools Can Be Effective in Shutting Down COVID
The most accurate word to describe the millions who appear worried about the two coronavirus vaccines approved this month may be “hesitant.”
While about 60 percent of the American public says it is ready and willing to be vaccinated against the coronavirus virus, a sizable majority remain unwilling to commit — or “hesitant.”
Pfizer’s vaccine was approved Dec. 11, with distribution beginning a few days later. A second coronavirus vaccine, this one developed by Moderna, was approved Dec. 18, on a day when new records were set once again for infections, and at a moment in our history when there remains a large cohort of vaccine skeptics who either plan to refuse to be inoculated or who say they are unsure.
Two in five Americans, according to recent polling by both Gallup and the Pew Research Center, do not plan to get the vaccine.
The number who say they are skeptical is staggering, but not unexpected, given the virulence of the anti-vaccine movement, the damage done by a racist medical establishment, and a general (and well-earned) distrust of major institutions that infects much of the American public. But it is a number that could have great impact on our ability to achieve so-called “herd immunity” and stem the spread of COVID 19 cases.
The Mayo Clinic, for instance, has said as much as 94% of the public would probably need to be vaccinated or contract the virus to achieve the herd threshold. If just 60% get vaccinated, that would mean a full third of Americans would need to contract the virus — more than 100 million. Given that about one in 50 who contract the disease have died, that puts a potential death toll at the 1.8 million to 2 million range.
Others point to a lower target. Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, told Vox that “true herd immunity, where you get a blanket of protection over the country,” would require “about 75 to 85 percent of the country to get vaccinated,” adding that he “would say even closer to 85 percent.” That still would require tens of millions beyond those vaccinated to develop antibodies by contracting the disease — an unnecessarily brutal and inhumane approach that will leave hundreds of thousands more dead.
That’s why the polling should be of concern. More than half of those who expressed skepticism to Pew say they definitely won’t get vaccinated — or about one in five Americans. The other 20 percent say they can be convinced, that their concerns range from seeing themselves as not being at risk (about half of Americans say they’re not concerned about contracting the virus) to concerns about the research and development of this particular vaccine.
Vic Monaco, a retired journalist who I’ve known for decades, is generally a big believer in the efficacy of vaccines, but this one gives him pause. For him, the issues were President Trump’s pressure on the Food and Drug Administration to approve a vaccine before he leaves office, and the speed at which Pfizer drug was developed, though he has done more research on the research process and feels a bit more comfortable.
“I also have been surprised and concerned by new reporting that 1) the vaccines may only last 4-6 months and 2) that asymptomatic carriers can still spread the virus after getting vaccine,” he told me on Facebook. “This is far from a bright future, and I will keep my eye on other news/vaccine reactions before I get mine in the spring or summer.”
Another longtime journalist friend, Michael Redmond, told me he plans to “take the vaccine when it's available. And yet, because vaccine development has always been a “long and slow process,” the "warp speed" production of the COVID drugs is troubling.
“Tech evolves, sure,” he said. “I've read several explainers why/how the new vaccines are effective and safe, but I still feel some unease.”
Both are liberals who trust science and voted for Joe Biden, which indicates that this hesitancy is not just a province of the right or that it can be chalked up to education, even as Pew reports that, the less college one has, the more likely they are to be skeptical of the vaccine.
Pew also found that Democrats and the left more broadly are less skeptical, though there is a sizable left/progressive anti-vaccine cohort — typified by Robert Kennedy Jr., an environmentalist and the son of the late Attorney General. Kennedy argues that vaccines are not studied for safety — a charge the medical and research communities vehemently deny. He says the public should do it’s own research and decide for itself.
He told the religious TV network Daystar in October (https://www.daystar.com/news-updates/general-updates/vaccines-fact-vs-fiction-with-robert-f-kennedy-jr/) that vaccines are not “tested against placebo.”
Nobody knows what the risk profile is of those vaccines. And nobody knows whether the vaccines are causing more injuries than they’re averting. And the science indicates that indeed, many of those vaccines – if not all of them – are causing more injuries than they are avoiding.
His solution? “People need to do their own research on that issue.”
This argument has a democratic veneer but, when practiced in the real world, often results in bad-faith research designed to prove an opinion already held. This has been the specialty of the anti-vax movement, which has turned confirmation bias, cherry-picking of details, and fear-mongering into an art form.
The anti-vax movement has a sizable international following — the Center for Countering Digital Hate estimates that “31 million people follow anti-vaccine groups on Facebook, with 17 million people subscribing to similar accounts on YouTube” — but it remains unclear just how many of those followers are committed to the movement.
Still, even if they likely make up a relatively small portion of the public, they point to a larger set of more legitimate concerns that reach beyond the outright denial of the anti-vaccine movement. The involvement of the Trump administration and the earned distrust both of Big Pharma and federal regulators cannot be discounted, because they could be driving away the very people we want most to be vaccinated.
The polling, for instance, shows that African Americans tend to be more skeptical of vaccination than the rest of the population, due to the racism embedded in American medicine. Black patients have been used as guinea pigs in experiments while also having their basic medical concerns dismissed by doctors for much of medical history. (Nanette D. Massey’s blog offers as good an overview as you will find of this history.)
So it is not surprising that African Americans as a group, according to Pew, are “less inclined to get vaccinated than other racial and ethnic groups: 42% would do so, compared with 63% of Hispanic and 61% of White adults. English-speaking Asian Americans are even more likely to say they would definitely or probably get vaccinated (83%).”
There are efforts underway in the Black community to ameliorate their concerns (listen to the United States of Anxiety podcast for a detailed discussion of this issue). They need to succeed because, as everyone knows at this point, the black community has been hit harder than just about any other by the virus. Blacks are contracting the disease and dying at greater rates than Whites — due mostly to Blacks making up a significant portion of front-line workers — which makes them the most likely to benefit from the vaccine.
But history is a hard thing to overcome, especially when one often has been its victim.
And there are others on the left who have legitimate concerns about a vaccine development process that relied almost completely on a for-profit, corporate drug behemoth to create and distribute what many are hailing as the silver bullet in the fight against COVID.
Valerie Volk Sober, for instance, is skeptical because of Pfizer's “history of big fines levied for misleading the public.” Pfizer is not the only Big Pharma firm with such a history, she adds, “but they're the worst.”
As I wrote last week, I plan on getting vaccinated as soon as my turn comes around, but I also think it is being oversold and that this overselling will play into the fears some of the more vaccine-averse always feel. The press and many in government have declared the vaccine a silver bullet, even though widespread vaccination is a way off. If the vaccine does not perform at 95% effectiveness — a number that most journalists have failed to define for the public — if the real world effectiveness proves to somewhat lower, the skeptics will have their ammunition.
We can’t pretend that the skeptics don’t exist or that they are just fools. We have to find a way to reach those who can be reached, while being honest and transparent as we study the impact the vaccines are having in the real world.
Government failure has contributed greatly to the failure to curtail COVID’s spread. People are not wrong to be skeptical that a solution created by the private sector under an incompetent president will provide a definitive solution. Humility demands that we acknowledge this.