After months of social distancing and stay-at-home orders, the encouraging progress in the development of a COVID-19 vaccine has been a rare bright spot, a hopeful sign that we may yet find a way out of this pandemic.
But despite the scientific promise of these efforts, a vaccine can only be effective if people get vaccinated. Right now, we are not doing nearly enough to tell people about the importance of getting a COVID-19 vaccine when one becomes available — and this inaction threatens to squander the promise of vaccine breakthroughs, not to mention the billions of dollars of taxpayer money invested in them.
Researchers at more than a hundred institutions, including my own university, are rushing to develop brand-new COVID-19 vaccines at an unprecedented pace. Meanwhile, anti-vaccine opinions appear to be growing — and hardening. In a Yahoo News/YouGov poll conducted in late July, just 42 percent of Americans surveyed said they plan to get a COVID-19 vaccination when one becomes available. That’s down from 55 percent when the survey was first conducted in mid-May.
Those figures are deeply troubling. Most experts agree that 60 percent to 70 percent of the population must get vaccinated to achieve herd immunity, the point where so many people are immune to the virus that it is likely to stop circulating. If we don’t reach that threshold, the virus will likely continue to threaten millions, including those who cannot be vaccinated because of pre-existing health conditions. And as long as the virus is circulating, getting vaccinated is the only way to ensure you are immune. If so few people choose to get the vaccine, life may not return to normal for any of us.
I have studied “vaccine hesitancy” in several countries around the world, and my team’s research has shown that many people with concerns want to engage in honest and open conversation. They often say they do not have all the information they need to choose vaccines, and they often don’t know whether to trust information they find online. Many just need someone they trust to tell them the facts.
Some of the most common concerns revolve around vaccine safety and effectiveness. The extraordinary conditions under which COVID-19 vaccines are being developed likely will heighten those questions. One recent study, for example, found that safety was the chief concern cited by 77 percent of people surveyed in considering whether to get a COVID-19 vaccine.
Many studies suggest that a doctor’s recommendation can be the deciding factor for people who are unsure about choosing vaccines. Public health officials can help by providing information and training for doctors to make strong vaccine recommendations. While we don’t yet have data on the safety and effectiveness of specific vaccine candidates for COVID-19, we can be talking about the safety precautions that are built into the development process and how we will know that an approved vaccine works. Transparent, open dialogue now will help assuage reasonable concerns and build the public confidence we will need for the vaccine to be widely accepted.
Outside of the medical establishment, we need to initiate grassroots campaigns that leverage community resources to stress the importance of getting a COVID-19 vaccine. In uncertain situations like this pandemic, people don’t like to be told what to do, but they do want to know what their peers and community members are doing. Public health officials should be working now with schools, churches and other neighborhood networks to address questions and build community solidarity for COVID-19 vaccination.
This won’t be easy. Throughout this pandemic, we have seen a frustrating lack of consensus about the steps we can take to control the virus, turning even simple precautions such as wearing a face mask into heated political debates. Convincing hundreds of millions of people to line up for a COVID-19 vaccine will be an even bigger challenge, but it is one we need to confront now.
Lavanya Vasudevan is an assistant professor of family medicine and community health at Duke University and a member of the Duke Global Health Institute and the Duke Human Vaccine Institute.