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Too Many Americans Still Mistrust the COVID-19 Vaccines. Here’s Why

Here’s What’s Behind Americans’ Uneasy Relationship With Vaccines
BY JEFFREY KLUGER  JANUARY 5, 2021 9:36 AM EST
Source: Time

If you’re feeling impatient waiting your turn for a COVID-19 vaccine, here’s a little good news: Angela Padgett will gladly give you her place in line—at least for now. Padgett, president of a day spa in Raleigh, N.C., is under no illusions about the mortal danger the pandemic poses to herself, her family and the world writ large—indeed, she had COVID-19 back in July. But as for the vaccine that is supposed to put an end to all of the suffering at last? Not today.

“I am a little bit hesitant,” she says. “I can appreciate President Trump trying to get this moving fast and I’ve taken pretty much every vaccine [for other diseases]. But I think it was rushed through very early, very quickly. So I would like a little more data.”

Padgett is not alone. According to a December survey undertaken by the Pew Research Center, nearly 40% of Americans say they will definitely not or probably not get the COVID-19 vaccine when it becomes available to them. Gallup polls put the number at 37%. That’s bad news not just for the vaccine refusers themselves but for the public as a whole. Experts including Dr. Anthony Fauci, head of the National Institute for Allergy and Infectious Diseases, had previously concluded that achieving herd immunity—the point at which a population is sufficiently vaccinated that a spreading virus can’t find enough new hosts—would require anywhere from 60% to 70% of Americans to take the vaccines. But lately, he and others have been inching that number upward, now estimating that herd immunity could require as much as 85% vaccine coverage.

The holdouts have multiple reasons for their reluctance. There are, of course, the dead-enders in the anti-vax community, for whom no vaccine is safe or acceptable. There is, too, a faction peddling conspiracy theories about the COVID-19 vaccines in particular. As one falsely goes, the disease is caused by 5G cell towers, so a vaccine would be useless against it. (The rumor has been repeatedly debunked on Snopes.com and other sites.) Another spuriously claims the vaccines are a plot by the Bill and Melinda Gates Foundation—or, alternately, Elon Musk—to inject microchips into Americans. That last one—debunked herehere and elsewhere—has gained enough traction in the fever-swamp corners of the Internet that it prompted a rare acknowledgment from Bill Gates himself. “It doesn’t help that there are false conspiracy theories about vaccines, including some that involve Melinda and me,” he wrote in a foundation letter he released on Dec. 22.

But most people in the COVID-19 vaccine hesitancy camp are more rational, more measured—informed enough not to believe the crazy talk, but worried enough not to want to be at the head of the line for a new vaccine. “For first responders and for older people with underlying conditions it’s a godsend,” says Padgett. “But I do believe this was rushed. I’m reasonably healthy. Six months to a year just to get more data on it is what I’d need to be vaccinated.”


For all the urgency to get as many vaccines into as many arms as possible, the reluctance of such a large swath of the population to be among the early adopters is not completely without merit.

“I think it’s reasonable to be skeptical about anything you put into your body, including vaccines,” says Dr. Paul Offit, professor of pediatrics at the Children’s Hospital of Philadelphia and director of its Vaccine Education Center. Coming from Offit, a vocal proponent of universal vaccination and a particular boogeyman of the anti-vax camp, that carries particular weight. He goes further still, acknowledging that the speed with which the COVID-19 vaccines were developed can cause people special concern. “The average length of time it takes to make a vaccine is 15 to 20 years,” he says. “This vaccine was made in a year.”

Then too there is a question of effectiveness. Both of the vaccines that have been authorized for emergency use in the U.S., one from Pfizer-BioNTech and one from Moderna, have what Offit calls “ridiculously high efficacy rates—in the 95% range for all [COVID-19] disease and for Moderna’s product 100% for severe disease.” But in the haste to get the vaccine to market, test subjects have been followed up for only two to three months, so it’s impossible to say with any authority how effective the vaccines will remain at six or nine or 12 months.

Finally there are the side effects. Anaphylaxis—or a severe allergic reaction—is possible with any vaccine, though medical protocols call for people who have received the shot to wait 15 minutes before they leave so that they can be treated if they do have a reaction. More troubling are spotty reports of Bell’s palsy—partial facial paralysis—following COVID-19 vaccinations. But those numbers are exceedingly small. One false Facebook posting purported to be from a nurse in Nashville who got the vaccine and suffered Bell’s palsy, but that too has been debunked, as repeated searches have turned up no nurse in the Tennessee health system under that name. All the same, it sparked outsized fear of a real but minimal risk.

“There were four cases of Bell’s palsy within a month or month and a half in the Pfizer trial out of 22,000 recipients,” Offit says. “So that works out to roughly eight per 10,000 per year.” Such a case count may be low, but it does exceed the average background rate of Bell’s palsy in the general population, which is 1.2 per 10,000 per year, Offit says. Other sources put the incidence as a somewhat higher 2.3 per 10,000.

Armed with numbers like that, however, humans are not always terribly good at calculating risk. On the one hand even an eight in 10,000 chance of contracting facial paralysis does sound scary; on the other hand, about one out every 1,000 American was killed by COVID-19 this past year. The mortal arithmetic here is easy to do—and argues strongly in favor of getting the shots.

So too does the way the vaccines were developed—which is actually not as rushed as the calendar would make it seem. The Pfizer-BioNTech and Moderna vaccines both use mRNA—or messenger RNA—to prompt the body to produce a coronavirus spike protein, which then triggers an immune response. That is a novel method for making a vaccine, but the basic research was by no means conducted within the last year.

“The technology for the vaccine has actually been in development for more than a decade,” says Dr. Richard Pan, a pediatrician and a state senator in California. Pan has pushed hard over the years for laws mandating vaccines for children to attend school and, like Offit, has earned the animus of the anti-vax community for his efforts. He is just as big a booster of the COVID-19 vaccine—though he would not propose mandates until there are enough doses for everyone to get a shot—and tries to reassure doubters that no matter how soon they get the vaccine, there are a lot of people who went before them.

“I point out to people that when you get the vaccine you’re definitely not the first,” he says, “because there are tens of thousands of people who have been involved with clinical trials.” Health care workers who are already being vaccinated increase that number dramatically—some 2 million have gotten the shot in the U.S. as of this writing.


Offit’s and Pan’s reassurances will surely not assuage everyone, and here demographics play a role. As with so much else in the U.S., vaccines have become a political issue. The Gallup organization has been tracking vaccine attitudes by party since July and has found Democrats consistently more likely to get vaccinated than Independents or Republicans. In a poll taken at the end of November, 75% of Democrats said they would be willing to take the COVID-19 vaccine, compared to 61% for Independents and 50% for Republicans. Age plays a role too, with willingness to be vaccinated generally tracking susceptibility to the disease. In the December Pew Research Center poll, for example, 75% of adults over 65 reported that they intended to be vaccinated, compared to just 55% under 30.

But nowhere is the difference starker than among racial and ethnic groups, with 83% of Asian-Americans surveyed expressing an intent to be vaccinated, compared to 63% in the Latinx community and 61% among Whites. In Black American respondents, the numbers fall off the table, with just 42% intending to be vaccinated.

This is of a piece with a long history of medical disenfranchisement and much worse. Some of the mistrust goes back as far as the infamous gynecological experiments J. Marion Sims conducted on enslaved women—without anesthetic—in the 19th century; as well the Tuskegee experiment that began in the 1930s and involved decades of studying the progress of syphilis in Black men without informing them that they had the disease or offering them the antibiotics needed to treat it. But the structural inequality and bias continues today.

According to the U.S. Centers for Disease Control and Prevention (CDC) the death rate from COVID-19 is 2.8 times higher for blacks than it is for whites and the hospitalization rate is 3.7 times higher. Dr. Ala Stanford, a Philadelphia-based pediatric surgeon and founder of the Black Doctors COVID Consortium sees a lot of reasons for that disparity, not least being that in the neighborhoods in which she works, Blacks and other minorities were being tested for COVID-19 at only one-sixth the rate of white communities, which tended to be higher-income, according to data from Drexel University. “[The tests] had to be scheduled from nine-to-five, when most people were at work,” Stanford says. “There were no evening or weekend hours [and] they weren’t accepting children.”

What’s more, Black Americans are disproportionately likely to be front-line or essential workers like home-health aides and are less likely to have the kinds of other jobs that would let them work from home. Less social distancing plus less testing means more sickness and death, which plays into the lived reality for many people that Black lives are valued less than white lives in the U.S. That, in turn, breeds more suspicions of the system as a whole—including of vaccines.

“The main fear I hear [about vaccines] is that someone is injecting coronavirus into my body,” says Stanford. “And I answer in as detailed a way as I can about the mRNA and the protein and how it looks like coronavirus but it’s not.” That kind of clarity, she says, can help a lot.

Offit hears even starker—and more poignant—fears from Blacks. “One particular man did not want to get the vaccine and I asked him why,” Offit says. “He said, ‘because for my race they make a different vaccine.’”

One way Stanford sought to push back against such suspicions was to offer up herself as a living example, getting vaccinated on camera through the Philadelphia Department of Public Health. The local media sent a pool camera and the footage was shown on the evening news. Dr. Brittani James, a professor at the University of Illinois Hospital and executive director of the Institute of Anti-Racism in Medicine, did something similar, streaming her vaccination online.

“I talk until I’m blue in the face,” she says, “but there’s something I think for people to see me or see other Black people getting it that can really do a lot to soothe their fear. Like hey, guess what? If I’m wrong, I’m going down with you.”

Whether that kind of role-modeling and example-setting will work to reduce resistance is impossible to know at the moment, simply because vaccines are still unavailable to the overwhelming share of the population. If you can’t get the shot in the first place, it doesn’t matter how hesitant or receptive you are to it. Offit, who is white, does believe that efforts like James’s, to appeal to members of her own community, can be truly valuable.

“I think if someone like me says something, people are just going to see it as ‘Of course he’d say that,’” Offit says. He cites by way of example the effectiveness of TV ads by the National Medical Association, a professional organization of Black American physicians, showing one Black nurse inoculating another with the COVID-19 vaccine. “It’s subtle,” Offit says, “but they’re trying to create those images.”

Stanford believes Black churches can play a role too. During one of the testing drives she helped organize, church parking lots were used as sites to administer the tests—which helped increase turnout. “We know that in the African-American community, [the church] is a trusted institution,” she says. “Even if you don’t go to church, you know that’s a safe space.”Dr. Ala Stanford receiving her COVID-19 vaccine. Stanford's vaccination was televised in order to promote the safety and efficacy of the shot.Dr. Ala Stanford receiving her COVID-19 vaccine. Stanford’s vaccination was televised in order to promote the safety and efficacy of the shot. Emma Lee
Source: Time
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In all communities, it helps too if doctors and other authorities listen respectfully to public misgivings about vaccines, explaining and re-explaining the science as frequently and patiently as possible. But there is a burden on the vaccine doubters themselves to be open to the medical truth. “Questions are fine as long as you listen to the answers,” Pan says. “So talk to your doctor, go to sources like the CDC and our incredible mainstream medical organizations. Those are the ones you should be getting information from.”

Adds Stanford: “My belief is that you don’t coerce or convince, you listen to concerns and you understand the fears and are empathetic with people. Then you educate and allow one to make their own choice.”

Pan also sees a role for social media companies, which must better control misinformation on their platforms. Journalists too must step up, avoiding false equivalency or both-sides-ism; there is no need to give equal time to rumor mongers or conspiracy theorists simply to appear balanced.

Ultimately, no vaccine is perfect, and the COVID-19 vaccines do have more questions associated with them than others, because there hasn’t been that much follow-up time since the study volunteers got their shots. But those questions are less about safety than about just how long the shots will prove protective. The truth is that they work.

Another truth, of course, is that for now, in the early stages of the vaccine rollout, masking and social distancing remain the best methods for protecting ourselves and others—and they will be part of our lives for at least many months to come. But slowly, over time, the vaccines will eliminate that need. What’s required now is trust in the power of the shots or, as Stanford puts it, in “faith and facts over fear.” Pandemics eventually stop raging. It’s vaccines that hasten that end game—and save millions of lives in the process.

WRITE TO JEFFREY KLUGER AT JEFFREY.KLUGER@TIME.COM.

As the article states the average time to actually develop a vaccine or new drug is 15 – 20 years. This vaccine has be developed in under a year. Why do you think people are hesitant around the world to take the COVID 19 vaccine? How often have pharmaceutical companies been fined for the drugs they develop and why? How effective or ineffective has the FDA been in protecting the public at large from predatory drugs and drug epidemics? Why? Why not?

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‘I’m not an anti-vaxxer, but…’ US health workers’ vaccine hesitancy raises alarm

Coronavirus

With up to 40% of frontline workers in LA county refusing Covid-19 inoculation experts warn that understanding and persuasion are needed

Amanda Holpuch

Amanda Holpuch in New York @holpuch
Sun 10 Jan 2021 03.00 EST
Last modified on Sun 10 Jan 2021 10.07 EST
Source: The Guardian

Registered nurse Valerie Massaro administers the second dose of the Pfizer/BioNTech vaccine to health care workers at the Hartford HealthCare at the Hartford Convention Center in Hartford, Connecticut on January 4, 2021.
 Registered nurse Valerie Massaro administers the second dose of the Pfizer/BioNTech vaccine to health care workers at the Hartford Convention Center in Hartford, Connecticut, this week. Photograph: Joseph Prezioso/AFP/Getty Images
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Susan, a critical care nurse based in Alaska, has been exposed to Covid-19 multiple times and has watched scores of people die from the illness. But she did not want to get the vaccination when she learned it would soon be available.

“I am not an anti-vaxxer, I have every vaccine known to man, my flu shot, I always sign up right there, October 1, jab me,” said Susan, who didn’t want to give her last name for fear of retaliation. “But for this one, why do I have to be a guinea pig?”

The two authorized vaccines, made by Moderna and Pfizer-BioNTech, are safe according to leading expertsand clinical trials – for one thing they contain no live virus and so cannot give a person Covid – and with tens of thousands of patients, they have had about 95% efficacy. But across the country, health workers with the first access to the vaccine are turning it down.

Misinformation ‘superspreaders’: Covid vaccine falsehoods still thriving on Facebook and Instagram

The rates of refusal – up to 40% of frontline workers in Los Angeles county, 60% of care home workers in Ohio – have prompted concern and in some cases, shaming. But the ultimate failure could be dismissing these numbers at a critical moment in the US vaccination campaign.

Dr Whitney Robinson, an epidemiologist at the University of North Carolina, told the Guardian if these early figures coming from healthcare workers are not addressed: “It could mean after all this work, after all this sacrifice, we could still be seeing outbreaks for years, not just 2021, maybe 2022, maybe 2023.”

Vaccine hesitancy is common – 29% of healthcare workers said they were vaccine-hesitant, according to a survey by the Kaiser Family Foundation published last month. And it’s not exclusive to the US – up to 40% of care workers in the UK might refuse to have the vaccine, the National Care Association said in mid-December.

The numbers coming from hospital and care homes are unique in that they give a more specific picture of who is refusing the vaccine and why. Once vaccines are available to the general public, patterns will be more difficult to identify because the US does not have a centralized system to track vaccinations.

“If we don’t understand the patterns of who is not vaccinated, it will be hard to predict where outbreaks might spring from and how far they might spread,” Robinson said.

It will also leave underfunded public health agencies scrambling to identify and respond to hesitancy in the community.

“We can’t just write off somebody’s decisions and say, well that’s their personal decision,” Robinson said. “Because it’s not just their personal decision, it’s an infectious disease. As long as we have pockets of coronavirus anywhere in the world, until we have mass global vaccination, it’s a threat.”

Some employers and unions are seeing the numbers for what they are: an alarm in need of a response.

In New York City, the firefighters union found last month that 55% of 2,000 firefighter members surveyed said they would not get the vaccine.

But Covid cases are climbing at the FDNY. Twelve members have died and more than 600 were on medical leave in late December.

So, the Uniformed Firefighters Association (UFA) president, Andrew Ansbro, collected questions from some of the roughly 8,200 firefighters his union represents. A virologist friend had been helping Ansbro shape the union’s response to Covid-19 and answered their questions in a recorded video. The 50-minute video has now been viewed about 2,000 times.

“I actually received a couple dozen phone calls and messages from members that said it changed their mind,” said Ansbro, who was vaccinated on 29 December. “I think the vaccination numbers are definitely going to be higher than 45%.”Advertisement

He said people were concerned about how new the vaccine was, had read misinformation online and were worried about long-term effects. In other workplace surveys, people have shared concerns about how it could affect fertility or pregnant women. Some healthcare workers infected with Covid don’t think it’s necessary while they still have antibodies.

Each of these questions can be answered. And national surveys have shown that in general, vaccine hesitancy is decreasing.

But these surveys also suggest action is still needed to address populations more likely to be distrustful because of the country’s history of medical abuse.

Recent surveys show that Black people are the most vaccine-hesitant. In mid-November, 83% of Asian Americans said they would get the vaccine if it was made available to them that day. That sentiment was shared by 63% of Hispanic people, 61% of white people but just 42% of Black people, according to a Pew Research report.

Dr Nikhila Juvvadi, the chief clinical officer at Loretto hospital in Chicago, told NPR that conversations with vaccine-hesitant staff revealed mistrust was an issue among African American and Latino workers.

She said people specifically mentioned the Tuskegee Study, when federal health officials allowed hundreds of Black men with sexually transmitted diseases to go untreated to study disease progression. The study lasted from 1932 to 1972.

“I’ve heard Tuskegee more times than I can count in the past month – and, you know, it’s a valid, valid concern,” Juvvadi said.

Juvvadi, who administered vaccines at the hospital, said one-on-one conversations validating these concerns and answering questions had helped people be more comfortable with the vaccine.

Vaccine hesitancy in healthcare workers has also put pressure on health systems intent on getting doses to as many people as possible, as quickly as possible.

Georgia’s public health commissioner, Kathleen Toomey, announced last week that the state would expand vaccine access to adults 65 and older and first responders because healthcare workers were declining to take it.

Dr Toomey said that while hundreds of healthcare workers were on waiting lists to get the vaccine in the state’s urban center, Atlanta, in rural areas the vaccine was “literally sitting in freezers” because healthcare workers there did not want to take it.

At one of the Texas hospitals hardest hit by the virus, Doctors Hospital at Renaissance in the Rio GrandeValley, workers contacted local EMTs, paramedics and medical workers from outside the hospital to distribute their remaining vaccines because of their limited shelf-life.

Susan, the nurse in Alaska, said her preference would be for her parents to get the vaccine first because they are more vulnerable.

She has made peace with the vaccine and plans to get it the next time it is offered. She said she was ultimately convinced to get it after speaking to other health professionals who did not dismiss her concerns and listened to her questions.

Now, however, there is another hurdle. Susan has declined the vaccine twice because of logistics. She is currently on a temporary crisis assignment in rural Texas and the travel meant both times she was offered the vaccine, she would be in a different state when it was time to take the second dose. Susan said: “I feel terrible I’ve said no.”

Why do you think medical professionals are hesitant to take the vaccine? Shouldn’t one lead by example? If they are unwilling to do it, why should you be willing? Will you take the COVID 19 vaccine?

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