Beating vaccine skepticism
In January, when covid-19 seemed like a distant threat, I had a patient with the flu. The infection hit her hard; she had to be put on a ventilator and was given intravenous steroids. I took care of her during her long hospital stay after she was released from intensive care. Each day, the resident physicians and I would ask her: “Any thought about getting the vaccines we discussed?”
Every day, the answer was the same: No. We told her that her illness would have been prevented by the vaccine, that her asthma and other medical problems put her at risk for serious complications from another bout of influenza. It didn’t matter. “I don’t trust shots,” she told us.
This patient is the reason I worried when I saw the recent announcement from the Centers for Disease Control and Prevention advising state health departments to plan for distributing a coronavirus vaccine by Nov. 1. More than a third of people surveyed in a recent Gallup poll said they would refuse a free vaccine. A perceived rush by the federal government may only solidify their skepticism — and make it harder to defeat the pandemic.
It is imperative that the approval process for the vaccine be guided by science, not politics or profit.
Only a timeline supported by robust medical evidence, combined with transparency about what is happening during Phase 3 trials, can help the government win over the constituency it needs most: health care providers. Doctors’ recommendations are among the most important factors in people’s decisions to get immunized. When people ask us whether they should get the vaccine, we need to be confident about why we’re answering “yes.”
Even once there is a vaccine that we’re confident is safe and effective, our job persuading patients to get it won’t be easy. Public-health officials should help guide physicians and nurses on how to communicate effectively, prioritizing emotionally powerful stories about the suffering covid-19 can cause over a fire hose of statistics, which can actually backfire. Language, too, is important: Health workers should avoid “herd immunity,” which conjures up visions of cattle, and instead use “community immunity,” which conveys that we’re all facing this pandemic together.
Officials can also help by modeling good behavior. To engender trust in the vaccine, we need to see our political leaders and their family members rolling up their own sleeves to get it. It will be a disaster if leaders twist receiving the vaccine — or refusing it — into a political statement.
Honesty, clarity and a responsible timetable are the only ways government can win over health-care providers — not to mention the skeptical patients we’ll need to persuade. Erin N. Marcus is a professor of clinical medicine at the University of Miami Miller School of Medicine and a Public Voices fellow.