Many don’t want vaccine — at least not right now
Despite pleas from public health experts, surveys find reluctance from people across demographic groups
Larry Gaines has helped family and friends sign up for a coveted COVID-19 vaccine, but he’s in no rush to get a shot himself. The Baltimore resident feels there are still “a lot of unknowns” about getting vaccinated.
“I want to be healthy,” said Gaines, a prostate cancer survivor who will soon turn 65. But right now, he said, there “is not information to make a decision. I don’t have all the facts.”
Polling shows that a range of people are hesitant to get a vaccine — for reasons that vary from concerns about side effects and a rushed approval process to doubts that it’s necessary to get vaccinated.
The public’s willingness to get immunized against COVID-19 has grown in recent months, but reluctance remains higher among groups including Black people, Republicans, rural residents and young Americans, surveys show.
Doses of the two approved vaccines remain in short supply, and experts say access to them is the most pressing issue right now. But, they added, it’s still crucial to address people’s concerns about getting inoculated.
“The vaccines are more important than ever because we need to stop the virus from spreading,” said Gigi Gronvall, an immunologist and senior scholar at the Johns Hopkins Center for Health Security.
To achieve “herd immunity” — when enough people are immune to a disease that its spread is checked — experts say the majority of Americans will need to be vaccinated for COVID19. They don’t know exactly how many, but perhaps more than 70%.
And while some wonder whether it’s still worthwhile to get vaccinated now that coronavirus variants have been identified, Gronvall said immunization is even more important.
“If you’ve been vaccinated, your immune system gets to work right away,” she said.
While the vaccines now in use may be less effective against variants, they still appear to provide significant protection, she said.
Polls suggest a significant portion of people want “to wait and see” how the vaccines work out for others before they get one — about 31%, according to research by the Kaiser Family Foundation’s Vaccine Monitor project.
Generosa Torres, a 66-year-old Baltimore City resident, is among those waiting to make a decision. She has been getting a flu vaccine for years, but the coronavirus vaccines are still so new she intends to wait a few months to see what side effects they may have.
She has learned through her own research, she said, that even though the first dose seems to be creating no side effects, some patients are reporting negative reactions to second doses — and the recent appearance of new strains has only complicated things.
“I have no problem with others getting the vaccine right away,” the Spanish speaker said through a translator. “For them it’s a good idea. But I’ve always been very cautious. The flu vaccine is tried and true. This one is still too young.”
Torres plans to wait at least until the summer before making a decision.
The speed at which the vaccine was developed contributed to fears, public health experts say. The two vaccines in use in the United States received emergency authorization for use during the pandemic, but government regulators must continue to see data about people participating in vaccine trials before final approval can be issued.
“Operation Warp Speed was a name that made me cringe the moment I heard it, because I knew that the reaction would be that somehow it had been expedited in ways that might compromise safety,” said Sandra C. Quinn, a public health professor at the University of Maryland, College Park.
Although the COVID-19 vaccines were developed in an unusually short time frame, experts say they were still subject to rigorous federal standards and no safety measures were cut. The country’s most prominent infectious disease expert, Dr. Anthony Fauci, is among the many officials who have tried to reassure the public about the vaccines’ safety.
“This is something that the evidence has shown in rigorous scientific analysis to be safe and effective, so I’m rolling up my sleeves,” Fauci said in December as he received his first shot.
Public health officials strive to explain that COVID-19 vaccines authorized in the United States do not contain the live virus. They work by training the immune system to recognize and fight the virus that causes COVID-19.
Two vaccines are currently in use in the United States: One developed by Moderna, found to be 94% effective, and the other by Pfizer/BioNTech, which is 95% effective. Side effects may include a sore arm and short-term flu-like symptoms such as fatigue, fever and body aches, which doctors say is the body’s natural reaction to the shot.
A newly released CDC survey found that hesitancy to take the vaccine has fallen. The portion of people who said they intended to get vaccinated increased from about 39% in September to 49% in December, when the first vaccine became available in the United States.
Among those who didn’t intend to get vaccinated, certain groups were prevalent: younger adults, women, Black adults, residents of non-metropolitan areas, adults with less education and income, and those without health insurance.
Similarly, the Kaiser Family Foundation’s Vaccine Monitor research project reported in late January that “a growing share of the public is open to getting vaccinated, but many of the same groups that were hesitant in December remain hesitant now.”
Nearly half the people polled in January wanted to get a vaccine as soon as possible or already had gotten one.
But about 43% of Black people surveyed and 37% of Hispanic people said they wanted to “wait and see” about the vaccine, which was significantly more than white people, at 26%.
The poll also revealed a partisan split, finding that “vaccine enthusiasm” increased for Democrats and independents, but didn’t change for Republicans.
Only 32% of Republicans said they wanted the vaccine as soon as possible or already had been vaccinated, compared to 64% of Democrats.
“We think it’s an important component to understand because it means that people with different partisan identities might need different” messaging about the vaccine, said Liz Hamel, a vice president at the Kaiser foundation and its director of public opinion and survey research.
Currently, access to the vaccine is having a greater impact on vaccination rates than hesitancy, said Dr. William Moss, executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health.
As for herd immunity, the “ballpark figure” of vaccine coverage for COVID-19 may be around 75%, but that’s an oversimplification, Moss said.
The threshold depends on various factors, he said. For example, it would be higher in urban than in rural areas because people in cities generally have more contact with others.
Moss said he believes the priority now should be vaccinating those at highest risk of severe disease, rather than focusing on herd immunity.
“I see our primary goal right now with vaccines as reducing hospitalizations and deaths,” Moss said.
The state’s GoVax campaign to combat vaccine hesitancy has a focus on minority groups, who have been disproportionately affected by the pandemic. The effort includes multilingual materials and “trusted leaders” and community advocates discussing why they got vaccinated.
A long-standing history of discrimination against African Americans in the medical world has contributed to vaccine doubts, said Dr. Lisa A. Cooper, who directs the Johns Hopkins Center for Health Equity and the Johns Hopkins Urban Health Institute.
She pointed to the Tuskegee
syphilis study of Black men from 1932-1972, in which the U.S. Public Health Service withheld treatment from the participants; and Henrietta Lacks, the Baltimore County woman whose cells were used for medical research without her consent.
“I think people have not forgotten those things,” said Cooper, one of 60 Black members of the National Academy of Medicine who recently signed a New York Times op-ed urging Black Americans to get vaccinated.
Cooper said much has changed, including stringent regulations on medical research and more involvement from scientists of color.
Still, she said, people “remember that they were deceived by scientists.”
Gaines, the Baltimore man who is hesitant to get the vaccine, said that in the Black community, “we’ve had so many adverse things” come from the medical world, such as the Tuskegee experiment and Lacks’ experience.
With the COVID-19 vaccine, “I really believe everybody has good intentions,” Gaines said.
“I think they’re doing the best they know how,” he said. “But people make mistakes.”
Gaines said he is “not 100% closed” to getting the vaccine, but wants to wait before making his decision.
“I’m watching and I’m listening,” he said.