Vaccine uncertainty fading, yet some still resistant to the shot
He has been pushed off Facebook and banned from Twitter, but Larry Cook battles on at StopMandatoryVaccination.com, where the Los Angeles man tries to explain why COVID-19 vaccines are evil and why President Donald Trump — who he insists will return to power — got one anyway.
Some evangelical Christians tie the vaccines to Satan, the mark of the beast and an impend
ing apocalypse.
In sunny Surf City, Huntington Beach Mayor Pro Tem Tito Ortiz refuses to wear a mask and defiantly declares, “I ain’t taking that vaccine — hell no!”
As tens of millions of people rush to get vaccinated and squash the pandemic, hesitancy is actually fading in the hardest-hit communities. A recent poll by the nonprofit Kaiser Family Foundation found that 55% of Black adults said they had been vaccinated or planned to be soon, up 14 percentage points from February. Sixty-one percent of Latinos and 64% of Whites said the same.
“It’s one thing to say you don’t want a vaccine when it’s only been out for four weeks and you can’t get it anyway,” said Andrew Noymer, an epidemiologist and demographer at UC Irvine who studies infectious diseases. “It’s different when we have six months of data and you see that people’s toes aren’t falling off after they get the shots.”
Still, 13% of respondents said they’ll refuse vaccines anyway. Republicans and White evangelical Christians were the most likely to shun shots, with almost 30% of each group saying they’ll “definitely not” get vaccinated.
Troubling stratification
Public health experts have never seen such political stratification over a health crisis and find it deeply troubling. This intransigence could pose a threat by allowing the virus to continue circulating — and mutating — into more virulent forms that could endanger everyone, they said.
“The extent to which this particular vaccine, this particular disease, is perceived very differently depending on what political party you’re in — that, to my knowledge, is unprecedented and lamentable,” said Arthur L. Reingold, chair of California’s vaccine safety review panel and head of epidemiology and biostatistics at UC Berkeley.
“The vaccines are safe and effective and the benefits far, far, far outweigh any risks. It’s going to make it difficult to achieve the level of vaccination and immunity in many communities that we would, in public health, like to have.”
If 80% to 85% of the population needs to be vaccinated or have been infected to reach herd immunity — where the virus essentially fizzles for lack of fresh hosts — vaccine skeptics could contribute to a real problem.
“When you think back to last summer, it was the Republicans who were all excited about the vaccine and the Democrats who were all concerned about it,” said Kevin Schulman, professor of medicine at Stanford University. “We should never allow public health to become a political issue, but that we’ve let those affiliations flip suggests they’re not that ingrained.”
Efforts to reach skeptics are, perhaps belatedly, underway in earnest, with a $24 million advertising buy featuring powerful spots from the Ad Council depicting a grandmother’s first visit with her grandchildren and triumphant scenes from sporting events. “The COVID-19 vaccines are here. … It’s up to you,” say the tags at the end of the spots.
Social media sites are booting anti-vaccine evangelists off their platforms — on Facebook, a search for Cook’s StopMandatoryVaccination page delivers a list of reputable sources on vaccine information, as well as “Stop Mandatory Vaccination by Larry Cook is a #FakeNews site,” and prominent anti-vax activist Robert F. Kennedy Jr. has been banned by Instagram and other platforms for trafficking false information.
But outlandish ideas still circulate. The vaccines insert a chip into your body so the government can track your every move. They make you infertile. They alter your DNA. They give you COVID-19.
Prominent evangelical leaders have been preaching the virtues of vaccines and of science for months in an effort to counter laughable misconceptions, such as “Jesus wouldn’t let the virus hurt those inside a church.”
“God revealed a lot of his will when he gave you that brain. And he expects you to use it,” said Rick Warren, pastor of Saddleback Church, in a training for religious leaders on how to approach COVID-19 with their flocks.
Hesitancy versus refusal
It’s fair to say that vaccine hesitancy has been around since Edward Jenner began working with the smallpox vaccine in the 1770s, Reingold said.
But that hesitancy exists on a spectrum. Some have questions that can be addressed, while others will refuse despite any information they receive, said Richard Carpiano, a public health scientist and medical sociologist at UC Riverside.
“If you don’t think the pandemic is that big a deal, if you believe these conspiracy theories that the government is trying to control you, you’re not going to think it’s important to get a vaccine,” he said. “Anyone endorsing that kind of stuff essentially has blood on their hands.”
Hardcore “anti-vaxxers,” as they’re called, are actually a pretty small community that appears larger because of all the publicity it attracts and its adept manipulation of social media, said John Swartzberg, clinical professor emeritus in the Division of Infectious Diseases & Vaccinology at UC Berkeley. For these people, there’s nothing anybody can say or do to change their minds.
But many hesitant people — a much larger group than the anti-vaxxers — have good reason to be hesitant, he said. Some simply wait for more data on efficacy and risks. Others have a history of abuse and neglect by the health care system. Some have heard rumors about chips and infertility and others distrust Big Pharma.
“I think that’s the group that we really need to bring along,” Swartzberg said. “Without those that are vaccine hesitant, it’s going to be difficult to get enough people immunized to get to any semblance of herd immunity.”
Stanford’s Schulman thinks of the vaccine rollout as a product launch, much as Apple launches a new iPhone.
“Apple would spend a year thinking about how to communicate its message, and at the end of the day, if they get 30% of people to buy an iPhone, they’d be excited,” he said. “This is the most important product launch of our lifetime, and we need to get to 85% market share, not 30. It’s really important for us to get in front of this.”
Overcoming distrust
Ken Williams is an osteopath and longtime member of the Orange County Board of Education, which sued the state last year to allow “in-the-seat” learning on campuses. As a physician, he was one of the first offered the vaccine and was happy to fill out the paperwork — until he got to a box saying he consented to sharing his information with the state.
He didn’t check the box. So he didn’t get the shot.
Since then, Williams signed up with Orange County’s vaccine-scheduling app, Othena, and has received both shots. Othena didn’t have that box, he said.
“Hesitancy goes back to a distrust of government,” he said. “I don’t think it matters who is in government. On Jan. 6 we had the Capitol tragedy, which was terrible, then we’ve had political divisiveness over the last several months, with the Biden administration seeing the pandemic as a great opportunity to reset society.”
The decline of the family doctor and rise of corporate medicine hasn’t helped, he said.
“The primary care physician has been pushed to the side and you don’t know who the hell is giving you the injections at CVS, Walgreens, Walmart,” he said. “Patients don’t go to the doctors they trust for these services any more.”
The Kaiser Family Foundation found that about half of those in the “waitand-see” group said they’d be more likely to get vaccinated if the jab was offered during a routine medical appointment.
Williams tries to steer his patients toward vaccination. He tells them they have the right to defer, but they should weigh the consequences, which include infection, permanent injury and death. Or, they could take the vaccine and get the benefits of immunity.
Going viral
Saddleback pastor Warren and his wife, Kay, did just that in January. But after Kay Warren tweeted that they’d received their COVID-19 vaccines, she was inundated by hundreds of vile attacks.
Rick Warren, at the helm of the megachurch, has preached that wearing masks and getting vaccinated are ways to love your neighbor as you love yourself. In an online seminar with Francis Collins, director of the National Institutes of Health, the men said Christ would call us to be healers and do whatever possible to preserve life. Warren wrote a rap song about COVID-19 for kids and a website addressing evangelicals’ questions is at christiansandthevaccine.com.
Enlisting the help of people such as Warren and Williams is one way to turn the tide, experts say.
Schulman and a co-author, Stacy Wood, published “Beyond Politics — Promoting COVID-19 Vaccination in the United States” in the New England Journal of Medicine in February. It lays out 12 strategies for overcoming hesitancy, including, “Find a common enemy.” That would be the virus, not one another.
Kaiser found that the most persuasive information to share with skeptics was that the vaccines are nearly 100% effective at preventing hospitalization and death, that scientists have been working on the technology used in the new vaccines for 20 years, and that they’re free.
Skeptics likely will become more willing if vaccination is required to travel or go to work. But it’s important to be realistic.
“We’re not going to get 100% uptake. We don’t get that for any vaccine,” UC Riverside’s Carpiano said.
It’s understandable that people are hesitant, Berkeley’s Swartzberg said. “This is new and something’s being put into your body and it feels scary,” he said. “But when we see tens of millions of people getting vaccinated and not dropping dead or getting hospitalized with COVID, that’s going to be a very powerful message. I’m optimistic.”