COVID-19 Vaccine Distrust: Why It’s High, and How to Respond to It
Key takeaways:
Vaccine distrust is a growing problem that can have serious consequences.
Concerns about safety, fear of unknown side effects, and misinformation about COVID-19 are some reasons why people may not accept the vaccine.
Education, transparency, and promotion of vaccine acceptance by healthcare workers and community leaders are the best ways to combat vaccine distrust.
VIDEO: The importance of vaccine trust in black communities
Refusing a vaccine when one is available is known as “vaccine hesitancy.” In recent years, vaccine hesitancy has increased worldwide — so much so that the World Health Organization considered it a top 10 global health threat in 2019. Misinformation is a major cause of vaccine hesitancy, and there is much misinformation about both COVID-19 and its vaccine because they are new.
We’ll go over common causes of vaccine hesitancy and explore some ways to handle it, as well as provide some reliable sources of information.
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Why is vaccine hesitancy a problem?
Vaccine hesitancy or distrust is a problem because it can make it harder to contain a disease. To improve disease control in a community, the community must reach “herd immunity.” Herd immunity means that the majority of people cannot get sick or spread the disease to others. In this way, the whole community is protected.
The percent of people that need to be immunized to achieve herd immunity is different for different diseases. For COVID-19, experts estimate that between 70% and 90% of a community would need to be immunized against the virus to achieve herd immunity, although the exact number is not known. People can become immunized either by having a COVID-19 infection or through taking a vaccine.
Since COVID-19 can be a very serious illness, if 70% to 90% of Americans became sick, a large number of people would need to be hospitalized and many could die. This is why having a vaccine that works is so important. With a vaccine, many more people could become immunized without getting sick. If not enough people take the vaccine, though, achieving herd immunity becomes much more difficult.
Why are some people hesitant to get the COVID-19 vaccine?
There are many reasons why people may hesitate to take the COVID-19 vaccine.
Distrust of vaccines: Some people will not accept any vaccines at all. For example, some people choose not to get the yearly flu vaccine because they think it does not work or they worry that it will make them sick. Others worry about links between vaccines and autism disorder, and although these links have been disproven, they choose to skip recommended childhood vaccines.
Vaccine timeline: Others may accept common vaccines, but may hesitate to take the COVID-19 vaccine because it is new and was created quickly. In the past, development and approval of most vaccines took years. For the COVID-19 vaccine, creation and approval took less than a year. This seems rushed to some, and may contribute to concerns about vaccine safety. However, development of the vaccine was not as rushed as it seems. Scientists have used the technology behind the COVID-19 vaccine for 20 years. This is why they were able to create the vaccine as fast as they did.
Effectiveness: While some people worry about safety, others worry about effectiveness. After development of the vaccine, scientists studied it in human volunteers. These early studies have shown that the vaccine is safe and effective, but there is still much that is unknown, including how long the vaccine is effective, if it works against new strains of the virus, and whether or not someone who is vaccinated can still spread the disease to others.
Side effects: Fear of unknown side effects and frustration about unknown long-term effects are other reasons that some people may not accept the vaccine.
Lack of concern about the virus: Finally, there are also some communities where people do not consider COVID-19 to be a serious risk. In these communities, people may not accept a COVID vaccine because to them the risks of the vaccine seem greater than the risks of the disease.
Why are communities of color and rural communities reluctant to receive the vaccine?
Communities of color may be more likely to distrust the vaccine because they have less trust in the medical system — which unfortunately has a history of mistreating them.
African Americans
In the past, African Americans were subject to medical experiments. For example, in 1932, the U. S. Public Health Service started the Tuskegee Syphilis Study in Alabama. The study involved nearly 400 Black men and went on for 40 years. During this time, the men were never told the true purpose of the study and were not offered treatment for the disease, even when one became readily available.
Another example of medical mistreatment of African Americans is the story of Henrietta Lacks. Lacks was an African American woman who had cervical cancer in the 1950s. Her doctor sent a sample of her cells, without her consent, to Dr. George Gey, a cancer researcher. Dr. Gey soon discovered that Lacks’ cells continuously doubled and did not die, unlike any other cells he studied. He named them HeLa cells. The study of these cells over decades has aided many medical discoveries, including cancer treatment and the creation of the polio vaccine.
Today, these cells are still being used to study cancers, toxins, drugs, and viruses. However, Lacks never knew that her cells were being studied, and neither she nor her family were ever compensated, despite the discoveries that emerged from her cells.
Native Americans
Other communities of color, such as Native Americans, have faced similar medical mistreatment.
In the 1960s and 1970s, the Indian Health Services forcibly sterilized approximately 1 in 4 Native American women under the guise of different medical procedures and without consent.
In 1989, the Havasupai Tribe agreed to allow the Arizona State University to study their communities’ blood samples to determine if there was a genetic reason for their increased rates of diabetes. The tribal members who signed a consent form believed they were giving consent for the study of diabetes only. Instead, researchers went on to study and publish findings on several unrelated medical conditions, as well as the tribe’s likely historical origins.
Experiences such as these led to understandable distrust of the medical community and any new medical treatment, including vaccines.
Not all members of these communities completely distrust vaccines, however. Compared to Non-Hispanic White Americans, only 10% of Native American children are less likely to be fully vaccinated against common diseases, and 20% of Native American adults are less likely to accept a flu vaccine.
Even the COVID-19 vaccine has support within tribal communities. Despite the centuries-old distrust of the medical system, there are tribal members who have volunteered for COVID-19 vaccine trials and have encouraged others to get vaccinated because they feel it is ultimately best for their community.
Hispanic Americans
Although they may not have the same history of medical experimentation, Hispanic communities are also wary of new medical treatments. This is because, like African Americans, they have a history of racism and discrimination with the government and medical system. Unfortunately, these are also the communities most affected by COVID-19.
Rural communities
In rural communities, vaccine reluctance is due to misinformation rather than a historical distrust of the medical system. In many rural areas, particularly where local leaders have not required precautions, members may not consider COVID-19 to be a serious danger. Similarly, many rural community members view vaccination as a personal choice, rather than a community responsibility.
In other communities, members have spread conspiracy theories about vaccine safety and effectiveness. Such misinformation appears common in rural areas and contributes to increased vaccine distrust.
Why is vaccine distrust higher in some countries (like Russia) than others (like China)?
Vaccine hesitancy is a worldwide problem and occurs in more than 90% of countries.
Research on acceptance of the COVID-19 vaccine shows that vaccine acceptance depends on how much the people of a particular country trust the government. For example, vaccine acceptance rates in Asian countries where citizens overwhelmingly trust the government are close to 80%. In the United States, COVID-19 vaccine acceptance is around 69%.
In countries with low government trust, like Russia, people do not believe that the vaccine is effective and so the acceptance rate is less than 50%.
Why are some healthcare workers hesitant to get the COVID-19 vaccine?
Healthcare workers share some of the same concerns about the COVID-19 vaccine as lay people, including worries about vaccine safety, unknown long-term effects, and the possibility of studies being rushed.
In a recent survey, 29% of healthcare workers were hesitant to accept the COVID-19 vaccine. It is important to remember, however, that the term “healthcare worker” includes not only doctors and nurses, but also those who work in roles requiring only a high school education. The same survey showed that those with a college education are more likely to accept the vaccine.
Additionally, 40% of healthcare workers are members of minority communities, which as previously mentioned are more likely to distrust vaccines due to a history of mistreatment by the medical community. Healthcare workers, like the members of the communities they serve, can also be affected by misinformation.
What is the best way to handle misinformation around vaccination?
The best way to approach misinformation is with education and accurate, fact-based information. Here are some tips for different groups.
Community leaders: Provide correct information about vaccine development, safety, and effectiveness, and make this information easily accessible.
Healthcare providers: Educate patients and colleagues, dispel myths for friends and family, and stay up to date on the rapidly evolving science. The most important way, however, that doctors, nurses, and pharmacists can help their communities is by showing them that they accept the vaccine for themselves and recommend it for their loved ones. Providing people with resources for accurate information is important, but showing people that the leaders and healthcare workers of their communities accept the vaccine is likely to be much more effective.
General public: Be curious about everything you see and hear. See something on the news? Read something on the internet? Hear something from a friend? Check verified sources to see if they agree. Then, ask your doctor or a healthcare provider in your community what he or she thinks about it. If verified sources or your doctor tell you something different, ask them to explain why and then where you might be able to get more information.
What are the best resources for objective, verified information about vaccines?
The World Health Organization, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics websites are all excellent resources for objective, fact-based, and verified vaccine information.
Local universities, hospitals, and doctors’ offices are also good resources for accurate and reliable information.
The bottom line
There is a lot of misinformation around COVID-19 and its vaccine. This misinformation contributes to vaccine distrust in many communities. Vaccine distrust can lower vaccination rates and make achieving control of the disease difficult.
The best way to improve vaccine acceptance is through education and example. With increased vaccine acceptance among healthcare workers and community leaders, people may be more likely to get vaccinated.
Why trust our experts?
