Harvard

Addressing Vaccine Hesitancy

Published on 22 April 2021

Image credit: Wyeth Nutrition Science Center

The impact of the Covid-19 pandemic on our macro-level societal functions and our micro-level personal lives cannot be understated. The pandemic has brought serious — and perhaps lasting — changes to how many of us communicate with others, travel, attend school, and work. And while the pandemic has opened new windows of innovation and solidarity, the toll has still been devastating. At this article’s time of writing, there have been roughly 30,000,000+ cases of Covid-19 in the United States, and over 545,000 deaths (CDC) (1).

Yet, compared to last March when the pandemic was just beginning to take shape, our prospects for eradicating the Covid-19 virus have since greatly improved, due in large part to our rapid manufacturing and distribution of vaccines. Currently, the Pfizer/BioNTech and Moderna vaccines have both been approved for general use in the U.S., and the Johnson & Johnson vaccine has been approved for emergency use. Additionally, 23 vaccines are in Phase 3 of their "large-scale efficacy tests" and are pending approval (2).

Each week, states receive vaccine allocations from the federal government based on their adult populations. It is then up to each respective state to decide how to distribute those vaccines to its residents — namely through “county health offices, hospital systems, pharmacies, mass vaccination sites and mobile clinics” (3). Some states have proven more efficient at administering their vaccines than others; at present, Minnesota has administered 89% of the vaccines it received, while Arkansas has administered 66% of theirs (4). In sum, 25% of the U.S. population has received at least one dose of a vaccine, and 13.7% of the national population is fully vaccinated (for a total of 130,000,000 doses administered) (5). The country has achieved President Joe Biden’s goal of 100 million vaccinations within his first 100 days by the 59th day, and the federal government’s recent deal with Pfizer/Moderna will likely secure 600 million vaccines by July (6). If we maintain our current vaccination rate of approximately 2.57 million doses per day — and while these vaccines alone will not halt the pandemic — they could very well help bring about a ‘herd immunity’ in which outbreaks of the virus become rare and sporadic (7).

One significant hurdle in the path of achieving herd immunity and eradicating the virus at large is vaccine hesitancy. In a February AP poll, approximately one-third of Americans stated that they do not want to take the vaccine or are unsure whether they will get one (8). Vaccine hesitancy presents a particularly complex challenge, as it cuts across several demographics and belief systems and does not stem from one single phenomena or cause. As journalist Derek Thompson of The Atlantic notes, hesitancy is the product of “a constellation of motivations, insecurities, reasonable fears, and less reasonable conspiracy theories” (9).

There are several forces that produce vaccine hesitancy among the populace. The dissemination of false and conspiratorial information on social media-- especially regarding side effects of the vaccine-- has been one of the most powerful forces in sowing fear. Social media platforms like Facebook have taken a tough stance against vaccine disinformation on their platform. While such measures shut down one avenue of disinformation, in many instances people’s hesitancy toward the vaccine is not a product of consuming conspiracies, but rather of genuine confusion regarding the efficacy and mechanisms of the vaccine. Many Americans have genuine queries regarding the speed with which the vaccines were developed and the potential side effects Writing off these kinds of concerns as foolish will not lead to a reduction in vaccine hesitancy.

While vaccine hesitancy is prevalent among all demographics, data shows that the phenomenon is more pronounced in a few specific groups. In particular, some minority populations, young people, and those with more conservative political beliefs appear more hesitant about receiving the vaccine than other groups (10). Much of the vaccine hesitancy seen in minority communities, especially Black Americans, stems from our country’s legacy of medical racism. Past injustices like the Tuskegee Syphilis Experiment and the Henrietta Lacks Case still weigh heavily in the minds of several Black Americans (11). These events, and the persistence of medical racism in the field today, have led to a systemic distrust of the medical system at-large. Any effort to mitigate vaccine hesitancy among minority populations must contend with this legacy.

Now having noted the historical and social forces that lead to vaccine hesitancy, what can be done to combat it? As a multi-faceted problem, addressing vaccine hesitancy requires a multi-faceted approach, with action at the individual, community, and national level. On an individual level, a technique termed “motivational interviewing” could be of great use. Instead of talking down to the individual, you meet them where they're at, and try to show how their motivation matches your desired goal (12). This conversational technique centers the individual with doubt or skepticism and works by matching their motivation with the goal of vaccinating them. At the community and national level, targeted messaging campaigns on various platforms and technology will be useful as well. Such messaging should be community-specific. For instance, older citizens might benefit from more community-based messaging from non-Internet sources, while a younger demographic may be best reached through social media messaging. These campaigns should try to explain in understandable terms how the vaccine operates and dispel common myths regarding them. In order to address vaccine hesitancy long-term in minority populations, both past and present medical racism must be acknowledged, and, when possible, amended. When possible, health care officials should partner with local community leaders/organizations to put out their messages, as such people know the best means of reaching people.

The Covid-19 pandemic has made many large, lasting changes to our way of life. While vaccines will not usher in a return to ‘normalcy,’ they have the capacity to make our lives safer and our world more open again. Combatting vaccine hesitancy will be a crucial part of getting to this stage. Whether this occurs through a conversation or a tweet, we can all play a role in this campaign.

Sources

Addressing Vaccine Hesitancy

Examining the U.S. Response to Covid 19: An Externalities-Based Approach

Renewable Energy Investing: How Investors Can Maximise Returns Whilst Saving the Planet

The Impact of Pedestrian-Friendly Urban Planning on Communities

Investing in America’s Economic Health Through Broadband Equity