There has always been a small but vocal contingent of anti-vaccine movements, which unfortunately has increased during the current contingency.
MEXICO CITY (Bloomberg) – With any luck, one of the few promising COVID-19 vaccines currently in human trials will receive regulatory approval, perhaps even in time for the Northern Hemisphere winter. However, one thing that concerns public health officials is what will happen if large numbers of people don’t want to be vaccinated.
Vaccines save millions of lives each year, yet there has always been a small but vocal contingent of anti-vaccine movements that reject science or believe in conspiracy theories about vaccines.
Unfortunately, their numbers are on the rise. Health authorities in Mexico and the United States, along with the World Health Organization, are fighting and trying to put an end to conspiracy theories and misinformation.
Going against the anti-vaccine movement is essential to work, but it is only part of the situation. The most significant danger is a widespread hesitation: what if rational people who get influenza vaccines and vaccinate their children, and want to be part of the solution to this pandemic, have concerns that public health authorities and governments do not address?
The World Health Organization ranks hesitation over vaccines as one of the top 10 threats to global health. One in six people who responded to a YouGov survey in the United Kingdom in June said they would definitely or probably not get vaccinated. A CNN poll conducted in May showed that one-third of Americans would not get a vaccine if one existed. As with everything in the United States, opinions about vaccines vary: 81 percent of Democrats would be willing to get vaccinated, and only 51 percent of Republicans said they were willing to get vaccinated.
Some of the skepticism reflects a distrust of the big pharmaceutical companies. Some reflect a distrust of the government, and some are simply because it has been a long time since we lived in fear of the many diseases vaccines now protect against.
Dr. Anthony Fauci, the leading expert on infectious diseases in the United States, has said that a vaccine that is effective in 70 to 75 percent, but which only two-thirds of the population can access, would not create the collective immunity necessary for economies to function again. Therefore, governments are very dependent not only on ensuring an immunization program but also on ensuring that the population is part of it.
However, if a vaccine promises too much if the risks are not clearly explained or problems with the delivery, trust in authorities, institutions, and even experts could be further damaged, with far-reaching consequences for public health and the economy. It is hard to imagine another time when so much is at stake not only in science but in how science is communicated.
One obstacle for health authorities is convincing people that a vaccine produced at lightning speed is no less safe than one that would typically take over a decade to develop. They will have to be clear about where the uncertainty lies. For example, it is impossible to know, even from large clinical trials, how vaccines will affect people with a range of different conditions; whether the vaccines will have long-term adverse effects; or what the impact of repeated doses might be if, as many expect, booster vaccines are required.
Most advanced countries have developed systems for reporting adverse consequences of vaccines and drugs precisely because there is uncertainty about their effects in different populations and over the long term. The United States has the Vaccine Adverse Event Reporting System (VAERS); the United Kingdom has the Yellow Card. While established vaccines have been linked to some rare cases of severe disease, researchers have not found a link between developed vaccines and adverse effects in most cases. This has not prevented the dissemination of incorrect information. Confusing and irresponsible messages have not helped either.
“The fact that it is developing in such a short time has been a cause for concern,” says Oksana Pyzik, senior lecturer in the Faculty of Pharmacy at University College London. “Indeed, we cannot afford to cut budgets in this process, precisely because there is so much momentum behind an anti-science movement.
There are other concerns, besides efficacy and safety, that governments will have to monitor. One is the risk of counterfeiting. The WHO says that one in 10 medical products circulating in low- and middle-income countries is either counterfeit or does not meet standards. Counterfeit medicines cause poisoning, untreated illness, and other dangers. And COVID-19 fraud is on the rise, from masks to medications, according to the United Nations. Vaccines will also be targeted. Officials have already discovered a fake “Israeli coronavirus vaccine” being marketed in South America.
Any doubts about the quality of a vaccine, which can also be affected by improper storage or transport, will affect confidence. And that confidence was being tested even before the pandemic. In the US, excessive abuse of prescriptions, especially opiates, has increased the skepticism of both doctors and pharmaceutical companies. The black and minority communities most affected by COVID-19 should have more reason to expect a vaccine. Still, vaccination rates are lower among minority groups due to lower levels of confidence resulting from historical abuses.
None of this suggests that vaccination is not the right choice for society and individuals. Researchers and pharmaceutical companies are moving at a rapid pace in this outbreak for very understandable reasons. The recent increase in cases in Europe and elsewhere underlines the imperative to find a way out of this pandemic.
“Understandably, people are more concerned about new vaccines, but all potential vaccines against COVID-19 are thoroughly tested to ensure they are effective and safe,” writes Dr. Mary Ramsay, director of immunization at Public Health England, in an e-mail.
“Whether people will trust claims by regulators that a vaccine is “safe and effective” will depend mainly on governments being aware of their concerns and being transparent about benefits and questions. Pretending that science is free of uncertainty does not serve either scientists or public health.
