Why vaccine hesitancy is growing during a deadly pandemic

We’re all desperate for a universal solution that will restore our pre-COVID lives.

But even some of science’s most ardent fans say they’re reluctant to roll up their sleeves and participate in the pandemic’s first wave of inoculations, unnerved by reports of speed, politicization and poor communication.

There isn’t one yet — and with initial vaccine supplies very limited, such apprehension may not pose an immediate problem, say experts. But persistent distrust could spell trouble for the nation’s ambitious Operation Warp Speed campaign to protect all Americans.

These aren’t your usual “anti-vaxxers,” the traditional tinfoil-hat conspiratorialists and fear-mongering celebrities like Jenny McCarthy and Robert F. Kennedy Jr.

Rather, they are “vaccine hesitants,” a broad and diverse spectrum of Californians whose real world experience of the pandemic so far – and lifelong interactions with government or healthcare systems – has sown distrust.

“It’s not anti-science that’s driving it. Instead, it’s questioning the integrity of the scientific research. It’s a socio-political issue — whether our current infrastructure is promoting the interests of the public, or the power interests, financial interests, corporate interests,” said Maya J. Goldenberg of Canada’s University of Guelph, author of the forthcoming book Vaccine Hesitancy: Public Trust, Expertise, and the War on Science.

Some so-called “hesitants” are liberals who are suspicious of President Trump’s cheerleading; others are anti-government libertarians. If affluent, they’re happy to wait at home until there’s more research. If poor, they are frustrated that vaccine manufacturers seem to be wooing Wall Street investors, not hard-hit minority communities.

“I believe in vaccines. They’ve helped my family and reduced the mortality of poor people,” said Margaret Gordon, a great-grandmother and co-director of the West Oakland Environmental Indicators Project.

“But we need more evidence. We have no assurance they’ll work,” she said. “There hasn’t been any real public education.”

As deaths mount, the U.S. Food and Drug Administration says it will consider historic “emergency use authorization” of a vaccine that shows safety and efficacy. This means looking at interim results of trials that would ordinarily take years, so data will be preliminary and incomplete.

To be sure, many Americans say they’d welcome anything that offers hope.

In the hard-hit Latinx community, “we have to do something. I think people will be ready.  We have people dying from this,” said Ignacio De La Fuente, a business consultant and former Oakland city councilman.

“The reality is, where we are today and what we are experiencing, it will be necessary to get the vaccine,” agreed Oakland Councilman Noel Gallo, whose district includes the Fruitvale, with more infections than any neighborhood in Alameda County, the Bay Area’s hardest-hit county.

But surveys show overall diminishing support. Back in May, 72% of Americans told Pew Research Center pollsters that they would “definitely or probably” get the vaccine against COVID-19 if it were available immediately. By September, only about half of respondents answered the same way.

Two-thirds of Californians, or 68%, are concerned about approval of a vaccine moving too fast, without fully ensuring safety and effectiveness, according to a Public Policy Institute of California poll.

Predictably, the “anti-vaxxers” have seized the moment, alleging that the Moderna vaccine contains dangerous polyethylene glycol, the Astra Zeneca vaccine transmits virus and the government plans to deploy vaccines using a secretive defense contractor to create a surveillance state.

But distrust has broadened to include many others.

Those suspicious of Big Pharma saw early press conferences with industry CEOs as evidence that “the bottom line was about shareholders,” said UC Riverside professor of public policy Richard Carpiano, who studies vaccine skeptics. “There was not really much science… It was industry types, using ‘corporate talk’ about earnings reports.”

Some Libertarians, already angered by mask mandates and business closures, see vaccination campaigns as another government overreach, he said, assaulting their civil liberties and medical freedom.

The use of the U.S. Department of Defense to help deliver vaccines under the military-sounding Operation Warp Speed campaign “feeds into this nightmare scenario of forced vaccinations, that the government’s going to come hold you down and stick you in the arm,” Carpiano said.

Then there are those on the opposite end of the spectrum: Liberals who believe so firmly in public health that they want to see data — lots of data. And no political drama.

“The concern is that the vaccine studies are too small,” said Berkeley-based health activist Karuna Jaggar. “We want to make sure that there are enough people, that those people are diverse enough, and that the right things are being studied.

“We’re about to run a massive experiment on the entire population. Rare safety signals may not show up in small or short trials,” she said. If a bad vaccine kills just 0.1% of all Americans, she said, that’s 330,000 deaths — a toll far higher than COVID-19.

The Washington D.C.-based power struggles between the White House and regulators worsen the doubt, said Jaggar. “We deserve an FDA that puts public health before politics.”

Meanwhile, the African American community feels ignored, said Dr. Owen Garrick of Oakland’s Bridge Clinical Research, which works to engage minorities in medical research. Because the initial analyses will be small, racial subgroups are less likely to be represented, he said. This adds to distrust built from decades of discriminatory access to health care.

“I would have expected better communication…, something that said:  ‘Here’s our strategy — help us think through the best ways to engage.’ But there’s been very little of that,” he said. “So people think either you made a conscious decision not to include them, or you didn’t think enough of them to bother.”

In Portola Valley, philanthropist Kathleen Bennett has been watching the research. And while she’s a fierce believer in vaccines, she’s decided to wait it out, safe in her comfortable home, until more safety data accumulates.

“I am quite ‘sheltered in place,’” said Bennett, founder and former head of The Girls’ Middle School. “I don’t feel I have to rush to get the very first COVID-19 vaccine. I don’t want to be among the first guinea pigs.”

But with a two-week trip to Hawaii planned for the winter of 2022, she’ll reconsider her decision next autumn, when there is more and better data.

“My hope is by next September, the first or second vaccines will have rolled out, and they have begun to see if they are safe and efficacious,” said Bennett.

That wait-and-see approach, combined with better outreach, could slowly build trust across the nation, said Goldenberg. “It’s not unreasonable to be mistrusting of something that doesn’t even exist yet. It’s not unreasonable to be worried about the first iteration of the vaccine.” 

“Hopefully, we will see that we have an excellent product,” she said. “The more data we accumulate, and the more we share those findings with the public, the more willing people will be to get the vaccine for themselves and for their family.

“Over time,” she said, “that will bring more people in.”