Rebuilding public trust will instill COVID-19 vaccine confidence

Moderna’s 94.5 percent vaccine efficacy rate brings renewed hope that a preventative therapy to reduce the spread of COVID-19 may be close at hand. This news is especially welcome as cases continue to spike across the country. But unless the American people trust it (or any of the other vaccines currently under development for that matter), nothing will change.

Only half of the American adults would receive a coronavirus vaccine if it were available today.  That number is down precipitously from over 70 percent in May. Even more startling, a smaller percentage — just 40 percent — of health care workers said they were likely to get vaccinated.

COVID-19 vaccine reluctance is even more prevalent among minority populations. A recent nationwide study found African-Americans are inherently skeptical of it: just 17 percent of Black American adults said they would take a vaccine even if freely administered. And of African Americans overall with a serious health condition, only 20 percent would definitely do it. After centuries of systematic racism and egregious abuse like the Tuskegee Syphilis Study, minority communities have a well-founded distrust of the public health care system.  

As COVID-19 cases rise, with states bracing for the possibility of more lockdowns through the fall and winter, why isn’t there a greater willingness to vaccinate? Why aren’t we as a nation desperate for a solution that will help us return to the way life used to be?

Vaccine hesitancy is not a new phenomenon. In 2019, the World Health Organization listed vaccine hesitancy as a top ten threat to global health. For over 20 years, so-called “anti-vaxxers” have generated fear over the measles, mumps, and rubella (MMR) vaccine. They claim it shares a causal relationship with the onset of autism in children. The scientific community has widely debunked such assertions; there is no credible data to support them. The public health risks of children not receiving vaccines such as MMR are well documented. Yet, the anti-vax community has built momentum and gained strength during the pandemic. So much so that the London-based Centre for Countering Digital Hate (CCDH) noted it could potentially hinder efforts to distribute a vaccine for COVID-19 when one is ready.

The fact the anti-vax community now includes nearly half of American adults who are tentative about receiving a COVID-19 vaccine – including many in the medical field — is troubling. But what’s driving this trend doesn’t surprise anyone in the public health community.  

Public trust in government is falling, accelerated by a lack of COVID-19 leadership over the past six months. President Trump failed to level with the American people and admitted he downplayed the risks of the Coronavirus during the pandemic’s early stages. His administration refused to mandate face coverings when the science clearly shows that they work. President Trump himself mocked the (now) president-elect for wearing masks during one of the debates. He has suggested he may fire Dr. Anthony Fauci, and his administration sought to undermine our nation’s public health agencies’ actions and recommendations. These political actions have created skepticism about the government’s ability to keep us safe and defeat the virus. 

With respect to the underserved and the years of racial inequity with restricted access to care and coverage, why should minority communities believe the nation suddenly cares about their health and well-being once a vaccine becomes readily available?

A vaccine is worthless unless people are willing to take it. And people won’t take the vaccine unless they have confidence in its safety and efficacy. For that to happen, we must regain our trust in our political leaders and public health institutions. That starts with consistent leadership and transparent communications from our elected officials and scientists. 

The combination of COVID fatigue and vaccine hesitancy is toxic. Americans are scared, and public support for a COVID-19 vaccine is heading in the wrong direction. We need public health professionals to articulate why an approved vaccine is safe to use and build public support for its distribution and adoption. Dr. Fauci’s commitment to science and his ability to communicate complex matters in a way we can all understand and trust is essential. Many others need to speak the truth and follow the science once a vaccine is available.

The question is, will America trust them?

Lyndon Haviland, DrPH, MPH, is a distinguished scholar at the CUNY School of Public Health and Health Policy.