Vaccine Hesitancy

How America’s trust issues are illustrated in our public health data.

Photo by Myriam Jessier on Unsplash

The experts agree, the way to achieve herd immunity for Coronavirus in the United States is for everyone to get vaccinated. Programs are rolling out all over the country to get the vaccine out to the public, but the reception has been surprisingly mixed.

A pharmacist was fired from a Wisconsin hospital and later arrested for destroying 500 doses of the vaccine in December. Why on earth would a hospital employee do such a thing?

It may surprise you to know that 15% of healthcare workers — doctors, nurses, EMS and others right on the frontline — are refusing to get vaccinated for Covid-19. If the healthcare community is not completely on board with getting vaccinated, how can we expect the greater population to get there?

Misinformation has been a huge barrier in managing the Covid crisis. There are still people walking around today who believe this is all a hoax. We’ve seen stories in the news from nurses who say people’s dying words were, “this can’t be real” or something to that effect. Even as they lay dying of Covid, people refuse to accept that the reality they believed in doesn’t match with their experience.

On a scale from “Covid is not real” to “Bill Gates is microchipping us” there are many conspiracy theories circulating around Covid, masks and the vaccine. People grab onto these ideas and they become their truth. The truth people know and understand becomes their reality. Even if it makes no reasonable or logical sense to us, it’s true and real to them. Convincing people that they have been misinformed is a challenge, one that has been a huge barrier in stopping the spread of this very real virus.

There has been a huge, celebrity fueled anti-vax movement in America in recent years that was so robust it actually brought back the measles. Our hesitancy to vaccinate ourselves and our children reveals two things about us as a culture: We don’t trust our government and we don’t trust our healthcare system.

And really, how can we?

Our for-profit model of capitalist healthcare has historically prioritized profits over patients.

Whoever came up with the idea of healthcare as a for-profit industry was an evil genius, in my humble opinion. Doctors shouldn’t be salesmen. Hospitals should have to take care of the sick regardless of their ability to pay. People should have access to quality, affordable care for their physical and mental health. Corporations shouldn’t be making billions of dollars every year on our sickness and suffering. Americans shouldn’t be going bankrupt because they had a heart attack or got cancer.

Healthcare is dirty business. The unfortunate reality is, most people don’t really understand our system or how it works, so they go without resources they need. It’s hard to trust a system if we don’t understand it, and it’s hard to find answers if we don’t speak the language. If we don’t get exposed to the right information, we are vulnerable to the conspiracy propaganda on social media. If that’s all we see, we might get brainwashed before we even realize it. We have to be diligent in checking our sources and seeking out information from experts, being careful of their religious or political biases.

Determinants of COVID-19 vaccine acceptance in the US — EClinicalMedicine (thelancet.com)

It’s no surprise we see more vaccine hesitancy in our minority communities. Our healthcare system has a long history of racism, which makes it harder for people to trust the system to have their best interests in mind. You can see in the graph above, only about 40% of black people surveyed said they would accept the Covid vaccine when it becomes available to them. This compared to 70% of white people who plan to receive it.

Systematic inequities have made this pandemic more deadly for people of color. The rate of Covid infection and death are disproportionately higher among our Black and Latinx communities. The graph below shows how the rates of infection and death are greater than the populations represented by each group. This phenomenon needs to be address at every level so we can better assess the disparities that cause these gaps in care.

Coronavirus Data By Race: Understanding The Disparities : Shots — Health News : NPR

How can we help people trust the system more?

Pretending the virus isn’t real, downplaying its deadliness and politicizing precautions were just a few ways our previous administration added to our distrust of our healthcare system and our government.

How can we possibly foster trust in a system that is so obviously broken?

Determinants of COVID-19 vaccine acceptance in the US — EClinicalMedicine (thelancet.com)

We can see in the data, the likelihood of accepting the vaccine for people from all demographic groups increases with their level of education. Approximately 50% of people with a high school diploma plan to accept the vaccine, compared to 80% of people who have completed an advanced degree. This trend suggests that people who achieve higher learning goals tend to trust science more than people who do not.

Education is crucial to making good health decisions. Educating with facts and data supported by real science is difficult with so much noise blocking the channels where information is delivered. Algorithms on our social media platforms learn our biases and show us more of the information we want to see, rather than showing us the unbiased truth. For this reason, it’s imperative to reach beyond social media for information, so we don’t end up in an echo chamber where we hear what we want to hear instead of getting the facts.

It’s ok to be skeptical.

There is no shortage of examples of times when doctors got something wrong. We can go to Netflix right now and watch documentaries like The Bleeding Edge that show how medical devices injure and kill people every year. The FDA keeps them around, hospitals still recommend them and doctors keep using them on real people. Why? Money. It always comes back to money.

In our current healthcare model, money is in the driver’s seat. Not patient outcomes. Not ethics. Money. In this system, we must learn to be our own advocates, which requires us to do our own research and make decisions that feel best for our unique circumstances. We must learn to filter information so we can recognize propaganda when we see it. We must be our own fact checkers, checking sources and looking for multiple viewpoints before arriving at a decision.

I’ve been talking to people in my circle, and it’s a mixed bag here, too. Most of the concerns I’m hearing are related to the rapid development of the vaccine, the lack of research/data for long term effects or fears around reproductive health. These are valid concerns that come with many questions. Some of these questions do not have answers at this time, and for that reason, everyone must do what feels right for them.

Overall, most people in my circle have said they will receive the vaccine when it becomes available to them. The potential for side effects or adverse reactions is smaller than the risk of contracting the virus and possibly spreading it to the people we love.

As a public heath worker, I will receive the vaccine this week. I am fortunate to do most of my work from home, and for that reason I feel guilty taking the shot before others who need it more than I do like teachers, grocery store clerks and other essential workers who have been keeping things going since this began. I am grateful for the opportunity to get vaccinated, and hope that it is a step toward getting back to normal as a family and a culture. (I miss people and places!)

For perspective, I will say that I am a white, college educated, forty-something woman who has worked in healthcare most of my life. My future fertility is not a concern, as my husband and I have a big, blended family. For me, the benefits outweigh the risks of the vaccine, and being vaccinated will make it safer for me to get out in the community and work with people again, something I am very much looking forward to.

If you need more information or want to know how you can get in line for the Covid vaccine, your state’s Department of Health website is a good place to start. There is much information about the efficacy, safety and availability of the vaccine out there. Educating ourselves and making the best decisions we can is the strategy we need to overcome this health crisis. In the age of information, ignorance is a choice we can no longer afford.

She/her. Lover of bees . Truth seeker. Free thinker. Survivor. LGBTQ+ ally. Black Lives Matter. Atheist girl in a Bible Belt world. Love always wins.

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