Bridging the Gap: Understanding Vaccine Hesitancy

Written by: Samuel Lew '24
Edited by: Elizabeth Zhang '23

We live in a transformed world. The COVID-19 virus has caused a complete shutdown for the past years, and as the world recovers from the pandemic and life returns to normal, it begs the question — what is “normal”? ​

During these uncertain times of living under the looming threat of COVID-19, new discussions have arisen about health and social distancing in schools, workplaces, and elsewhere. However, settling on a protocol to effectively mitigate the harm of COVID has not been an easy task. The news is plagued with controversies and disagreements concerning what is the best solution. Perhaps, one of the most heated conversations that are being held even today is concerning vaccines.

When the initial concern of the COVID-19 pandemic began to become a real threat, creating a vaccine against this virus as quickly as possible became a priority. Thankfully, within a bit over a year, a COVID-19 vaccine was readied and approved for emergency use by the FDA. The real problem surfaced when it became evident that not everyone was willing to get the vaccine. Some people were hesitant or ignorant about the COVID-19 vaccine, while others were immediately against it.

These are people with different opinions, yet it is so easy to group them all and brand them as ignorant and dumb. In truth, most of these people are uncertain and worried, which is appropriate considering that the world is currently in the middle of a transformation. Is it right for vaccinated people to act so condescendingly? Is it motivating to hear these insults or will it just push the unvaccinated farther away?

There are different reasons why the unvaccinated are resistant to getting the vaccine. Most commonly, people are concerned that vaccines will cause future diseases or autism.[3] Often science is not enough to steer them off this thinking. But there is so much more in this anti-vaccine mindset that it is unfair to pin this image onto them and then berate them. Perhaps, it is the process itself of creating the vaccine that must be examined more carefully to understand these concerns.

For a vaccine to be made public, it must first be approved by the FDA. Although research and then FDA approval typically takes many long years to accomplish, certain circumstances allowed the COVID-19 vaccine to be approved quickly. One reason was that the COVID-19 virus has similar traits to the virus responsible for the SARS outbreak during 2002-2004. Therefore, there was already data that accelerated the process of creating the active components (mRNA, bacteria, toxins that are used as an antigen) of the vaccine[1]. Regarding the FDA approval, typically the vaccine needs to undergo 3 phases of clinical trials[1]. In this case, there were many readily available patients for testing, which again sped up the process greatly. Although the research and FDA process is well thought and refined from experience, there are still holes and flaws that can cause concern for some people, especially those from marginalized communities.

How do we define “safe”? If these clinical trials are to represent the effectiveness and safety of using these vaccines for the entire population, the trials then must include a diverse patient sample. This is not true. Minorities are heavily underrepresented in clinical trials. The FDA reported that only 5% of clinical trials participants are Black or African American. Hispanic and Latino origins are even less represented with only being 1% of the whole patient sample[2]. These clinical trials do not incorporate human diversity to the fullest. Safe for the white population is not the equivalent of safe, which is why it is understandable why some can be worried and distrustful of the people who approve of this vaccine. 

One may argue that the solution is for more people of color to participate in studies and trials to help diversify the data. Again, this solution is ignoring the harsh history that minority groups have faced. A lot of people forget people of color were often abused and used for “research”. The Tuskegee Experiment was a cruel and unethical study conducted between 1932 and 1972. The U.S Public and Health Service began observing Black men living in Tuskegee with untreated syphilis[4]. These men were impoverished and thus manipulated into joining the study with the promise of free medical care. Instead, the participants were lied to. There was no indication that the study was on syphilis that could lead to deadly symptoms such as blindness, mental illness, heart diseases, and others[4]. Instead, they were told that the study was for “bad blood”. The participants were not treated for syphilis but were purposefully given ineffective medical care[4]. Past trauma can still haunt the present. Scars are not easily healed. Even though this vaccine will help so many people, it needs to be acknowledged that for some it brings back these old wounds.

In the same way, people tend to ignore the historical complications that can cause anti-vaccine mindsets, accessibility is also something that is not discussed enough. Everyone believes vaccines are readily distributed everywhere. Schools are providing them. Medical clinics are always present to administer vaccines. Not everyone, especially those who are from the underclasses of society, has the resources and ability to receive the vaccine. Everyone talks about how the vaccine is free but forgets that there are no medical clinics available in certain communities. Some families have to figure out how to travel to locations where there are vaccines that are being provided, which can prove to be costly. This lack of accessibility that some people forget can hinder the ability to get vaccinated.

While the common perception of the unvaccinated is that they are ignorant and foolish for not getting vaccinated, the sentiment is probably not directed at all of those who are unvaccinated. But think about what those words do to those who have legitimate concerns. Vaccines are important, especially given that the world is still recovering from the pandemic, but science can only take you so far in creating a better future. Connection and bridging science with emotion will prove to be more effective encouragement rather than a condescending approach. It is only through understanding the mindset of those who are anti-vaccine and creating this trust that we can help those who are unvaccinated be safer. Perhaps, the next time you approach someone who is anti-vaccine, we ought to listen before we are quick to speak. 


Works Cited:

[1] Center for Drug Evaluation and Research. FDA's Drug Review process: Continued [Internet]. U.S. Food and Drug Administration. FDA; [cited 2021Nov14]. Available from: https://www.fda.gov/drugs/information-consumers-and-patients-drugs/fdas-drug-review-process-continued

[2] Figure 18. percentage of all active physicians by Race/ethnicity, 2018 [Internet]. AAMC. [cited 2021Nov14]. Available from: https://www.aamc.org/data-reports/workforce/interactive-data/figure-18-percentage-all-active-physicians-race/ethnicity-2018

[3] GabyC_GabyDo. Understanding anti vaxxers and their opposition to vaccines [Internet]. Global Citizen. [cited 2021Nov14]. Available from:https://www.globalcitizen.org/fr/content/everything-you-need-to-know-about-the-anti-vaxxer/?utm_source=paidsearch&utm_medium=usgrant&utm_campaign=verizon&gclid=Cj0KCQiA4b2MBhD2ARIsAIrcB-SR80sU0_jx-6ukAfd3IybtVIP59I0PtJBJeS6PtbR8avSEI82ZAvgaAu0xEALw_wcB

[4] Nix E. Tuskegee Experiment: The infamous syphilis study [Internet]. History.com. A&E Television Networks; 2017 [cited 2021Nov14]. Available from: https://www.history.com/news/the-infamous-40-year-tuskegee-study

[Image Citation] Forbes. https://www.forbes.com/sites/joshuacohen/2021/03/08/covid-19-vaccine-hesitancy-is-worse-in-eu-than-us/?sh=b9cbe92611f1