Eddie Rice is a believer in vaccines. The Melbourne locksmith has previously received jabs and understands that they undergo rigorous testing before being rolled out. This time, as scientists sprint with potential shots to protect the world from Covid-1
“This is pretty unique just because it’s going to be so fast,” said Rice, 29. “I do not know enough of science to know 100% that it is safe.”
Governments and drug manufacturers have long been subject to skepticism and even hostility from a small but vocal group of anti-vaccination campaigns. In the fight against coronavirus, they may also be reluctant to reach a wider section of the population – people like rice who would normally be on board.
Fading trust in governments, political interference and the idea of creating a shot in record time are questionable. Temporary interruptions of studies due to unexplained diseases in volunteers – part of the vaccine development that does not usually make headlines – add to the anxiety. These concerns could hamper the high-stakes search to curb a pathogen that has killed 1.1 million people.
Provided that vaccinations can be successfully developed, mass-produced and implemented, vaccine advocates must be convinced enough that the shots are the key to ending the crisis. In a survey of 20,000 people conducted over the summer, more than a quarter of those surveyed said they would not get a Covid shot. Russia, Poland, Hungary and France had the lowest support, the World Economic Forum and the Ipsos survey showed.
Efforts to overcome this mood are starting with health workers. Medical personnel are at increased risk of catching the virus and spreading it to others and are likely to be among the first to be vaccinated. Any concerns they have about the quality of a vaccine may hamper wider acceptance.
Their support must not be taken for granted either. Medical workers would be careful not to damage the trust they have earned by promoting a product they do not trust, he said. Sara Gorton, Head of Health at Unison, a UK-based union representing nurses, paramedics and others in the field.
“If healthcare professionals are expected to advocate the vaccine, their natural concerns must be addressed in advance,” she said. “It won’t help with recording if you go to get your jab and the person giving it to you is not able to say reassuring things.”
A survey in Hong Kong earlier this year showed that only 63% of nurses expressed a willingness to get a potential Covid shot. It cited uncertainty about efficacy, side effects and how long the protection would last. Support was higher as cases rose but slipped as infections ebbed, according to researchers, including Kin On Kwok, an epidemiologist at the Chinese University of Hong Kong.
If less than two-thirds of nurses during an outbreak intend to be vaccinated, “we expect it will be much more challenging to promote the vaccine to the public in the post-pandemic period,” they wrote.
Anxiety about China’s growing influence in the former British colony may be another factor behind the lack of conviction. A mainland-sponsored effort that offered free tests to all Hong Kong residents so that only a quarter of them show up. Chinese vaccine developers have spearheaded the race. Although the final phase of trials has not been completed, thousands in China have already received doses under expansive emergency use regulations.
One of the biggest concerns among skeptics is that critical steps to demonstrate safety and effectiveness could be carried out in a hurry, despite assurances – as promised in September by nine US and European developers – to avoid shortcuts to science.
Vaccines led by AstraZeneca Plc and the University of Oxford, Pfizer Inc. and BioNTech SE and Moderna Inc. are among those in the final phase of the tests, and important data may come before the end of the year, paving the way for emergency approvals. This achievement would be achieved by compressing a development process that usually takes up to a decade, to only months. Public confidence in vaccines that have not been thoroughly tested could be low, according to analysts at HSBC Holdings Plc.
The pursuit of a Covid shot has become more and more politicized, reducing the number of people likely to get one, according to Scott Ratzan, a physician and public health specialist at City University of New York. Officials will have to demonstrate why an immunization that has been proven safe is beneficial to individuals and communities, he said.
Among the majority of the public, vaccines are embraced as safe and straightforward ways to prevent disease, but concerns about a Covid shot have escalated in recent months. Americans’ willingness to be vaccinated against the virus fell to 50% in September from 66% in July, a Gallup poll shows.
“Most people support vaccines,” said Ratzan, who is part of a group working to increase confidence in future Covid vaccinations. “We have to find the fence. Do they hesitate? Are they insecure? How do we throw them up? ”
Interruptions of trials have not helped. While it is not uncommon to pause studies to investigate potential side effects, these episodes highlight why the work cannot be rushed. Testing of the AstraZeneca vaccine in the US remains on hold after a volunteer in a British trial became ill more than a month ago. Johnson & Johnson said last week that it would stop its investigation to investigate a disorder that it did not specify in a participant.
The rapid pace of the investigation has made people uneasy.
President Donald Trump has been pushing for a vaccine before the November 3 election, though many companies and experts have said it is unlikely. He acknowledged earlier this month that the goal may not be achieved, but accused “policy” after regulators released new standards that could delay approval.
As the virus continues to run rampant, the pressure to come up with a vaccine has increased. The US effort to speed up the delivery of a vaccine is called Operation Warp Speed.
“People are scared – in a pandemic you can expect it – and hastily the political proclamations have made people even more nervous,” said Seth Berkley, CEO of Gavi, Vaccine Alliance, the nonprofit working to immunize children in poor countries and helps lead a program to implement future Covid vaccines worldwide.
Past Fiascos may give rise to doubts in some regions. The Philippines started in 2016 a major attempt to vaccinate children against dengue, the mosquito-borne disease, but it was suspended after the shot was associated with a higher risk of serious illness in some who had not previously been exposed to the virus.
Some people will also remember an outbreak of swine flu in the United States in the United States. At the time, President Gerald Ford presented a plan to vaccinate everyone in the country, and soon more than 40 million Americans had received shots. But it never turned into a pandemic as feared, and some of those who had been vaccinated developed Guillain-Barre syndrome, which can cause temporary paralysis.
Suspicions that extend beyond the usual anti-vaccine movement pose an additional problem for health advocates who are already struggling to contain a wave of misinformation. In one example, social media posts pushed a false story that seven children had died in Senegal as part of a Covid vaccine trial.
AstraZeneca chief Pascal Soriot issued a statement on Friday calling misinformation a “clear public health risk” and urging the public to stick to reliable sources following reports of a campaign in Russia to undermine the drugmaker’s vaccine with Oxford.
Efforts to track down and counter misleading allegations are increasing. Unicef, which focuses on protecting children and is one of the largest vaccine providers, said it forged a digital partnership with the Yale Institute for Global Health and others to create content aimed at taking on lies before they come out of control.
In the past, much of the opposition has revolved around the value of “purity”, claiming that vaccines contain unsafe levels of toxins, he said. Angus Thomson, senior social scientist at Unicef.
“What we have seen is an interesting focal point for freedom,” he said. “Suddenly, vaccination is about restricting your freedom.”
Public engagement will also need to be increased to explain how vaccines are set up and how they will be deployed, said Heidi Larson, head of the Vaccine Confidence Project, a research group. Many promising Covid shots rely on new approaches, such as messenger RNA.
“There has not been much discussion about why these vaccines can be manufactured faster, the new technologies are used, how some might have a dose and others two,” she said. “We need to talk more about it.”
Although health officials will confront restraint and even “malicious” behavior from people who shout false information, there is reason for optimism, according to Berkley, Gavi CEO.
Progress has been made on the therapy front to help patients who become seriously ill, but a vaccine is still seen as crucial to the global exit strategy, especially in concerns about long-term complications months after the first symptoms.
“I have to believe in my heart if we follow the processes, if we end up with a safe and effective vaccine that has undergone strict regulatory approval, if people start taking it and they can go back to normal or close normal, it will lead to other people wanting the product, ”said Berkley.
– With the help of Rachel Chang