We are on the cusp of the newest phase of this pandemic. We have lived through disbelief, disinterest, disinformation, confusion, concern, panic, resignation, boredom and now, finally, relief. Or are we there yet?
Even as we recognize the potential of vaccines to end this very difficult time, we have to consider skepticism that the vaccines will work and that they will be safe. How did we get here and how do we get past this moment?
It has been a long journey. The first vaccines were for smallpox in the early 1800s, when a small amount of the material (a polite word) from the blisters of someone with the disease was heated to weaken the virus (even though they did not know it was caused by a virus or even what a virus was), then injected into another person. Remarkably, it worked. Not so remarkably, there were a lot of skeptics and side effects. In fact, some people did get the disease and even died because the process was not standardized and the science incomplete. Vaccination skepticism was born. It has been with us ever since.
Vaccines can be scary. There is a lot of sophisticated science involved and the public is asked to take a giant leap of faith to get an injection (ouch!) of something they don’t fully understand. It is a big potential problem in this phase of the pandemic. What are the solutions?
As that question implies, there are a number of things that need to be done in order to convince the public of the necessity and safety of vaccines, whether it is this one or another.
First, let us not forget the remarkable history of vaccination. Not only have we virtually wiped out smallpox and polio, we have brought measles, mumps, rubella, tetanus, yellow fever, hepatitis A, herpes, cervical cancer and Ebola, among others, under control. This is an astonishing record of success and arguably as significant in preserving human health as antibiotics.
Second, the speed of vaccine development has accelerated remarkably. It took 200 years to find a vaccine for smallpox, 30 years for polio, five years for Ebola and one year for Corona-19. This is both a blessing and a curse. When the public waited decades for the polio vaccine, the public was desperate enough that there was only subdued resistance. In Africa in 2015, on the other hand, the Ebola vaccine became available relatively quickly only to find the public not ready to accept it. It was a hard lesson in the need for public relations campaigns to convince those at risk that this was not a Western plot to sterilize them or worse. It took a year of workers in the community bringing the message and answering questions, one group at a time before there was widespread acceptance.
In some ways, the Western countries now face the same issues, a confusing illness, difficult science and a skeptical public. We have the advantage in the United States of better mass communication and more education but, as we have seen, those advantages can be turned on their head with sometimes misleading information and conflicting messages from leadership. However, the basic task is the same, to answer each person’s questions with patient and repeated explanations that allow them to make good choices.
We will need 70 percent of the population of the entire world to either have gotten the disease or gotten the vaccine before this epidemic will recede into memory. That is a daunting task. It will require a lot of sacrifice and good luck to limit infections to a half-billion people; that means we need to vaccinate 4.5 billion people worldwide and about 200 million people in the United States. A vaccination program of that size has never happened before. We have an enormous amount of work to do to not only get enough vaccine, but to supply the gowns and gloves, syringes and needles, refrigerators and workers to get it distributed.
Fortunately, through public-private partnerships where governments work with private industry, these logistical hurdles are being addressed pretty well.
Should we be wary of exotic new scientific findings? Of course we should. The healthcare workers would support your concerns. Science thrives on skepticism. The people who have worked on these vaccines for the past year have been intensely skeptical of their own work. Only after checking and rechecking, testing and checking again have the medications been offered to the public. Will there be problems? Almost certainly. Will the vaccine be safer than getting the virus? Undoubtedly. In the first 1.4 million people who got the vaccine, there have been 44 allergic reactions, all resolved without consequence in less than an hour. That is one in 30,000 people. By comparison, one in 10 people who get the virus are ill for weeks and one in 50 die. The odds are with the vaccine by a long shot.
What doctors and leaders have to do is work on the emotional side of this equation to get the public to believe in the safety and usefulness of vaccination, not only for everyone else, but for themselves.
I remember lining up to get the first polio vaccine in 1952. Despite being terrified of needles as 5-year-olds, we could not wait for the opportunity. That was how frightened we were of polio. We should be no less concerned about COVID-19. Having others vaccinated will not make it safer for you for several years. When it is your turn, I urge you to get the vaccine. It, literally, may save your life. And, until we have a significant portion of people immunized, please stay safe by continuing to be distanced, wearing a mask and washing your hands. These measures work. The cost of social distancing is very high and painful for many people. Washing your hands and wearing a mask is just annoying. Getting the vaccine is sensible.
Hang in there. 2021 will be better.