Hesitancy over a COVID-19 vaccine may threaten public health

Midway into November and well into the second wave of the coronavirus pandemic, health experts are increasingly worried about public mistrust over vaccines, and by the lack of a clear communication strategy to address the many questions being asked by Canadians about a vaccine for COVID-19.

Karyn Methven, a cancer survivor, is terrified of contracting COVID-19. “Gosh, this is really urgent,” says Methven, of Delta, BC. “We’ve hit the 10-thousand mark now in Canada, you know. Ten thousand deaths.”

Courtney Vasquez, a mother of two, says she wants to “wait a few years, see how it plays out,” referring to the development of a vaccine for COVID-19.

These are some of the voices from a town hall recently convened for Global News: The New Reality, to gauge Canadians’ views on a potential vaccine for coronavirus. 

Nine Canadians offered their views on a potential vaccine for COVID-19. They were among thousands of people who wrote to Global News about the topic. Their comments, along with new polling data, also confirm a disturbing trend emerging around COVID-19: growing hesitancy over a potential vaccine.

“We found that most people are OK with the idea of getting vaccinated,” says Steven Taylor, a professor in the Department of Psychiatry at the University of British Columbia, who has researched vaccine hesitancy.

“But the number of people who are becoming hesitant seems to be rising.”

It’s still likely months before scientists complete clinical trials on potential COVID-19 vaccines, and public opinion could change in the meantime. 

While Health Canada says that Canadians should have confidence in the process, the federal department is still working on a plan with the provinces to address misinformation, confusion and unanswered questions from the population.

That messaging plan hasn’t rolled out yet, says Dr. Supriya Sharma, the federal department’s chief medical advisor, “but it will be coming out fairly, fairly soon.”  

It isn’t clear whether this will be soon enough.

Slim majority willing to take vaccine when available 

According to a survey carried out for Global News between October 23-26 by the polling firm Ipsos, just 54 per cent of the Canadian public is willing to take a vaccine as soon as they can. Of that figure, only 22 per cent feel strongly about taking a vaccine right away.

The poll also found that just 61 per cent of respondents support mandatory vaccination for COVID-19, down from 72 per cent who supported a mandatory vaccination program just four months ago. 

Taylor from UBC says public health authorities should have launched a communications plan about vaccines months ago.

“We knew this was going to be a problem,” he says. 

Rumour cost $500 million

Heidi Larson has travelled the world, working for the United Nations, fighting rumours that vaccines are somehow harmful.

She warns that a failure to anticipate and address doubts and misinformation could have disastrous consequences.

“The most dramatic example that I saw was just a rumour in Northern Nigeria, driven by political distrust,” says Larson, the founding director of the Vaccine Confidence Project, a research group based in London, England.

She says this rumour triggered resistance to a vaccination campaign against polio in Nigeria. It allowed the disease to spread through 20 countries and “cost the global polio program $500 million to reset the clock,” she says.

‘Operation Warp Speed’

Taylor also says that public officials should be careful about how they describe or label new vaccine projects. 

“If you’re going to call your vaccine development program something like ‘Operation Warp Speed,’ which is the name of the program in the United States, that implies that things have been rushed,” Taylor says.

Instead, he said governments should emphasize the safety of the process, as opposed to its speed. “Vaccination development and dissemination programs with more reassuring titles would be more likely to engage the public trust (e.g., calling the program ‘Operation Due Diligence’ instead of ‘Operation Warp Speed’),” he wrote, in a recently co-authored journal paper.

Canada has one of the strongest regulatory systems in the world for developing and approving new vaccines. 

Under this system, three federal scientific teams review a vaccine prior to approving or rejecting it. Sharma, from Health Canada, says one team looks at pre-trial research on animals, a second team reviews human clinical trials, and a third team reviews the manufacturing process.

Sharma also notes that the department’s review of potential COVID-19 vaccines will be “the same as with any other vaccine.”

So if the department determines a vaccine candidate doesn’t mean the standards, Health Canada will not approve it, she explains.

“There’s a lot of information that’s not accurate,” Sharma says. “There’s just such a volume of information coming at people. I think it’s awesome and challenging to find out what’s trustworthy information, versus something that people are just sending around.”

Values-based approach

Saad Omer, director of Yale University’s Institute for Global Health, warns that governments should not assume people will take the vaccine.

Whether dealing with vaccine hesitancy or climate change skepticism, the challenge for communicators is to reinforce the message that the science is sound, but also to meet people where they are at in terms of their values, Omer explains.

“You can’t change people’s values, and you shouldn’t try to change people’s values. But you can speak to people’s values,” Omer said. 

Pharma pledge

The pharmaceutical industry is also taking steps to boost public confidence in their efforts. In September, the CEOs of nine pharmaceutical companies signed a pledge to adhere to accepted scientific standards in the hunt for the vaccine.

“We’re not cutting corners at all. We’re taking our time, and that’s why the vaccine is not available right now, because it takes time,” Jean-Pierre Baylet, general manager of Sanofi Pasteur Canada, told Global News’ The New Reality

Whatever findings the pharmaceutical companies come up with in clinical trials will ultimately need to be shared with Health Canada for scrutiny and review. 

Shifting the focus  

At the moment, billions are being invested in developing a vaccine. But, says Yale’s Saad Omer, a coordinated public education campaign is falling by the wayside. 

“This is a substantial public health catastrophe,” he says. “And the moment should be matched by the size and the reach of a systematic public health campaign that clarifies the vaccine development and approval process, that talks about what is known and what is unknown.”

Populist politicians around the world, alongside a few celebrities, are filling the void with misleading information alongside all sorts of conspiracy theories.

It isn’t just the public at large, either, that is vaccine-hesitant. Mistrust over a coronavirus vaccine also runs through the health care community, amplifying the communication challenge even more. 

“Health care providers,” says Omer, “need information and training in communicating around this vaccine. That’s not being done in most countries in the world, and that’s one of the things that keeps me up at night.”  

Both Omer and Heidi Larson, of the Vaccine Confidence Project, agree that the way to instill confidence is through engagement at the community level, with voices that people can trust.

“It’s about caring about people,” Larson says. “It’s about caring about their emotions and feelings, and why they feel like they’re hesitant, because that’s a big problem right now.” 

At the same time, she says it’s a “huge opportunity” to set the record straight on vaccines and to instill confidence.

“If we get this wrong, that will not be forgotten.”  

See this and other original stories about our world on The New Reality airing Saturday nights on Global TV, and online

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