As the first covid-19 vaccines roll out across the U.S., some of us are chanting “inject me now!”, while others are anxious about potential side effects. I reached out to two dozen scientists and public health experts to see how they’re feeling about these vaccines. I asked them if they’re planning to get a vaccine when it’s available, as well as what concerns, if any, they might have and what they would say to people who are uneasy about vaccination.
Across the board, all of them expressed wanting to take the vaccine as soon as they can, saying they feel confident that the clinical trial process has done its job of vetting these vaccines for public use.
On Monday, the first doses of Pfizer and BioNTech’s FDA-authorised covid-19 vaccine reached the U.S. public. By the end of this week, Moderna’s similar mRNA vaccine is expected to receive its own emergency use authorisation. Both vaccines appear to be highly effective (over 90%) at preventing symptoms from covid-19 and are poised to turn the tide against a pandemic that has killed more than 1.6 million people worldwide, and more than 300,000 Americans, in less than a year.
Yet some people are worried about taking a vaccine. Some of this fear can be traced to debunked myths about how these or other vaccines work (mRNA vaccines are not changing our body’s DNA, for example). Some people may wonder whether political pressure encouraged scientists or public health agencies to take shortcuts along the way.
“I am a frontline healthcare worker who interacts with numerous patients who are covid-19 positive on a regular basis. I think it is important to not only protect myself, but also my colleagues, friends, family members, and other patients,” said Krutika Kuppalli, a physician and assistant professor in the Division of Infectious Diseases at the Medical University of South Carolina.
Get the vaccine? “Yes, definitely,” said Robert Ambler, dean of School of Health Sciences and Practice at New York Medical College and a former chief medical officer at the CDC’s Agency for Toxic Substances and Disease Registry. “Phase 3 trials require very intensive study of the effectiveness and safety of a vaccine.”
While these vaccines were developed in record time, this speed has come from avoiding logistical hurdles, such as the often years-long delays between trials — not by taking shortcuts like studying a small number of people. Indeed, more than 70,000 volunteers in the U.S. alone have been enrolled in Pfizer/BioNTech’s and Moderna’s Phase III trials combined — a bigger number than most Phase III trials of a potential new drug. And though these are the first mRNA vaccines to reach the general public, this kind of vaccine has been studied in smaller trials of animals and people for over a decade, with a good safety track record so far. The FDA, despite some missteps during the pandemic, has repeatedly rebuked attempts by the Trump administration to interfere in its vetting process.
Just as importantly, these vaccines really do seem to work at preventing people from getting seriously sick.
Peter Hotez, dean for the National School of Tropical Medicine at Baylor University in Texas, is among the scientists who have been trying to develop a vaccine for covid-19. His team’s vaccine is now being tested out in India, where it could be especially useful because of its relative low cost. He said he trusts the vaccines that will soon be available to the public.
“The reason is that all of the OpWarpSpeed vaccines, including ours, work by inducing virus-neutralising antibodies, and we know that VNAs are the best guarantee to keep you and loved ones out of the ICU,” he said.
That’s not to say these vaccines don’t have side-effects, which include things like headache and fatigue, or there aren’t any lingering questions that will take time to answer.
“The available data so far do not raise concerns for me. But I would like to see more, such as duration of immunity, characteristics of persons for whom the vaccine failed, and longer-term safety follow-up,” said Walter Orenstein, a former director of the CDC’s National Immunization Program and currently the associate director of Emory University’s Vaccine Centre. Orenstein is already enrolled in Moderna’s Phase III trial, which is still blinded. If it turns out that he received the placebo, he said he would get the real deal as soon as he can.
Some of the experts I spoke to had concerns about the rollout and distribution of these vaccines.
“It’s so unclear how many doses are going to be available after the initial 20 million doses of each that are available now,” said Angela Rasmussen, a virologist affiliated with the Georgetown University Medical Centre’s Global Health Science & Security in Washington D.C.
Brandon Brown, an epidemiologist at the University of California, Riverside, notes that any vaccine will have to be carefully deployed to high-risk groups at first, given the limited supply. The CDC has already devised guidelines for the distribution of these first doses, highlighting front-line health care workers and elderly people living in nursing care facilities as a priority. But each state will have its own distribution plan, and there have already been accusations that certain groups may get to cut in line. On Monday, the White House reversed plans to have its staff receive the vaccine before the general public.
“No one should be able to purchase their way to the front of the line if they are not at the highest risk,” Brown said.
Aside from supply and distribution constraints, there’s the worry that too many people will decline the vaccine when it’s finally available. Polling varies on the question, but as many as 40 per cent of Americans are still uneasy about getting a covid-19 vaccine. Some of this hesitancy has been fuelled by the propaganda of the anti-vaccination movement, which continues to go unchecked on websites like Amazon and across social media. But there is also a very understandable sense of mistrust of the medical profession among communities of colour, which fuels their greater rates of vaccine hesitancy compared to the general public.
Clinical trials, for the most part, have done a good job of including a diverse group of volunteers, which is important not just scientifically but for building back that trust. States like New York are also emphasising the contributions made by scientists of colour in developing these vaccines, while health care workers of colour are volunteering to be some of the first people getting the shots outside of a trial.
Many of the scientists I spoke to acknowledged that there won’t be one easy way to convince everyone on the fence about a vaccine.
“People of colour, for example, justifiably want the history of exploitive medical research and health disparities acknowledged and addressed. People who are sceptical of the process may need to hear about how the regulatory process works in general,” Rasmussen said. “So it’s a work in progress that I adapt to the specific concerns of the hesitant group I’m speaking with.”
Still others might hope to appeal someone’s sense of empathy.
“I would talk to them about the importance of not just their health but those in the community, their friends, family, neighbours,” said Kuppalli, when asked what she would say to people in her own life who were hesitant about a vaccine.
In speaking with these scientists, both now and throughout the year, I came away feeling like creating a safe, effective vaccine for covid-19 was the easy part, relatively speaking. The next step of getting it to enough people is going to require plenty more work.