PROVIDENCE, R.I. (WPRI) – Cheryl Phillips considers herself a supporter of vaccines.
She gets a flu shot each year and says she will definitely get a COVID-19 vaccine if one becomes available. But, she said, probably not right away.
“[I’m] a little nervous about the COVID vaccine because it seems they might be rushing to get something out ASAP,” Phillips told Target 12 in an email. “I’m not sure about round one.”
She’s not alone.
The Associated Press and NORC Center for Public Affairs Research recently released a poll showing 31% of Americans weren’t sure if they would get vaccinated for COVID-19. Another 20% said they would refuse, suggesting roughly half of Americans are wary.
The concerns exist despite scientists across the globe promising that the development process is being done safely, and policymakers suggesting vaccines are the key to solving many of the health, economic and societal ailments created by the public health crisis.
“I’m asking you please to not be lulled into a sense of complacency,” Gov. Gina Raimondo said in late June when cases, hospitalizations and deaths were falling in Rhode Island after an intense couple months in April and May.
“By the way, it’s going to be this way … until we have a medicine that works or a vaccine that’s effective and available to everybody,” she added.
Debate surrounding vaccines is nothing new, as there are pockets of people across the world who oppose the medicine for personal, religious and safety reasons – despite widespread acceptance in the scientific and health care communities.
“I don’t believe any [vaccine] will be safe or effective without long-term safety studies and zero liability,” said Deborah O’Leary, chairwoman of the RI Alliance for Vaccine Choice, an advocacy group that opposes mandated vaccinations.
“For me, it’s a hard no,” she added. “While I would not stand in the way of anyone who would want to receive one … I would certainly fight any efforts to mandate this or any vaccine.”
But the poll that showed half of Americans are concerned about coronavirus vaccines – which still don’t technically exist – goes beyond the groups of people already against vaccines, and the number has raised eyebrows among some public health experts who argue developing and eventually administering a vaccine will be key in the fight against COVID-19.
“The idea is really to save lives,” said Alysia Mihalakos, chief of the Center for Emergency Preparedness and Response at the R.I. Department of Health.
‘We’ll be in a very different spot a year from now.’
Public health officials say one way the disease could disappear is if the population achieves “herd immunity,” a medical term meaning so many people have already contracted the disease that continued spread is unlikely.
In June, the state released the results of an antibody test that showed only 2.2% of the Rhode Island population showed signs of having contracted COVID-19, meaning the vast majority of residents would still need to get the disease to achieve herd immunity.
The other option, Mihalakos explained, is the development of some type of medicine, such as a vaccine or a treatment.
“One of two things may need to happen for the coronavirus to go away,” she said. “Either it will have to impact the entirety of the population, or people will have to be protected against it another way.”
Mihalakos joined the state’s Health Department right around the time of the 9/11 attack on the World Trade Center, which was quickly followed by the anthrax attacks of 2001, and she primarily focused on bioterrorism.
But she said the job has evolved over the years as threats to human life have changed, and she was instrumental in the state’s planning effort behind vaccine distribution for H1N1 – better known as the Swine Flu – when it emerged in 2009. The U.S. Centers Disease Control and Prevention estimates the then-novel flu strain resulted in 61 million cases and 12,469 deaths in the United States.
As with coronavirus, Mihalakos said there was a lot of skepticism surrounding the H1N1 vaccine, which didn’t end up being distributed widely because the flu had largely faded away by the time the medicine became available.
Unlike the H1N1, however, COVID-19 isn’t showing any signs of slowing down, and Mihalakos’ team at the Health Department has been preparing since the beginning of the pandemic for the eventual rollout of coronavirus vaccines.
Convincing the public that they are safe is part of that process, she added.
“Vaccine hesitancy is something that we address all of the time for all types of vaccines,” Mihalakos said. “It’s about education, it’s about sharing with people the facts that we know and understand about vaccines.”
She pointed to two successful vaccines currently being used in the Democratic Republic of the Congo, which – like the current vaccine development effort – were created under emergency circumstances and have since become instrumental in fighting off Ebola, a virus that causes a severe and often fatal disease.
It will also be months before any rollout could happen, as only a handful of potential vaccines have entered into the final stages of the vetting process, and their ultimate success isn’t guaranteed.
Still, development of the COVID-19 vaccines has happened in record time, which scientists explain is possible in part because there’s already been extensive research put into creating vaccines for other types of coronavirus, the virus family to which COVID-19 belongs.
The work is being powered by a gusher of money, with the Trump administration alone investing $8 billion into vaccine development through its program known as Operation Warp Speed.
Given the time between now and when a vaccine is ready helps, according to Dr. Ashish Jha, incoming dean of Brown University’s school of public health. Jha said he’s bullish a large part of the 51% of people who are currently expressing concerns about coronavirus vaccines could be convinced otherwise.
“The way I look at it is that 30% [of people] is probably quite persuadable and we don’t have to get everybody to get a vaccine,” he said during a recent university-hosted discussion about COVID-19. “I also think the disease dynamics will totally change even once you’ve vaccinated 20% to 30% of the population and the spread of the virus will dramatically get lower.”
Jha said he does worry that communities where immunizations are low will likely see continued spread of the disease, but he’s nonetheless optimistic a successful vaccine could change the narrative surrounding the public health crisis in the future.
“America is a country with a lot of mini communities,” he said. “But as a nation, I think we’ll be in a very different spot a year from now.”
Other vaccine challenges
Yet public health experts are still quick to warn people against thinking vaccines are a silver bullet, despite how they’re often characterized, and they say it’s entirely possible that some medicines will be more effective than others.
It’s also unclear how long any one vaccine could provide protection, a timeframe that varies across such medicines. (People get a flu shot each year, but a tetanus shot every 10 years, for example.)
There are also logistical hurdles that will eventually materialize, such as having enough syringes and vials in place to administer potentially billions of individuals shots needed across the globe. Mihalakos said they are already buying up such supplies, and looking to the federal government for guidance on which people will be prioritized to get the vaccines first once one becomes available.
She said it is a “decent assumption” that the effort might mirror how the state prioritized older adults, people with health conditions and those who worked in high-risk jobs when facing a global shortage of testing materials in March.
But a lot could depend on the data that comes out of the vaccination trials, as some medicines work better on certain populations – especially when it comes to age.
“Until we have those guidelines, it’s difficult for us to truly plan for what order the vaccine would be issued,” she said.
A group of federal lawmakers, including Massachusetts Congressman Joe Kennedy III, on Thursday wrote a letter to President Trump demanding answers on his vaccine strategy, including how his administration planned “to distribute vaccines to hot spots and the most vulnerable communities.”
“We need to ensure that supply chains are in place and we are able to manufacture syringes, needles, vials, and everything needed to provide vaccines to the public,” the lawmakers wrote. “Delay in vaccine distribution should not again be tied to our inability to prepare.”
How quickly such a plan will materialize is unclear, leaving Americans with more to consider the future of the COVID-19 vaccines. But for all of the hesitancy, half of Americans still say they would receive a vaccine, which is a baseline that proponents like Jha expect will only grow in the coming months.
The group also includes people like Andrea Riccio, a Rhode Island resident. Her thinking has moved in the other direction, with the pandemic making her view all vaccines more positively.
“I haven’t gotten the flu shot in years, but I will definitely be getting the vaccine once it becomes available, and I will also be getting the flu shot from now on,” Riccio told Target 12 in an email. “I just want this over with. It has honestly been one of the scariest things I’ve ever been through in my life.”