Overcoming vaccine hesitancy

The rapid development of the vaccines to prevent covid-19 has to be considered a massive scientific success because creating such things usually take a long time. You would think that that was the biggest hurdle in combating the pandemic and that after that was achieved, the rest would be smooth sailing, with everyone getting vaccinated and the spread of the disease brought under control. And yet getting enough people get the vaccine to achieve herd immunity is turning out to be the hardest part, a situation that I would not have thought possible when the outbreak was causing panic back in the first half of 2020.

And yet that is where we are.

We know that Republicans, and Trump supporters particularly, are more likely to be. vaccine hesitant. The program This American Life had a segment in which Republican pollster and messaging guru Frank Luntz convened a focus group of people who had voted for Trump and had expressed hesitation or opposition to getting the vaccine, to see kind of appeal might get them to change their minds. He began by asking the participants why they were not going to take the vaccine and the responses were the usual mix of downplaying the seriousness of the disease and misinformation such as the vaccine could not be trusted because it had been rushed, that it only affected a small segment of people who were old or had other health issues, that Democrats and the media and the drug companies had exaggerated the severity of the disease and delayed releasing the results in order to defeat Trump, and so on. There was even a woman whose husband had been in intensive care for three weeks and almost died of the disease but still will not get the vaccine because she feels that our bodies can naturally fight off infections.

What Luntz found was that their views were very hard to shift. In particular, appeals by celebrities and politicians, even prominent Republican senators and congresspeople who were all supporters of Trump, seemed to have no effect at all. What shifted them at least a little were facts and emotions delivered towards the end of the session.

The facts were delivered by Dr. Thomas Friedan, former head of the CDC, who briskly made five points.

One, if you get infected with the virus, it will go all over your body and stay there for at least a week and be much more likely to cause you long-term problems than the vaccine. Two, if you get the vaccine, it will prime your immune system, but then the vaccine is gone. It will not be with you anymore. Three, more than 95% of the doctors who have been offered this vaccine have gotten it as soon as they can. Four, the more we vaccinate, the faster we can get back to growing our economy and getting jobs. And five, if people get vaccinated, we’re going to save at least 100,000 lives ofAmericans who would be otherwise killed by COVID.

The emotion was delivered by Chris Christie who did not ask them to get vaccinated but simply recounted his own experience of how he had been at a meeting of seven people in the White House, including Trump and young, fit, and healthy people, all of whom had repeatedly tested negative. Six of them, including him, came down with the disease. He also spoke about his 64-year old cousin and her husband who both got it, were hospitalized, and had died just two weeks earlier. His story seemed to have an effect.

Research indicates that the most effective person to persuade people to take the vaccine is, unsurprisingly, their personal physician. There is apparently an ad campaign in the works that will feature doctors talking to their own patients that will be sent out to them via their phone or computers. Let’s hope that works.

I had not known that Luntz had volunteered to the radio show to do this focus group because he had had a stroke last year that affected his left arm and his speech and made him much more aware of the need to heed medical advice.

The experience made him really angry with all the people who weren’t getting vaccinated. He says the stroke was this thing he could probably could have prevented if he’d done what the doctor said. But he didn’t take care of himself, didn’t take his medication. And now, seeing people do some version of that, not protecting themselves by getting the vaccine, endangering themselves and others, it was driving him crazy. Like, you people are healthy. You don’t realize what you have.

On his show last Sunday, John Oliver also discussed vaccine hesitancy and what might be done about it. He blasted people like Tucker Carlson and Alex Jones who are spreading doubt and confusion. He says that people like Carlson who disingenuously claim to be ‘just asking questions’ about the vaccines and other covid-19 preventive measures when they damn well know that the answers are available, are using the old strategy of creating doubt, because when people are not sure about something, they tend to not take any action. This is the strategy of climate change deniers and tobacco companies and anti-vaxxers.

Luntz’s participation in this focus group, in which Republican minority leader Kevin McCarthy also participated, seemed to have aroused the ire of Carlson and he has attacked both, despite them having impeccable Republican credentials, perhaps because Luntz’s polling has produced results unfavorable to Trump.

Luntz, one of the most influential pollsters in the country, has been critical of both Democrats and Republicans over the years. 

He recently suggested based on polling he has conducted among U.S. voters that former President Trump is viewed as “a genuine villain” and predicted “there isn’t even a shred of hope for him if he should ever try to reenter politics.”

Saying anything that is less than glorious praise of their Dear Leader rouses these people into a frothing fury.


  1. says

    My favorite idea for vaccine hesitancy: if you’re not vaccinated you’re not allowed to vote. After all, you’ve demonstrated that you’re not a responsible adult and are too stupid to vote. People in the military who don’t want a vaccine should be dishonorably discharged (which also bars them from voting). Oooh, voter suppression! Republicans like disqualifying voters, I bet they’d get behind this idea.

  2. steve oberski says

    if you’re not vaccinated you’re not allowed to vote

    My prediction, should this come true (I realize this is a satirical/ironic suggestion), Republicans enact legislation at the state level making vaccinations easier to get for Republicans (older, white, evangelical, male) and harder to get for visible minorities (Democrats).

  3. anat says

    Meanwhile Cliff Mass estimates that many states are at or near herd immunity, between past illness and current vaccination rates. Just a bit more effort!

  4. invivoMark says

    I would suggest not contributing to the idea that the vaccines were developed with any exceptional rapidity. We have decades of studying coronaviruses, viral immunity, protein-based vaccines (such as the Hepatitis B vaccine), and lipid nanoparticle RNA delivery. We had vaccines in the wings from SARS-1 and MERS that we just never got around to doing the clinical trials for.

    We had already done the research. All we needed was the spike protein sequence and a few hours at a computer. The rest is just testing to see if it works. And on that, we just got lucky.

  5. dean56 says

    “Meanwhile Cliff Mass …”

    You shouldn’t be looking to that clown for any reasoned thought. If his pooh-poohing of the seriousness of climate change was not enough to tip you to his “political views over science” philosophy his equating of the protests after George Floyd’s murder to Kristallnacht should be the latest indication of that he’s not a rational commenter.

    It isn’t clear, in any case, how a meteorologist would have any insight into the issue of herd immunity.

  6. mnb0 says

    “….. achieve herd immunity is turning out to be the hardest part, a situation that I would not have thought possible when …..”
    Then you’re pretty naive when it comes to human nature. The list of pseudosciences is long (and yes, atheists fall for it as eawily as other people) and internet has helped enormously to spread false information. Combine this with humans being very good at deluding themselves (including you, MS, and me myself). The simple conclusion is: it would have been a miracle had it been otherwise.
    On a somewhat longer term I’m not overly worried. As soon as family and other loved ones die or have to recover from the ic most pseudosceptics will change their minds. The one you mention is an example.

    “And yet that is where we are.”
    The fact that not only the USA, but all countries are at that same point confirms my analysis. A popular Dutch politician has “connected” nazi-occupation with lockdown. In the interior of Suriname many maroons and indians think the vaccins are yet another evil white scheme to control coloured people.

    This Monty Python spin off summed it up:

  7. garnetstar says

    I agree with @4 invioMark, in that I think a very compelling reply to “It was rushed, I don’t trust it, the government made it”, is pointing out that vaccines against coronaviruses have been worked on since SARS-1, which, I believe, broke out around 2003, by independent non-government researchers. So, the existing work was really solid and had been done over about 20 years, and as @4 said, only needed tailoring to SARS-19.

    Also, didn’t SARS-1 have quite a large fatality rate? I seem to recall something in the horrific doulbe-digits, even maybe 50%? You could also say that, if SARS-19 spreads a lot, even if it doesn’t kill people as much or if their own immune systems “overcome it” (!), even benign infection will allow SARS-19 to mutate and perhaps turn into something as lethal as SARS-1.

    No need to point out that SARS-1, even it also is a coronavirus, is actually a different virus and the chances of this coronavirus mutating into it are zero. They won’t know that.

  8. Who Cares says

    @invivoMark (#4):
    Yes and no to the speed.
    Yes in that we broke the record of a completely new vaccine being developed to actually immunizing people with it by more then three years (previous was the Mumps vaccine with four years, it was 9 months for COVID). And that is compared to the usual 10 to 20 years for the development of a vaccine.
    No in that the actual selection and initial production period to trials was not faster (or slower) then the period that is needed/used for the Flu vaccine in a given year. The speed gain was due to stripping the testing and approval to the absolute bare minimum, and that is why the vaccines available today in the US and the EU are only allowed on the market due to a provisional or emergency approval/authorization.

    And getting lucky? Not really, there have been over 500 candidates of which over 200 got into the make enough to test part. We have a dozen or so left over of which over half are still in the testing stage. And that is by counting Sputnik V (which has problems that theoretically might have more to do with quality control at the plants that got licensed, but seeing how the Russians are reacting to any setback they cause themselves if pointed out by others I don’t hold my breath) and the relatively low effectiveness Chinese vaccines (as admitted by the head of the Chinese CDC, Gao Fu)

  9. Jazzlet says

    On the speed of the vaccines development two more points. First vaccine devvelopment costs money and that was available in quantity when it was needed. Second you need a lot of people at risk of the disease to test the vaccine, with something like ebola vaccine developers have had to wait for outbreaks to do the required testing, with COVID-19 there were thousands of people all over the world both at risk of catching the disease, and eager to be part of the trials.

  10. invivoMark says

    @Who Cares #8:

    I think you have missed my point. We did not develop the COVID-19 vaccine “from scratch” in 2020. Scientists have been painstakingly learning everything we needed to know in order to make the current vaccines over several decades. Coronavirus vaccines were not just theorycrafted, they were sitting on shelves waiting for MERS or another SARS-like virus to become human-to-human transmissible so that we would fund their clinical trials. The pre-clinical data were there to show safety and efficacy in animal studies, and LNP delivery of mRNA into humans has already been approved by FDA for other treatments. In my view, that all counts toward the development process of the SARS-CoV-2 spike protein vaccines.

    From where we started at the beginning of 2020, a reasonably competent grad student would have been able to complete the “development” process for any of the approved vaccines. That has nothing to do with “emergency funding” or “Project Warp Speed,” it’s just the state of the science. What was accelerated about the vaccine approval process is that clinical trial phases were allowed to be conducted concurrently, and that the review of clinical trial data was fast-tracked.

    No testing or requirements for approval were “stripp[ed] … to the absolute bare minimum.” This is the sort of dangerous misinformation that makes people feel uneasy about the vaccine, so please stop spreading it. The clinical trials were well above the minimum size for each phase, and safety and efficacy were demonstrated just as well as they would be for any other vaccine. The difference between an emergency use authorization and full approval is that typically subjects have longer follow-up times for trials submitted for full approval requests. By now, sponsors already have most if not all of the additional data they need to pursue full approval.

    We did, however, get undeniably ridiculously lucky. There was no guarantee that spike protein would be enough to induce protective immunity. As I mentioned, we have never run a coronavirus vaccine through clinical trials before. Many viruses just don’t have very immunogenic virion proteins. Or they have ways around antibody-mediated neutralization, and the T cell response is insufficient to curb an infection. For some viruses, inactivated virus or virus-like particles don’t provide sufficient protection. For some viruses, a vaccine can actually enhance infection, making a person more susceptible to the disease -- this happened with a measles vaccine that was under development back in the 1960s, due to a phenomenon called antibody-dependent enhancement.

    We should have been hopeful for a vaccine that was 70% effective. We got incredibly, ridiculously lucky, and it won’t be this good with every future pandemic.

  11. Who Cares says

    The estimated time period for approval of the vaccines even when running as much of the approval process in parallel as possible was 12 to 18 months, else said first people getting vaccinated this year not last year. So go ahead and call it streamlining, but that is just an euphemism for stripping when it means remove as many hurdles that slow down the approval process as possible. It will also not make a lick of difference if you use other words since it just means that in a few months the new words will have the same negative connotations.

    Clinical trials were not well above minimum sizes. Remember Trump touting that a vaccine would be ready before the election? That was based on a sample size that everyone piled on as too small so it was changed (and Trump in typical fashion flipped out since suddenly reality contradicted what he claimed) to what was considered the absolute minimum sample size. The only reason that that one got a bigger sample size was that that the process to change what was to be submitted to the FDA was not strip…streamlined and took longer to finish then the new time frame of the clinical test and the streamlined checking and approval of the data.

    We did not get lucky. You are doing a logical fallacy because you see that the vaccines approved for emergency use in the US/EU happen to use the spike protein as target. That is ignoring 99% plus of the other candidates that have failed, are still in the various trial stages or got approved most of which were/are not using this specific target (the Chinese for example have an approved COVID vaccine that as you indicate is based on SARS vaccine research since it is that SARS vaccine). So it is not luck, if the spike protein had failed there would have been other candidates that would have succeeded.

    That 70% was based on traditional Adenovirus vectors and that is what that type of vaccine delivers. Even taking that into account both Moderna and BioNTech are in the 60% to 70% range with a single shot. They can do two shots due to the type of vaccine. The Russians got creative with Sputnik V by using two different Adenoviruses as vector to bypass/reduce the problem of the human body reacting to the vector and not the payload, and what was delivered to the EMA seems to indicate that that trick did manage to get to the 90% it is just a question of how reliable that data is (and if the Russians will ever find producers who can actually produce the type of vaccine that that data covers).

  12. invivoMark says

    @Who cares,

    I see you are not someone who is willing to listen to reason, or to honestly consider any of the facts that I have presented, so you are not worth my time to engage further. I only hope that you keep your misinformed opinions to yourself moving forward, instead of continuing to spread it to ignorant people who might inadvertently be convinced that you know what you’re talking about. This is a dangerous virus, and misinformation is deadly.

  13. rockwhisperer says

    Husband and I both got our second Moderna shots yesterday. We had mild discomfort after our first shots. Not so after the second ones. I’ve had considerable muscle and joint pain, while my upper arm below the shot site is apparently threatening to fall off. My husband woke up in the middle of the night, not automatically breathing, and his lack of automatic breathing continued for a few hours. (He doesn’t suffer from sleep apnea, and the problem continued while he was awake and upright.) He was also very nauseated and had a severe headache. Worse, after getting his shot, he drove up to our nearly-constructed retirement house in a mountainous, sparsely-populated area to wrangle contractors. Meanwhile, I’m stuck in our in-town house wrangling a new furnace inspection; the two locations are about 4.5 hours of hard driving apart. So, he was enduring this scary reaction without benefit of anyone in the same house who could support him, and responses to 911 calls can be quick or not so quick.

    It’s still worth it. Absolutely.

    However, since I’m partially disabled, I have a housekeeper come every other Wednesday afternoon. Today was her day, she’s skittish about the shots as a result of ignorant, conspiracy-theory inputs from her housemates, and I admitted that I had a great deal of discomfort from the vaccine. Whack me upside the head with a clue-by-four; that is not something appropriate to admit to a vaccine-averse person. No way are we telling her about my husband’s reaction.

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