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I have been following with great interest all the news over the past several months on who is getting vaccinated and how stories about people’s ambivalence or hesitancy about getting vaccinated are being covered. As someone who has experienced a lot of medical errors, I’m very sensitive to people’s worries about whether the vaccine is safe. At the same time, I have reviewed the epidemiologic research on the development of the vaccines and the investigations into safety concerns and feel confident that the current vaccines being offered in the U.S. are safe and effective. Because of that, I personally feel motivated to try and ensure that others are able to take advantage of these vaccines now that they are available to us, especially people from communities that are currently and historically marginalized by medicine and healthcare. Indeed, like most epidemiologists surveyed by the New York Times, I think the “pandemic won’t really end nationally until more people, including children, are vaccinated.” One thing I have been following is how much attitudes are changing. The Pew Research Center has been asking people about their attitudes towards the vaccine for a year now. Their data show that the fall of 2020, when we conducted our survey, represented a low point in people’s willingness to get vaccinated. I can believe that, too! It was scary to me, as an epidemiologist, to see how promises of the vaccine coming out quickly were used in the Presidential election campaign. But since vaccines actually become more widely available, more and more people have gotten the vaccine and the share of the population that says that they do not plan to get vaccinated is shrinking. A lot of the focus on “hesitancy” can feel misplaced. As Dr. Rhea Boyd, co-founder of The Conversation, a national campaign to provide Black and Latinx communities with information about the COVID-19 vaccine, wrote in the New York Times, “Many are quick to blame ‘vaccine hesitancy’ as the reason, putting the onus on Black Americans to develop better attitudes around vaccination. But this hyper-focus on hesitancy implicitly blames Black communities for their undervaccination, and it obscures opportunities to address the primary barrier to Covid-19 vaccination: access.” Dr. Boyd’s article really got me rephrasing the question “why do people not trust public health?” instead as “What can we in public health do to earn people’s trust?” And each human interest story about hesitancy tends to only show one small window into what are often really complex pictures. For example, an article in BuzzFeed told a story about how Young Vietnamese Americans Say Their Parents Are Falling Prey To Conspiracy Videos, which they were concerned was turning the older Vietnamese community off of vaccination. But another story on the Vietnamese immigrant community reported Vietnamese Community Emerges Among Alabama’s Most Vaccinated. I’m sure both stories are true. This is a bit of a nerdy thing to focus on, but so much of how we interpret data depends on who our comparison group is, and when we are working with racialized data, in particular, it’s so important for us to understand why we are comparing one group to another and what we think any perceived differences or similarities mean. That is certainly a lesson I took from Structural Racism, Health Inequities, and the Two-Edged Sword of Data: Structural Problems Require Structural Solutions, a recent article by one of my heros, Nancy Krieger. While a lot of the early attention was focused on racial differences in people’s willingness to get the vaccine, a Marist Poll from mid April found that, of the dozens of variables they examined, the biggest predictor of a person saying they would definitely not get the vaccine was not race. It was political party: 46% of Republican men reported that they would choose not to be vaccinated. Compare that to the 3% of Democratic women. A series of articles have come out recently that provided guidance for how to talk with people who might have different perspectives about the vaccine, and specifically, how people who are supportive of vaccination can listen well to people who are hesitant to get vaccinated. I thought this article in the New York Times was particularly helpful. Happy reading!
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