Why developing a COVID-19 vaccine is only part of the struggle

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Dr. Lilly Immergluck last week gave what she called "the vaccine lecture" to a group of Morehouse School of Medicine students.

Immergluck, a pediatrician, infectious disease specialist and an assistant professor at the Atlanta school since 2005, talks each year to all students there about how vaccines have helped control the spread of the measles and other diseases. Part of her goal is to encourage students to share with patients—and their communities—the effectiveness of vaccines, a conversation that's taken on greater importance as researchers work on a COVID-19 vaccine.

"We don't know where (we are on vaccine research), but we need to be informed," Immergluck said in a telephone interview.

Public health experts and local doctors are worried many Americans won't take a vaccine once it's ready. Several polls show about 60% of Americans, at most, would be vaccinated while the rest say they won't or are unsure.

Although a vaccine is likely months, or a year away from being approved, the information wars have begun over the effectiveness of a vaccine. Some , such as YouTube, earlier this month removed from their sites "Plandemic," a short film blaming the outbreak of the disease on the World Health Organization and claiming the flu vaccine increases chances of getting COVID-19. Critics said the film was full of misinformation, but some anti-vaccination activists are continuing to find ways to repost it.

Most communication work on the pro-vaccine front is currently being done by educators and experts instead of public health organizations. Dr. Scott Ratzan, a longtime public health communications expert who is a guest lecturer at the City University of New York, is working with Emory University professor Dr. Ruth Parker on at least one potential public awareness campaign and exploring other ideas with experts worldwide.

The U.S. Centers for Disease Control and Prevention did not respond to several requests for comment. The U.S. Health & Human Services Department did not respond to an email request for comment.

The Georgia Department of Public Health said in a statement it speaks frequently about the importance of vaccines, particularly for the flu. For now, though, "We have not done anything promoting a COVID-19 vaccine as we don't know enough about it yet."

Vaccine hesitancy and skepticism isn't new. The arguments against vaccination in 18th-century Europe, according to an infographic on the Measles Rubella Initiative website, included concerns about safety, a general distrust of medicine or that smallpox was God's punishment and shouldn't be treated. In recent years, the vaccination debate has focused largely on influenza shots and measles vaccinations, as several states with outbreaks last year tried to tighten exemptions to lower infection rates.

Glen Nowak, a former CDC communications director who now runs the University of Georgia's journalism and mass communication Center for Health & Risk Communication, says there are pockets of vaccine hesitancy among conservatives who don't trust government and some progressives worried about safety. Nowak believes a public campaign is critical.

"We should be undertaking that work today so when the vaccine is available, we can get the highest acceptance rate," he said.

Anti-vaccination activists have participated in rallies encouraging states to reopen in recent weeks. The activists say they are demonstrating for individual liberty and against vaccine requirements in some states. They organized a teleconference a few weeks ago, according to news accounts. Prominent activists include Robert F. Kennedy Jr., son of the former U.S. attorney general who leads an environmental preservation organization. One Facebook group, Stop Mandatory Vaccination Now, has more than 140,000 followers.

"Medical mandates are justified with the excuse of 'protecting others,'" Larry Cook, a leading anti-vaccination activist, wrote Monday in a post shared by anti-vaccination groups on Facebook. "Don't make someone else's health status my problem."

In response to the anti-vaccination pages, several people have created pages encouraging vaccinations. Facebook and Twitter direct browsers searching for the anti-vaccination groups to the HHS site or vaccines.gov.

Ratzan, Immergluck and others say one issue is many people are reluctant to get shots because they don't understand how vaccines work in the human body. Another challenge is health experts sometimes don't operate from the same sheet of music in their messaging. As Parker noted, there were mixed messages about what masks work best. Initially, some experts said a mask wasn't necessary.

Polling shows vaccine supporters have work to do to convince some racial groups about the potential effectiveness of a COVID-19 vaccine.

A recent survey in New York, the epicenter of the disease, by a team that included Ratzan, found Hispanics were least likely to say they would get vaccinated (30%), followed by African Americans (50%); whites (71%) and Asians (73%). Health experts say some Hispanics are worried about what will be done with vaccine records. Many African Americans are leery, citing examples such as the Tuskegee Experiment, where the federal government oversaw research, starting in 1932, in which about 400 black men in the Alabama community with syphilis were deliberately left untreated for as long as 40 years so doctors could study the disease.

"(I)f a new vaccine is going to free us to live more like the people we were before the pandemic, our data suggests we will need to provide them with the credible information and assurances they need to decide that the vaccine is right, for them, their families and their communities," Ratzan's team wrote in an op-ed published Sunday in The Star-Ledger of Newark. "We should be addressing this challenge now."

As the research work continues toward a , Immergluck stressed the importance of getting flu shots because of a potential spike in infections of both diseases this fall.

"We are just going to tap out our medical and health care settings in so many ways if we can't try to minimize the impact of influenza on top of the (COVID-19) situation," she said.


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