Why vaccine hesitancy could be a bigger problem than expected

Salon reached out to experts on what we should expect after the Pfizer and Moderna vaccines are distributed

By Matthew Rozsa

Staff Writer

Published December 26, 2020 10:00AM (EST)

US President-elect Joe Biden receives a Covid-19 vaccination from Tabe Mase, Nurse Practitioner and Head of Employee Health Services, at the Christiana Care campus in Newark, Delaware on December 21, 2020. (Alex Edelman / AFP / Getty Images)
US President-elect Joe Biden receives a Covid-19 vaccination from Tabe Mase, Nurse Practitioner and Head of Employee Health Services, at the Christiana Care campus in Newark, Delaware on December 21, 2020. (Alex Edelman / AFP / Getty Images)

With pharmaceutical giants Moderna and Pfizer/BioNTech announcing successful vaccines last month, the COVID-19 pandemic has entered a new chapter in its history. Instead of public health experts wondering when an effective medical treatment will be available, the goal now is getting as many people vaccinated as possible. If that does not happen, the human race will not achieve herd immunity and the novel coronavirus could literally plague us for generations.

Unfortunately, not everyone can be vaccinated at once, and hence priority is being given to health care workers, residents of retirement homes, police officers, firefighters, teachers and grocery store employees in the initial phases of production. Eventually, though, vaccines will have to be more widely distributed in order to completely eradicate the coronavirus.

"I think we're all hoping for somewhere between 70% to 75% of the population, which will achieve herd immunity," Dr. Georges Benjamin, executive director of the American Public Health Association, told Salon.

Dr. Monica Gandhi, infectious disease doctor and professor of medicine at the University of California–San Francisco, referred Salon to the CDC's phased allocation guidelines. Gandhi argued that "this is a very ambitious and rapid rollout campaign," comparing the COVID-19 vaccine rollout with that of the smallpox vaccine in 1947. On that occasion, 6,350,000 were vaccinated in New York City over a period of less than a month.

"This is 2020," Gandhi explained. "We have mass logistical capability. We have mass transit ability. We can freeze things and ship them, and there's nothing more dire than getting people vaccinated. So because of that, I am convinced that it will happen quickly."

Benjamin discussed the polio vaccine rollout in 1956, arguing that one of the essential qualities that made that campaign successful was the fact that "influencers" publicly got vaccinated.

"Influencers matter in terms of helping to get people to get to vaccine acceptance," Benjamin explained. "Now in those days it was one or two very, very big people. It was Elvis Presley on 'The Ed Sullivan Show,' which everybody in the world watched."

Richard Horton, the editor-in-chief of the medical journal "The Lancet," made a similar point in a recent editorial, where he observed that the World Health Organization played a key role in making sure the smallpox vaccine was widely taken.

"Although the agency could not compel countries to take smallpox eradication seriously, its moral leadership was important. WHO staff were not merely technical advisers," Horton writes. "They became ardent advocates. The agency led the global campaign by creating a special targeted programme. Clear objectives were set. The ultimate goal was eradication. But along the way, secondary objectives were set, such as completeness of reporting."

It is hard to calculate how many lives will be saved by the COVID-19 vaccine rollout plan as it is currently being implemented.

"There are too many moving parts," Benjamin told Salon when explaining why it is difficult to predict exactly how many lives will be saved by the vaccines. Adding that he is optimistic that the vaccines will "have a significant impact on both morbidity and mortality over time," he emphasized that the success of the mass vaccinations will depend on how many people get vaccinated, how quickly America's infrastructure is able to distribute the vaccines and "how compliant we remain in those non-pharmacological interventions of masking: keeping our distance and washing our hands. It's a package."

In terms of the vaccine itself, Dr. Russell Medford, Chairman of the Center for Global Health Innovation and Global Health Crisis Coordination Center, told Salon by email that Americans should feel confident about its effectiveness.

"Americans should expect, with 95% certainty, to be personally protected from developing any symptoms or complications from COVID-19 after receiving both doses of either the Moderna or Pfizer vaccines," Medford explained. "However, we do not yet know whether being vaccinated also prevents one from harboring the SARS-CoV-2 virus and thus posing a threat of potentially infecting others. Thus, for the time being, all Americans who receive the vaccines must also rigorously practice mask wearing and social distancing."

Medford added that "the current rapid rise in infection, hospitalizations and death will not be immediately impacted by the roll-out of the vaccine alone but the faster that Americans are vaccinated, combined with rigorous mask wearing and social distancing, the greater and more rapid that impact." Even so, he pointed out that "If everyone is vaccinated, and given the 95% effectiveness of both the Pfizer and Moderna vaccines, transmission of the SARS-CoV-2 virus within the US population, along with COVID-19 hospitalizations and death, will effectively, if not completely, cease."

As of this week, the US government has 200 million doses of the Pfizer and Moderna vaccines, which can each be used to treat 100 million people.

By Matthew Rozsa

Matthew Rozsa is a staff writer at Salon. He received a Master's Degree in History from Rutgers-Newark in 2012 and was awarded a science journalism fellowship from the Metcalf Institute in 2022.

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Coronavirus Covid-19 Furthering Herd Immunity Moderna Pandemic Pfizer