Public Health Expert Calls To Repair Distrust In A COVID-19 Vaccine

Aug 1, 2020
Originally published on August 1, 2020 10:29 am

Scientists are in a sprint to find a vaccine that could stamp out the coronavirus pandemic. Dr. Anthony Fauci, the nation's top infectious diseases expert, said on Friday he's "cautiously optimistic" that a safe and effective COVID-19 vaccine will be ready for distribution in early 2021.

But it's unclear how many people will actually get a vaccine if it's approved. Only about half of Americans said in May that they were willing to get a coronavirus vaccine.

That resistance doesn't surprise Dr. Sandra Quinn, a professor and chair of the family science department at the University of Maryland, whose work at the start of the H1N1 pandemic showed even more vaccine skepticism. A 2009 study she co-authored found that less than 10% of all respondents said they would embrace a vaccine, with many believing the perceived side effects would outweigh a relatively mild illness.

Distrust in government

But COVID-19 is deadlier than the swine flu, and she says the current opposition to a coronavirus vaccine is rooted in a climate of conflicting information.

"We have forces that undermine science, contradictory messages day in and day out that create skepticism and diminish trust in government," she told NPR's Weekend Edition Saturday.

For example, she said Operation Warp Speed, the Trump administration's name for the push to deliver an effective COVID-19 vaccine by early 2021, sends the wrong message.

She thinks that terminology has Americans worried that a speedy rollout for a vaccine might come at the expense of safety.

"What that does, I think, is automatically raise a concern by many that, you know, we have Dr. Fauci and others who know vaccine research saying typically it takes years," she said. "We are still looking for an HIV vaccine, right? Decades later."

A call to bolster communication outreach

Boosting American confidence in vaccines starts with educating the public about the vaccine trial processes, Quinn said — a handful of which are well underway.

Biotech company Moderna and the National Institutes of Health have entered the third phase of a vaccine trial, the penultimate phase that assesses a vaccine's side effects before studying long-term safety and effective immunity. Tens of thousands of people will need to be recruited for all of the vaccine trials that show promise.

The current pandemic has shown that COVID-19 hits some communities at higher rates, especially those of African Americans and Latinos, where the disparities are fueled in part by underlying health conditions and structural discrimination. Quinn said it's imperative that the vaccine trials include enough diverse participants of all races and genders to know whether a vaccine will be safe for populations with different health issues.

Unlike H1N1, she says, "people are going to perceive the [COVID-19] risk as high." Quinn says because of that perception, greater transparency is required.

"We can't sugarcoat perceived risk of a vaccine," she said. "Talking about just disease risk to people will not do the trick."

Another way to repair public trust, Quinn said, is to launch robust public outreach efforts that encourage communities to ask: "What are your questions about the vaccine?" She suggests that state and local health departments work with community partners, from NAACP chapters to Boys & Girls Clubs to religious groups.

If vaccine skeptics' trust in science is shaky, Quinn's research has found social norms can go a long way in persuading people to get vaccinated. "If you believe that all the people you love and that care for you think you should get the vaccine, you are more likely to get it," she said.

Ned Wharton and Hadeel Al-Shalchi produced and edited the interview for broadcast.

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Scientists are working around the clock to find a vaccine. And if successful, it could mean the end to this pandemic. But a poll conducted by The Associated Press in May showed that only half of Americans said they're willing to get a coronavirus vaccine. And that included people who are normally up to date with their vaccinations. So what needs to happen to convince Americans to get vaccinated? And do they have a right to be skeptical? Dr. Sandra Quinn is the chair of the Department of Family Science at the University of Maryland, College Park. She's joining us from Washington, D.C.


SANDRA QUINN: Thank you for having me.

FADEL: What was your reaction to that AP poll?

QUINN: I can't say that I'm very surprised. In 2009 at the beginning of the H1N1 pandemic, when we also were looking for a new vaccine for that strain of flu, my own research at that point showed very low rates of acceptance, with African Americans being the lowest group, whites and Latinos actually higher. And when I say higher, Leila, still everyone was under 20% who said, yes, I'm going to get this vaccine. That was a different era. And today, what we're living in is actually a period where we have forces that undermine science, contradictory messages day in and day out that create skepticism and diminish trust in government.

FADEL: So how difficult does that make scientists work, then, in a moment where science is being undermined - that the messaging, is don't trust scientists?

QUINN: Well, I think it makes the work tough in a couple of different ways. Number one is that the first thing we need to do is recruit thousands of people for vaccine trials. The question will be initially, do we have enough people and enough diverse samples so that we have Native Americans, African Americans and Latinos, people of all ages, gender, all of those things in order for us to know whether this vaccine is going to be safe and effective with people who may have different health issues, different ages, et cetera? But I think there is some other hurdles. And that is we need to start today in getting our public ready for understanding this process. So one of the things we have to do is start, really, in language that the general public understands - is, what is this process? What are these clinical trials? What does it mean to be in a Phase 3 trial?

FADEL: But what does that look like for the public? How do you explain any of that in a way that will make them less skeptical?

QUINN: One of the ways that we regain some of this trust is state and local health departments, working with community partners. They may be health care systems. They may be the NAACP. They may be churches and mosques and synagogues. They may be boys and girls clubs. You know, part of what we need to do is put some resources and time into reaching out and saying, what are your questions about the vaccine? What are your concerns about the vaccine? They saw the FDA approved hydroxychloroquine initially and then pulled that approval back. Probably never should have been approved in the first place. But, you know, their credibility is on the line here as FDA. So to repair some of that trust, we have to be absolutely transparent.

FADEL: Right. So it sounds like there needs to be a public service campaign at the same time as the science is happening. But I wonder if everything goes - the best case scenario - the science works. The FDA approval comes through. This vaccine works. If half of the country doesn't take the vaccine, does it matter if it works?

QUINN: Here's what I think can help us. Unlike H1N1, where the disease was pretty mild for most people, I think as this continues to happen, people are going to perceive the risk as high. But what I also know from my own research is we will have to address things. Like, we can't sugar coat perceived risk of the vaccine - that we have to talk about both those things. Talking about just disease risks to people will not do the trick.

I also think what we know is that social norms make a difference. And so I know that in my own research that if you believe that all the people you love and that care for you think you should get the vaccine, you are more likely to get it. So part of that campaign that may include, you know, local and state health departments, the CDC, ideally the federal - you know, the administration, you know, civic leaders, religious leaders, celebrities, you know, all of those people. As they come out and start saying, I got the vaccine and here's why I did that, those things can help to shift that. We can do this, but it's not going to be an easy road.

FADEL: Dr. Sandra Quinn is the chair of the Department of Family Science at the University of Maryland, College Park. Thank you so much for joining us.

QUINN: Thank you.

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