What If COVID Vaccine Arrives and Many Say No?

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It is easy to imagine resistance to a future COVID-19 vaccine, agreed Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“When the first vaccine comes out, we will have some safety data from clinical trials,” said Offit, who was not involved in the new report. “But we won’t have data on enough people to detect any rare side effects.”

Beyond that, most people infected with SARS-CoV-2 do not become seriously ill. So younger, healthy people might decide their personal benefit from vaccination is not worth any unknown risks.

But vaccination is not only about yourself, both Offit and Schoch-Spana stressed. It’s about creating the “herd immunity” that protects the most vulnerable people in a community.

To “stop the spread of this disease and get our lives back,” Offit said, most of the population will need to be vaccinated.

He said it will be critical to communicate clearly about any vaccine’s effectiveness and safety — and its allocation.

No COVID-19 vaccine will be immediately available to everyone. Both U.S. government planners and the World Health Organization have begun discussing “strategic” allocation. Vaccination would likely first be open to health care workers, and then to other essential workers and people who are at higher risk of severe COVID-19 complications, including the elderly and those with certain medical conditions.

“It will be very important that allocation is fair, and that there’s public recognition of that,” Schoch-Spana said.

Reaching out to minorities, particularly Black Americans, will be crucial. They have not only been hard-hit by the virus, Schoch-Spana said, but have long faced institutional racism in the health care system.

So messages should come not only from national agencies, but local health authorities and community groups, according to the Hopkins recommendations.

Schoch-Spana said that kind of collaboration has been happening with coronavirus testing: “Non-traditional partners,” like Black churches, have helped to reach people.

And any allocation plan, the Hopkins report said, needs to consider more than which groups are prioritized. The vaccine also has to be available at no cost, and accessible in convenient, familiar places — like the neighborhood drug store.

“Sometimes people’s decisions [about vaccination] boil down to, is this convenient enough to fit into my life?” Schoch-Spana said.



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