In preparation for wider COVID-19 vaccination distribution—and to help those who are feeling some vaccine hesitancy—we wanted to share the following important message from Dr. Jeffrey R. Balser, President & CEO of Vanderbilt University Medical Center:
Against the noisy background of masking debates, surges, flattening curves, warp speed initiatives, conflicting messages, misinformation and political controversies—not to mention a revolutionary mRNA technology—millions of people are deciding whether to take the COVID-19 vaccine.
This, however, is clear: In the United States, more than 350,000 people have died from COVID-19, with over 3,000 people dying each day. Vanderbilt University Medical Center, like other hospitals and health systems across the nation, is experiencing what promises to be a long and very dark winter.
As much as we all might wish, the ills of 2020 did not vanish at the stroke of midnight as we welcomed 2021. This next year will be ushered in with record numbers of people still becoming ill and requiring hospitalization—and the death toll will keep rising.
Today we are vaccinating those at greatest risk: the people working at our nation’s hospitals and medical centers. But soon there will be sufficient vaccine supplies to begin the much-anticipated process of vaccinating the millions of people living and working throughout our country.
Yet finding that light at the end of the tunnel requires much more than giving two doses to everyone who wants to be vaccinated. As if the most ambitious vaccination effort in human history isn’t enough of a challenge, conquering COVID-19 means we need to build a cocoon of safety for those we can’t effectively immunize—our young children and our loved ones with conditions that suppress their immune systems. People who cannot be safeguarded by taking the vaccine themselves because it isn’t yet available to them, or because their immune systems won’t respond even if they do take it.
This is why we so desperately need to achieve so-called “herd immunity.” An often-discussed term, it’s when a sufficient number of us are immune to COVID-19 that indirect protection is provided to those who are not actually immune to the disease. Essentially, it’s when so many people are immune that the virus can’t spread through the population. Achieving herd immunity for COVID-19 is a huge challenge. Unlike the flu, where many of us have some level of immunity from years of exposure to similar flu strains, this is a new virus for all of us so the projections show we need 70-90% of the population to be vaccinated, to protect those who cannot protect themselves.
Given the COVID-19 vaccines are more than 90% effective, it is understandable that many people will take the vaccine to protect themselves. But we also know that many people—up to half of all Americans in some surveys—are considering not taking it. The reasons range from concerns about the newness of the vaccine and its safety, to general mistrust of research stemming from historical abuses such as the Tuskegee syphilis study, to skepticism about whether COVID-19 is even a serious problem.
So, if the only rationale to take the vaccine is “I will be protected,” then how do we convince those already reluctant to get vaccinated, especially when their personal risk of becoming seriously ill with COVID-19 may be small?
Just as Lincoln opined in his first inaugural address, this is a time for us to express “the better angels of our nature.” Beyond protecting ourselves directly, taking the vaccine to help achieve herd immunity isn’t an abstraction of epidemiology and science—it is a work of compassion. For those healthy and young, it’s a selfless act: “I’m doing this for you, even more than for me.” It’s an expression of concern for someone requiring immunosuppressants after an organ transplant whom we don’t even know. It’s an expression of care for someone who has been unemployed since the pandemic began, now struggling with food insecurity and homelessness.
It is this compassion for all in the face of uncertainty that we are asking everyone in our country to embrace. During World War II many of our citizens sent their family members overseas to fight in a war that threatened our way of life. Of the 16 million Americans who served in our military forces during the war, over 400,000 died, so the chances of dying were in retrospect about 3%. That’s not much different than the average risk of dying, across all ages and conditions, when someone has been diagnosed with COVID-19 in the United States. Wouldn’t we agree the pandemic threatens our way of life today, causing the most unemployment since the Great Depression and more than 350,000 deaths so far?
Compassion flows from understanding, and we need to build that understanding with our neighbors, friends and family. And we need to listen.
Many people have fears about taking this vaccine. It is comforting that it has been tested exhaustively in many thousands of people, with clinical trials that are even larger and more diverse than those we have used for vaccines in the past. But it is still the case that the technology is new and we completed the work in record time—and for some, that’s unsettling. And there is always an element of faith when people take a new treatment, including a vaccine.
However, what feels to many of us like the “sudden” appearance of two remarkably effective RNA-based vaccines isn’t very surprising at all. It’s the result of decades of public investment in government-funded research, alongside investments by industry and foundations, coupled with painstaking work by thousands of researchers over decades. This is no different than landing on the moon or sequencing the genome. Much to celebrate, but also based on our history of swift scientific innovation in this country, practically inevitable.
We also need to engage our communities by singing, not shouting. Most people are not looking for a lecture. Instead, people want us to listen and to hear what they’re not saying: Is it the nitty-gritty science they want, or is it validation that it’s OK to be apprehensive? Are they looking for someone who empathizes and understands they’re afraid—a fear that may be more agonizing to them than COVID-19?
This is one of those communication challenges where we need to harmonize like a chorus. The beauty of a chorus is that while everyone is singing from the same musical composition, the notes are not the same for each member. The full range of tones, with varied pitches, intensities and timbres, all create the resonating mixture of sound that attracts us to listen and holds our attention. Our diversity as a nation provides that complex range of singing voices, with varied communication styles and personal experiences—all influenced by our races, ages, gender preferences, and social and political backgrounds. Our chorus of perspectives is essential to making the case for immunization.
Before we can all remove our masks and be confident that we are truly caring for our neighbor, we need to give everyone a gift, including many people we don’t even know: the gift of vaccinating ourselves.