Vaccine hesitancy is “translating into death,” warns Dr. Mary Healy of Texas Children’s Hospital
The deadly delta variant continues to spread across the U.S., and even with an overall decline in COVID-19 cases, holiday travel could result in yet another coronavirus wave. To prevent that and end this pandemic, health experts are practically begging everyone to get vaccinated.
Yet the vaccination rates, particularly in Texas, “need very definite improvement,” said Dr. Mary Healy, a physician and assistant professor at Texas Children’s Hospital in Houston and a member of the Texas Medical Association’s COVID-19 Task Force.
When looking at vaccination rates across states, Texas is “pretty near the bottom,” she said. “With all the resources we have available to us, we should not be in that situation.”
Millions of Texans are still not fully vaccinated. The issue is not a lack of vaccines. Rather, it’s largely an abundance of misinformation, especially on social media, that scares people away from getting the jab, public health researchers say.
“Vaccine hesitancy is doing a whole lot of damage,” said Healy. “That’s translating to illnesses and hospitalizations. It’s translating into death.”
Modern era of misinformation
Misinformation-fueled vaccine hesitancy is a centuries-old problem, but the advent of the internet and social media has kicked up its intensity.
Misinformation is now “worse because it travels more quickly, and there’s more of it because it’s basically free or cheap to create,” said Claire Wardle, a communications expert who co-founded the nonprofit organization First Draft, which aims to study and combat the spread of misinformation.
Rumors of the frightening side effects of a vaccine used to just circulate around a local village. Now, rumors can spread across the entire country overnight. Public health experts struggle to keep up.
“The problem is that, if I’m the [Centers for Disease Control and Prevention], I need to constantly be listening to people’s questions and concerns,” said Wardle. “It’s this ongoing battle.”
Many misconceptions are spread by strong, online communities that have good intentions, despite the damage they cause.
But there are also “essentially grifters, who are deliberately trying to manipulate people,” said Wardle. Fake news websites design completely false headlines that tap into emotion, fear and anger about the COVID-19 vaccines, she said.
“They are desperate to get you onto their website,” she said. Each view makes their platform more appetizing to advertisers, and “they can make more money.”
Another issue is that when people search for online information from credible institutions like the CDC, it is “probably a 67-page PDF,” said Wardle. Meanwhile, the false information that people are “being sent on Instagram is a fun, colorful meme that seems really certain and tells you something really clearly.”
To keep up, the Texas Medical Association is running a more modern social media campaign to combat vaccine misinformation — one with fact sheets, colorful infographics, and vibrant videos — called Vaccines Defend What Matters. The TMA content is largely available in both English and Spanish.
One size may not fit all
While savvy social media campaigns like TMA’s are helpful, they are likely not enough, researchers say.
“There are groups who are at very high risk for whom the generic information may not be as useful,” says Dr. Arleen Brown, a physician and professor of medicine at UCLA. Brown and her research team interviewed residents in Los Angeles County’s communities of color.
The interviews were conducted in focus groups led by Savanna Carson, a public health researcher at UCLA and lead author of the study.
The study had 70 participants, all of whom were from ethnic or racial minority populations with a high risk of COVID-19 morbidity and mortality. These heightened risks were due to a combination of the participants’ race/ethnicity, socioeconomic status and age.
The researchers conducted the focus groups over a couple months in late 2020 and early 2021. The findings were published this fall in JAMA Network Open.
The researchers found a diverse array of reasons that led many of the participants to waver on whether they’d get the jab. This ranged from a desire for autonomy to fear that politicization compromised the vaccine trials.
But many of the reservations were distinctive to a participant’s racial identity. For example, many were concerned that the COVID-19 vaccines were mostly tested on healthy, white people. They worried that the vaccine effectiveness may be unproven for other populations. This is reasonable, as racial minorities have been historically underrepresented in clinical trials.
This is not the case for the COVID-19 vaccine trials, which reflected the country’s diversity. Still, that reservation remains. “When we talk with people about the vaccine, telling them ‘Someone who looks like you was represented in the trials’ can make a big difference,” Brown said.
There are barriers unique to low-income communities that hinder vaccine accessibility. For one, those living paycheck-to-paycheck cannot afford to miss several days of work if the vaccine’s side effects prove overwhelming. Other issues: The ability to get transportation to a vaccination site or to have the technology to register for vaccination.
The vaccine, said Carson, “isn’t necessarily always free even though we think of it as free.”
There is also unequal access to information and quality health care. Conversations with health care providers are the best way to dispel misconceptions. But not everyone has “seen a doctor in the last few years to know who to talk to,” said Carson.
Both Brown and Carson are part of the Community Engagement Alliance, or CEAL, network run by the National Institutes of Health. The network has teams across the country including one in Dallas, engaging with communities of color, the communities hit hardest by the pandemic.
The CEAL networks “try to really dispel myths and misinformation about COVID and COVID vaccines to really enhance diverse community participation, not just in the vaccine trials but also in the discussion around COVID and the vaccinations,” said Brown.
The goal, she said, is to “really enhance uptake in vulnerable groups of the vaccine and of credible information about the vaccine.”
“There needs to be an active engagement process,” said Carson, emphasizing that those engaging with vaccine-hesitant people should have empathy and a willingness to listen. You will “never understand community concerns unless you ask about them and engage the community in their decision-making and potential barriers to vaccination,” she said.
Jordan Wilkerson is a science writer with a Ph.D. in chemistry from Harvard University. He was an American Association for the Advancement of Science fellow at The Dallas Morning News.
COVID-19 vaccination rates
Percent of total population 18 and older who are fully vaccinated