Some of the most vulnerable to COVID say they won’t get a vaccine
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Let’s say researchers do figure out coronavirus vaccines that work and are safe – the other hard part is getting it to people here and around the world.
Distribution involves colossal logistical and ethical issues which we’re covering on the “Marketplace Morning Report” from multiple angles in the coming weeks and months. Nancy Kass is a professor of Bioethics and Public Health at Johns Hopkins. We aired part of our interview this week looking at vaccine nationalism, the impulse of countries investing in the vaccine to give first dibs to their own people.
Today we talk about the 20% of people in the U.S. who say they won’t get the shots. “Marketplace Morning Report” host David Brancaccio continued his interview with Dr. Kass.
This is part two of a two-part interview. You can read part one here.
David Brancaccio: Talk about, if you would, the sense of trust that will have to be built around any plan to address this? I mean, if people get the sense that fancy pants people, who are well connected or celebrities or well-connected politicians get the vaccine first, that could erode trust.
Nancy Kass: You’re absolutely right. And early on when there was a much more significant shortage of COVID testing than there is now, there were a lot of eyes being rolled at professional athletes, clearly being able to get access to testing every day. And I think that reinforced the trust concern that you’re describing. One of the things that I think is helpful about an allocation strategy that privileges both the first responders and the instrumental essential workers, is that they are often people with the lowest salaries doing the hardest work and often are people of color. But honestly, we have to have accountability. This is where statistics become important. The more we start to be able to keep track of who did get the vaccine and who didn’t, the more we can figure out whether we’re living up to all of those carefully thought out allocation plans, or whether powerful people are circumventing that left and right.
Brancaccio: There’s the question of when can I get my vaccine, but I’ve seen some public opinion polling. There are a lot of people in the U.S. who don’t want the vaccine even if it’s offered.
Kass: And I think those people broadly fall into three groups: there are the people who are anxious and have hesitation about vaccines generally. There are [also] the people who in general are OK with vaccines, they get their flu shot, they bring their kids to be vaccinated, but there has been so much rhetoric about how quickly this one is being developed, that they have some suspicion or anxieties about this one. And then there’s a third group of people who are not actually vaccine hesitant, but they don’t have enough interaction with the health care system. [For example,] one of the groups in this country that had such a high incidence and prevalence of COVID has been people of Latino descent. And some of these people are undocumented, and some of these people live with others who are undocumented. And you have to have a pretty trusted place where you can get health care, not to mention where all of the fees will be covered, to make sure that all of these people can safely, not in a public health sense, but from a personal welfare and staying in the country sense, get the vaccine.
Brancaccio: You mentioned Latinx people, but also the largest demographic group represented in a survey I saw of people who don’t want to get the vaccine, if offered, are Black Americans. And some of that is mistrust of the medical system given history of Black people being singled out as subjects in medical research in inappropriate ways.
Kass: As subjects in medical research, and quite honestly, Black people have not been served well in our health care system, as a whole. I want to be careful about my generalizations, but as a whole. It’s not just research, it is also racism that has persisted in health care that I think has contributed to the pretty significant disparities that we now see in our population, as well as all sorts of pre-existing social structures. This is again, where already a fair number of Black public health and medical professionals are doing a lot of work, engaging African American people in relevant communities, in doing TV spots, in doing a lot of things to start to communicate the message that this vaccine will be helpful to us. And I have colleagues who are starting to do work in barber shops, and in neighborhoods, and really doing the kind of pounding the pavement community work that becomes essential in in this kind of situation.
Brancaccio: Wasn’t it striking to see the CEOs of nine U.S. and European pharmaceutical companies signing a document to pledge that they’re not going to release a vaccine, unless it’s been tested to be effective, and not harmful, and that the paramount goal is safety?
Kass: It is essential. And the more we can have all the different key stakeholders: the heads of the pharma companies, people who work for the FDA, people who work for the CDC, local health department officials, all saying we’re not going to release or endorse a vaccine until there has been data that a group of scientists have signed off on saying it’s safe, until we know that there’s a group of data signed off by the best scientists saying that it’s effective. And that needs to be this mantra. But I agree with you, that that’s one of the most powerful things that those people can do right now.
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