Although access to COVID-19 vaccines remains limited, research suggests that some Americans want to “wait and see” how the vaccines work for others before they are vaccinated.
But experts say that getting the vaccine as soon as it is available to you will be vital in protecting yourself and others, stopping virus variants in their path and resuming some level of normality.
The share of people in this “wait and see” category has declined over time, according to a survey by the health policy think tank Kaiser Family Foundation, falling from 39% in December to 31% in January. In February, the most recent survey was 22%. This happened along with a gradual increase in the proportion of respondents (most recently, 55%) reporting that they had received at least one dose or that they would receive the vaccine as soon as possible.
Black adults (34%), young adults aged 18 to 29 (33%), Hispanic adults (26%), adults without a university degree (25%) and non-essential health workers (25%) had the largest share of respondents in the group wait and see.
The most common concerns in the wait-and-see cohort were the potential for serious side effects; the possibility of obtaining COVID-19 from the vaccine, which health officials say cannot happen; the prospect of missing work due to side effects; and the potential need to pay out of pocket for the vaccine, although vaccines are free. A quarter of waiters said a single dose vaccine would increase the likelihood that they would get the vaccine.
Susan Lopez, a hospitalist affiliated with Rush University Medical Center in Chicago, says community members raised questions about waiting to be vaccinated against COVID-19 during each of the 12 vaccine outreach sessions she did.
“I get asked a lot of questions about the long-term effects, like months and years later, especially with respect to mRNA vaccines, as they keep listening to their new technology,” Lopez told MarketWatch. Many people also feel overwhelmed with the technological logistics of registering for a vaccine appointment, she added.
Lopez said he tells community members that they want to wait for her to be there to provide them with the information they need to make the best decision for them. But she reaffirms that no safety steps have been missed in the vaccine development process, that all vaccines have been studied and that researchers will continue to gather safety information.
Lopez emphasized the importance of asking people why they want to wait, instead of assuming. Health care professionals must recognize that these feelings are valid, she said, while answering questions and providing information.
About a fifth of respondents in the latest KFF survey said they would definitely not be vaccinated (15%) or would only do it if necessary (7%). But KFF chief executive Drew Altman compared the group to waiting to see “undecided voters”. He argued that they should be the primary focus in efforts to build confidence in vaccines, “especially in black and Latin communities, where the need to build trust in vaccines and address information needs and barriers to access is more urgent” .
He also predicted that many could get their vaccines after seeing people they know were vaccinated without incident.
“Those whose minds can be changed most readily are in the wait-and-see group – and I hope all of their minds can be changed,” said David Abramson, an associate clinical professor of social and behavioral sciences at the NYU School of Global Public Health, who is doing research on vaccine hesitation and was not involved in KFF research.
“If that were the case, we would be closer to 80% [coverage] rate, and that would be great, ”added Abramson. “We would have the herd immunity rates that we would like.”
The Food and Drug Administration has granted emergency use authorization for the two-dose Pfizer PFE,
-BioNTech BNTX,
and Modern MRNA,
vaccines, as well as the Johnson & Johnson JNJ single dose,
vaccine.
As of Thursday afternoon, 64 million people in the United States (19.3% of the total population) had received at least one dose of vaccine and 33.8 million (10.2% of the population) were fully vaccinated, according to the US Centers for Disease Control and Prevention.
‘I usually scare them about how bad COVID can be’
What is the hurry to get vaccinated? To begin with, the longer you wait, the more you are not protected from COVID-19, said Alison Buttenheim, a behavioral epidemiologist at the University of Pennsylvania School of Nursing.
People tend to be concerned about the safety and efficacy of the vaccine, she added, but many do not assess the risks of the disease they are trying to prevent. “It’s really easy to just focus on the potential benefits, harms and risks of the vaccine and just ignore the disease,” she said. “We all misjudge our risk.”
William Parker, an assistant professor of medicine at the University of Chicago with first-hand experience in caring for patients with severe COVID-19, says he emphasizes that people should wait and see so they don’t want to see him at the hospital.
“I usually scare them about how bad COVID can be,” said Parker. “What is so exciting about vaccines is that they are tremendously effective in preventing these really bad results – hospitalizations and deaths.”
The virus killed more than 530,000 people in the United States as of Thursday, according to Johns Hopkins University.
A race to ‘starve the host virus’ – and repel variants
The urgency stems from the need to “starve the host virus,” said Abramson. Public health professionals want to reduce the number of people in a community who are potential carriers and transmitters of the virus, he said, so as more and more people are vaccinated, “it will soon begin to suppress the population of the virus itself. . “
Health professionals also want to quickly suppress the number of people sick with COVID-19, added Abramson – “and for every day that people expect and don’t get vaccinated, it’s another day when they have at least the possibility of getting sick, and in the worst case, be hospitalized and maybe even die. ”
“For me, speed is really the answer here,” he said.
The threat of the COVID-19 variants also makes vaccination an urgent goal, experts say. The variant first identified in South Africa, for example, is more infectious and appears to make coronavirus vaccines less effective. A senior UK scientist warned last month that the much more infectious variant first identified in the UK could “sweep the world”.
“As the virus has more time and more hosts to interact, there is a greater chance that additional variants will emerge or the variants that are circulating will have more space in the population and become a more serious problem,” he added. Abramson said. “It is really just a mathematical game to reduce the number of potential hosts.”
Lopez added: “Every opportunity we have to protect people sooner or later will be a chance to save a life or to save someone from the long-term COVID effects.”
‘A way back to normality’
The CDC said this week that fully vaccinated people can meet indoors and unmasked with other fully vaccinated people. They can also do this with unvaccinated people from another family, assuming that no one in that house is at high risk for COVID-19.
(People who are fully vaccinated, that is, those who received their second or only dose of vaccine at least two weeks before, still need to wear masks and practice physical distance in public environments, added the guidance).
CDC guidance, along with any additional guidance at the state level, will provide “a way back to normal” for many people, said Abramson. “The faster people are vaccinated, the faster they can take advantage of changes in distance protocols, protective measures, etc.,” he said.
“My wife and I are fully vaccinated, [and] one of my colleagues and his wife are fully vaccinated, so we all had dinner together, ”added Parker. “This is totally acceptable, once you are fully vaccinated.”
And from the point of view of herd immunity, Buttenheim said, “the faster we get 70% or 80% coverage in the country, the faster we can get our lives back on – and, if that’s important to you, keep vulnerable people safe . “
An altruistic reason to be vaccinated as soon as the injection is available to you is to set a visible example for others, especially if you are from a group that is experiencing high levels of vaccine hesitation or potential delay, Buttenheim added.
“We are really social creatures and we definitely look around our social environments for tips on what to do,” she said.
Three vaccines, ‘all great’
Experts also raised concerns about Americans rejecting the vaccine that was first offered to them and waiting for a “more effective” option – the result of disparate numbers of first-line vaccine efficacy that scientists say should not be compared directly.
Pfizer and Moderna’s mRNA vaccines have an efficacy rate of approximately 95%, but their tests were conducted before growing concerns about coronavirus variants, against which the 66% effective J&J viral vector-based vaccine was tested. . J & J’s global efficacy number also obscures the 72% effectiveness of the vaccine in the U.S. and the 85% effectiveness against serious illnesses.
While the two mRNA-based vaccines are different from the J&J vaccine in several ways, all three are effective in preventing serious illness, hospitalization and death – the measures that matter most, according to public health experts.
“The information I give [people] it is essentially, no matter what vaccine you get, it prevents hospitalization and death – so the best one will be the one they can get first, ”said Lopez.
Buttenheim agreed. “We just want people to get the vaccine that is offered to them,” she said. “They are all great.”
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