COVID-19 Vaccine Distribution: Addressing Vaccine Hesitancy

By Jessica Scott, PhDFebruary 23, 2021

This is part one in a series of blog posts exploring COVID-19 vaccine hesitancy, other barriers to immunization, and possible solutions.

As the COVID-19 vaccine rolls out across the U.S., one question on everyone’s mind is, “when do things go back to normal?” The answer depends largely on when most Americans will be vaccinated. And vaccine uptake depends on how confident people feel about receiving the vaccine. With a thorough-but-swift scientific review process, and rampant misinformation, many people are hesitant to accept a COVID-19 vaccine. Experts estimate that 70-90% of Americans will need to be vaccinated against COVID-19 before it is possible to return safely to normal activities. To ensure that people feel confident enough in vaccines to take them, health policy experts are tackling the issue of vaccine hesitancy.

Who is most likely to be hesitant about the COVID-19 vaccine?

First, the good news: the most recent survey data shows that Americans are increasingly more willing to be vaccinated against COVID-19, regardless of race, ethnicity, or gender. According to a summary from the Societal Experts Action Network combining multiple national polls for the week of February 12, at least 70% of all Americans say they intend to receive a COVID-19 vaccine at some point, up from a low of around 60% in early October.

However, there are worrisome gaps. In nationwide surveys, members of Black and Hispanic communities are less likely than other racial and ethnic groups to say they would take a vaccine if it were offered to them, in part due to mistrust of the medical establishment after generations of mistreatment. Speaking on CBS’s 60 Minutes, Dr. Reed Tuckson, a co-founder of the Black Coalition Against COVID-19 and former board member of Research!America, said that medical exploitation such as the infamous Tuskegee Syphilis Studies has fostered lasting mistrust, as have issues with modern policing and criminal justice. Women are also less likely to want a vaccine than men, and young people ages 18-29 are less likely to want a vaccine than older people.

How are experts addressing vaccine hesitancy?

For many experts, the key to addressing vaccine hesitancy boils down to one word: communication. Heidi Larson, director of the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine, says that people ask themselves four questions when it comes to vaccines: does it work, does it matter, is it safe, and is it compatible with my beliefs? According to Dr. Larson, the perception of a vaccine as important is the strongest indicator for vaccine acceptance. In other words, people are willing to take on some perceived risk if they think taking the vaccine will contribute to significantly better outcomes for themselves and those around them.

It is not enough for scientists to know the answers to questions of vaccine safety, efficacy, and importance; they must be able to effectively communicate those answers to non-scientists. Ideally, this communication involves community collaboration. Dr. Tuckson says that messaging about COVID vaccines is often most effective when it comes from trusted community members who can translate the language of science into the language of their particular community. Family physicians have an especially important role in voicing confidence in the COVID-19 vaccines to their communities. The most recent survey results from Research!America show that the number one factor that encourages people to accept a COVID-19 vaccine is a recommendation from their doctor.

Although vaccine hesitancy is an important consideration, it is not the whole picture, or even the most important part of the picture. The next blog in this series will discuss other barriers to vaccination in Barriers to Immunization: Beyond Vaccine Hesitancy.