Take your best shot | Health
Ask someone if they have received the COVID vaccine and the answer will certainly be categorical no matter which direction you take.
For those who have been vaccinated, the opportunity to protect themselves, their family, colleagues and neighbors is both a relief and a responsibility. For those who consider the vaccine untested, useless, or an unsustainable attack on their personal freedom, the resolution is equally absolute. And for health professionals and others responsible for public health, navigating this deepening chasm is truly complex.
Ongoing research from the Kaiser Family Foundation (KFF) indicates that the people most enthusiastic about new vaccines tend to be confident, older, better educated, democratic-leaning, and living in urban and suburban areas. People hesitant (or downright resistant) to vaccination are often younger, of color, less educated, Republican-leaning, and living in rural areas. Dive deeper into the fascinating array of information on the KFF website, and you will find that it is not that simple, as issues of accessibility, availability of credible information and other considerations are taken into account. into account. And demographics from the National Institutes of Health’s National Center for Biotechnology Information suggests that people whose thoughts and behaviors are globally resistant to vaccination are more likely to be older, educated mothers with higher socioeconomic status. raised.
Here in the Milwaukee metropolitan area, Health Commissioner Kirsten Johnson, MPH, and her colleagues are monitoring evolving data to drive targeted vaccination efforts and messaging in hopes of overcoming hesitation, especially among those most at risk of COVID-19 and its most heartbreaking complications. We recently spoke with Commissioner Johnson about these efforts.
MKE Lifestyle: Much of the ‘anti-vaccination’ debate has been relegated to immunizing children, but the pandemic has really brought to light the intensity and diversity of people’s emotions around this issue. How was it for you and your colleagues to see this unfold?
Commissioner Johnson: It played out as we had planned to a certain extent. We knew, especially since vaccines are new and new technology was involved, that a percentage of the population would be really anxious to get vaccinated, which is absolutely what we saw in the beginning when the vaccine was available for the first time. We knew the demand was going to be high, and it was, so we were able to vaccinate quite quickly the people who were eager to be vaccinated. We also recognized that there was going to be some reluctance to vaccinate, but I don’t know if we fully understood the extent of the reluctance, or who would be reluctant and why.
Do you think the response to this public health crisis and the vaccination efforts that followed might have been different if the pandemic had come at a less intense time of division in the country?
I think politics and that divide played into people’s decision-making about the vaccine and misinformation and how it’s shared. We know there is a lot of information shared on social media. We know that with these algorithms, if you search for one thing, you will only see the things you are looking for. It’s really unfortunate, because people are very strong in their beliefs and over the last five years – but especially the last year – it’s really contributed to these political divisions. It is really a disservice to public health and prevention.
How to overcome this aspect and reassure people who hesitate to vaccinate that vaccines are safe, effective and the best way to ensure individual and public health, and our only real common ground: a return to life before the pandemic?
Absolutely, there are people who have had side effects or vaccine injuries, but they are really rare, so the vaccine has been proven to be safe and also very effective. So the hardest part for us in public health is knowing that there is a percentage of the population that could get sick, be hospitalized and potentially even die, and that could be avoided with the vaccine. It’s really hard to get a message across, knowing that many, many people in our country have paid a heavy price, but also to be sensitive and to understand that people are hesitating for absolutely valid reasons, at the same time, knowing that there is a lot of misinformation. Finding this balance is certainly a challenge.
From our point of view, my point of view, from a public health point of view, we want people to be able to take off our masks. We don’t want to have to rewrite health ordinances. We don’t want people to be hospitalized. We don’t want people to die. It is preventable, but it is really difficult to overcome the political hurdle that played in the decision making.
Particularly frustrating because history shows that the effectiveness of vaccines is quite convincing, until the eradication of really horrible diseases.
In public health, even before COVID, I think we all felt a certain level of frustration with the anti-vax movement because vaccines are effective. I was a Peace Corps volunteer in West Africa, and… one of my jobs was to help coordinate the distribution of the polio vaccine in several villages. One of the things I did was a door-to-door vaccination campaign. It is heartbreaking to know that it is preventable and to see the burden of disease on populations that are not protected. To have had that experience and now to see it unfold here, 20 years later, is really a challenge.
But it’s the same methodology of making sure you allow people to ask questions, respecting their opinion, answering questions with the best science and data, meeting people where they are and by literally bringing them to their door, knowing that it depends on our ability as a country, as an economy, to move forward.
Some of the COVID conspiracy theories are pretty extreme.
Certainly, and all of our vaccinators can talk about it. We’ve heard the whole gamut. “It’s a disease that is invented and it’s for nothing.” “We put microchips in people’s arms so that we can control them. “We are going to change the DNA” – which is not that simple. It is difficult to observe the misunderstanding of an mRNA vaccine that had really been in development for a long time, and that this was precisely the first time that it could be used and used effectively, is difficult. … Then
many [suffering] could be avoided with two needle sticks.
Does the number of people in the medical community itself who are also reluctant to vaccinate surprise you?
This has been a huge challenge for hospital systems in terms of how to send messages and how to assure their staff that it is safe. If you look at the breakdown of the data, the percentage of doctors who get vaccinated versus the percentage of nurses versus the percentage of CNA, over 90 percent of doctors have a vaccine, and then it goes down from there. So we absolutely need our frontline workers to advocate and encourage their patients to get vaccinated.
The next phase of vaccination will depend heavily on our healthcare providers. We do what we can in the community and in the neighborhoods, and offer vaccines in every space we can imagine, making them as available as possible. But the next step really will be when people have that point of contact in a trusted health care provider versus a community event or someone knocking on their door.
Are you also working with the medical community to recognize and mitigate the impact of this new facet of reluctance to vaccinate in tandem with long-standing ones?
Yes we are. There is the Milwaukee Health Care Partnership of which we are a member and which is represented by all health systems. As we move through the pandemic, the focus has been on the COVID vaccine. But we now also recognize the number of children who have potentially missed their vaccinations because of COVID, because they couldn’t make it to their annual check-ups, or because people just haven’t done that. of prevention. And we are working collectively to solve this problem, to catch up with everyone. Part of that conversation is COVID, but also just vaccinations in general, talking about the piece of hesitation and trying to make sure people are protected.
I really think the message is if you have any questions or if you are worried talk to people you know, love and trust, and contact your health care provider, as we need them. people are vaccinated so we can all be safe. We just want shots. MKE
Learn more at kff.org/coronavirus-covid-19/dashboard
What are you worried about?
According to the National Institutes of Health, there are several types of bias that can impact vaccine reluctance.
Omission bias – believe something despite the scarcity of evidence.
Confirmation bias – favor arguments that support a pre-established position.
False or imagined correlations between events
Availability bias – give excessive credibility to more recent and easier to remember events and information.
Cognitive dissonance – in which perceived “conflicting evidence” may lead to the choice of an incorrect but apparently less dangerous solution.
Naturalistic bias – the belief that vaccines are man-made
and therefore unnatural, so their immunity is lower than natural immunity.
Vaccines and social networks
• Half of all vaccine tweets convey an anti-vax point of view.
• In 2019, YouTube demonetized anti-vax channels by removing their advertising. In the past year, YouTube has removed more than 800,000 videos for coronavirus misinformation.
• Pinterest now limits search results for “vaccines” to pins from internationally recognized health organizations such as the World Health Organization and the Centers for Disease Control and Prevention.