On Oct. 24, 2014, then-U.S. President Barack Obama hugged Dallas nurse Nina Pham during a meeting in the Oval Office. The image was startling.
Earlier that day, Ms. Pham had been released from a special bio-containment unit at the National Institutes of Health, where she had been transferred after contracting the Ebola virus while treating a patient at a Texas hospital. By that point in the outbreak, which had started about seven months earlier, the virus had killed more than 4,400 people worldwide – a huge number by pre-COVID-19 standards. The average person had become well-versed in Ebola’s dire fatality rate and horrifying symptoms – which is why it was rather stunning to see the leader of the free world physically embrace one of its sufferers, even though by that time Ms. Pham had completely recovered.
It’s obvious now that there was a calculated message inherent in that embrace, just as there was in photographs of Diana, Princess of Wales, shaking the hand of an AIDS patient in a London hospital back in 1987, and in footage of Elvis Presley getting his polio vaccination on national television in 1956. Each showed an important person seemingly willing to put himself or herself at great risk, to demonstrate that, in fact, there was little personal risk at all.
Those images were striking and undoubtedly persuasive, which is why – should researchers develop an effective, safe vaccine for COVID-19 – we will surely need those types of demonstrations again.
A recent Angus Reid poll of Canadians’ attitudes toward a potential COVID-19 vaccine reported that roughly a third of respondents said they would delay getting the shot should one become available. Three in five said they are worried about possible side effects, and only around 50 per cent of respondents said they would get the vaccine as soon as it is possible to do so.
The attitude is similar in the United States, where a poll from mid-May reported that roughly half of respondents would get a vaccine when and if it is approved. One in five said they would refuse. A poll in the United Kingdom found that nearly a third of respondents will or may decline a COVID-19 vaccine. Surveys in other developed countries report similar results.
We know that vaccinating only half the population, as per the results of the Angus Reid poll, won’t cut it. One computer simulation showed that a vaccine needs to be at least 80 per cent effective and have 75 per cent coverage to curb the pandemic. Those are terribly high bars for efficacy and uptake, especially when the pressure to develop a vaccine is so high and there appears to be a high degree of skepticism even among those who normally support and ascribe to the benefits of vaccination programs.
There are reasonable foundations for much of that skepticism. It normally takes about a decade to develop a vaccine and get it to market, whereas researchers now are trying to do this in less than a year. There is also astronomical economic incentive to develop a vaccine; it is not an exaggeration to say the global economy hinges on its development. What’s more, countries are in something of a biological arms race to develop (or get their hands on) the first doses, with the understanding that those that succeed will have an enormous geopolitical advantage. It is only natural that people would have qualms about injecting themselves with something developed at record speed, and with incredible incentive to the producers.
For now, Canada is taking important steps on development and procurement. On Wednesday, the government announced it had signed deals with Moderna and Pfizer Inc. – whose candidate COVID-19 vaccines are undergoing Phase 3 clinical testing – for millions of doses. But unless the vast majority of Canadians are willing to line up to receive those vaccines (should they be approved for use) those agreements won’t be worth all that much. The COVID-19 vaccine challenge is one part developing and distributing the thing, one part actually persuading people to get it.
Considering all the skepticism about its development and fears about side effects, that effort should start now. People need to know what Phase 3 clinical testing entails, the difference between an inactivated virus and an RNA vaccine, and how Health Canada regulates vaccines for human use. To people with measured and reasonable concerns, regular, clear and consistent communications will go a long way. And so too might an important person or two receiving their COVID-19 vaccines on live television.
The Globe and Mail, August 6, 2020