“The most important ingredient in all vaccines is trust,” says Prof. Barry Bloom, the Joan L. and Julius H. Jacobson Research Professor of Public Health at the Harvard T.H. Chan School of Public Health. “Without trust, a vaccine doesn’t do much good in the world.”
Bloom, with co-authors Glen Nowak of the University of Georgia and Walter Orenstein of Emory University’s School of Medicine, wrote a recent “Perspective” article in the New England Journal of Medicine calling for a major effort to build public trust in an eventual vaccine. The three say that the gap between the 50 percent of Americans who’ve said they’d accept a COVID-19 vaccine and the 60 to 70 percent believed needed to reach the threshold for “herd immunity” — at which enough people are immune that transmission is interrupted — “will take substantial resources and active, bipartisan political support to achieve the uptake levels needed.” The estimated shortfall amounts to about 33 to 66 million Americans.
Bloom, former dean of the Harvard Chan School, said in remarks to the media on Monday that misinformation distributed through social media and recent public tussles over the effectiveness of COVID treatments like hydroxychloroquine (which was granted emergency-use authorization, later revoked) have undermined public trust that vaccine candidates will be rigorously studied and widely administered only when determined safe and effective, without regard to political, economic, or other concerns.
Once a vaccine is approved, Bloom and his NEJM co-authors wrote, distribution will be affected by which strategy is pursued. One focusing on limiting illness and death may target health care workers, nursing home residents, prison inmates, and others at highest risk. But that strategy, they pointed out, may not be the most effective at halting community wide transmission. Such a plan would likely target essential workers, young people, and others who are responsible for most transmissions.
Without trust, however, even those within the selected demographics may not universally embrace a vaccine. Bloom and his co-authors said a major information campaign may be needed that enlists both those who have retained the public’s confidence, such as doctors, nurses and pharmacists, and the private sector, whose expertise at communications and advertising far outstrips that of public health experts. They harkened to the one mounted by the March of Dimes, a nonprofit begun in the late 1930s that supported research that led to the introduction of the Salk polio vaccine in 1955.
“High uptake of COVID-19 vaccines among prioritized groups should also not be assumed,” Bloom and co-authors wrote. “Many people in these groups will want to be vaccinated, but their willingness will be affected by what is said, the way it is said, and who says it in the months to come.”
From: The Harvard Gazette, “A public-relations campaign to build trust in COVID vaccine?“