With the recent announcement from both Moderna and Pfizer that they have produced a vaccine that is in the 90 to 95 percent effective range against COVID-19, medical professionals have turned their attention to a national strategy for ensuring the vaccine reaches target populations.
The Network for Regional Healthcare Improvement (NRHI) recently asked its members—who include a broad range of healthcare professionals from Regional Health Improvement Collaboratives (RHICs) and affiliate partners—to respond to the most common questions the public has about a potential COVID-19 vaccine.
There are a growing number of Americans who have expressed concern and skepticism over the safety and efficacy of a COVID-19 vaccine. In a September national poll conducted by Axios/Ipsos, “6 in 10 Americans now say they don’t want to take a COVID-19 vaccine as soon as it is available, up from 53 percent at the end of August.”
In a similar poll from the Pew Research Center, which surveyed more than 10,000 U.S. adults from Sept. 8 to Sept. 13, “about half (51 percent) say they would definitely or probably get a COVID-19 vaccine if it were available today. When Pew conducted the same poll in late April and early May, 72 percent said they would get a COVID-19 vaccine when it became available.”
When asked why they would not take a vaccine, “three-quarters of Americans (77 percent) said they think it’s very or somewhat likely a COVID-19 vaccine will be approved in the United States before its safety and effectiveness are fully understood.”
Dr. Jane Pederson, chief medical quality officer of Stratis Health in Bloomington, Minnesota; Cara Winsand, BS, Practice Transformation Program manager for the Wisconsin Collaborative for Healthcare Quality (WCHQ) and a member of the Dane County Immunization Coalition; and Dr. Jonathan Temte, MD, PhD, an expert in vaccines and immunization policy at the University of Wisconsin School of Medicine and Public Health, provided the following responses to the most commonly asked questions about a COVID-19 vaccine:
Q: Am I required to have a vaccination or is it optional?
No one is required to receive any vaccination; however, individuals who have not been vaccinated for various vaccine preventable diseases may be not allowed to be present in some settings where they could potentially spread disease to vulnerable individuals (e.g. young children, older adults, or people with immune deficiencies).
Q: I had a flu vaccine. Won’t that protect me against COVID-19?
Influenza and the coronavirus (COVID-19) are different viruses and therefore require different vaccinations. There is some new evidence that shows receiving any vaccination can help activate the immune system and decrease risk of viral infection; however, this effect is short-lived.
Q: I am concerned there may be side effects to a vaccine or that I even might catch COVID-19 because of the vaccine itself. Is that a possible outcome?
It is important to let the clinical trials for new vaccines progress in the manner that they are defined to identify side effects that may be possible. This is an essential step in assuring vaccine safety. All of the vaccines in clinical trials in the U.S. do not contain live viruses, and so would be unable to cause COVID-19 in a vaccine recipient.
Q: There has been a tremendous amount of conflicting advice about COVID-19, even from previous trusted sources like the CDC. Who should I trust about whether a vaccine will work and is safe?
NRHI representatives said trust in the CDC and FDA. The Advisory Committee on Immunization Practices (ACIP) at the CDC is charged with making recommendations using a well-established evidence-based framework. The FDA has recently exerted independence from political influence in standing up for rigid assessments of safety prior to approving any vaccine.
Q: The federal government was promoting use of hydroxychloroquine which was later shown to be harmful. How can I trust them when they say a vaccine is safe?
It is unfortunate the federal government chose to promote a treatment that was not proven safe and was instead harmful. If you are questioning information coming from the federal government, cross check what you are hearing with information from major medical centers and universities.
Q: I plan on getting the vaccine, but I don’t need to get my children vaccinated since they rarely catch COVID-19, right?
Children readily become infected with SARS-CoV-2 and are able to transmit to others, including family members. Fortunately, children are less prone to significant clinical illness. For the first round of COVID-19 vaccines, there will be no data on their use in children. Wait for future clinical trials to evaluate safety and efficacy in children.
Q: I don’t know anyone who has caught COVID-19 so why should I get vaccinated?
Because many people with COVID-19 are asymptomatic, people cannot know who around them has it and who does not. Vaccination protects people from contracting COVID-19 and prevents them from giving the disease to anyone else.
Q: Do vaccines contribute to the rise in autism?
Autism is increasingly recognized in both children and adults. Most children and adults have also received vaccinations for a variety of vaccine preventable diseases. NRHI officials said false statements were propagated in social media and other platforms stating an association between vaccinations (specific ingredients in the vaccines such as thimerosal) and autism. Numerous well-designed scientific studies have proven no association between vaccination and autism, yet unfounded concern continues to exist. This is leading to a real health risk for both children and adults contracting vaccine preventable diseases that lead to mortality and/or long-term disabilities.
Q: Newer vaccines are rarely effective. Should I be worried about the effectiveness of the COVID-19 vaccine?
There is no data to support the statement that newer vaccines are rarely effective. The opposite is true; for example, the chicken pox and shingles vaccines are both relatively new and both are highly effective. Since COVID-19 vaccines are still in development, it is not possible to state what their effectiveness will be; however, this should be part of the vaccine information that is released when the COVID-19 vaccine becomes available.
Q: I prefer natural or homeopathic remedies and therefore am concerned about the chemicals present in vaccines. Can they harm me?
It is important to remember that natural and homeopathic remedies are also chemicals, some quite powerful and not subject to regulatory oversight. It is prudent to question the ingredients in any product that enters the body. In the case of vaccines, the ingredients used to carry the active ingredients have gone through extensive testing and have been found to be safe.
Q: Like mask wearing, I believe vaccines are a civil liberties issue and I am within my right to refuse both, aren’t I?
It is not “against the law” to choose not to wear a mask or not to receive a vaccine; however, everyone who receives the benefits of being part of a society or community has the obligation to protect others in that society or community. Receiving a vaccine and wearing a mask should be considered one of these obligations, NRHI officials said.
Q: This is the quickest timeframe for the development of a new vaccine. Was the clinical trial process fully completed or is the government rushing a vaccine to market for political reasons?
It is COVID-19 that is pushing the vaccine industry because of the need to shorten the duration of the pandemic and limit ongoing morbidity and mortality from the virus. It is also true that political parties will want to “take credit” for bringing a vaccine to the American people; however, the ability to move quickly on vaccine development is the result of a large amount of dollars being put toward vaccine development. One thing to keep in mind is the companies that end up bringing the vaccine to market will be responsible if they produce a product that causes harm and this is an incentive to make sure it is safe as well as developed in a short timeframe.
Q: With so few members of the population supportive of getting the vaccine, why should I? Won’t the lack of vaccination among the majority of the population make it a waste of my time and effort?
It is true that some people express hesitancy toward a potential vaccine; however, the data do not show this is the majority view. Herd immunity (the protection of non-vaccinated individuals by being surrounded by immune individuals) will take a large percentage of the population to become immune through vaccination or if being infected creates natural immunity. By getting a vaccine people are helping achieve that goal; however, the most important reason to receive a vaccine is to protect oneself and those close to them.
Q: Will I have to pay the cost of the vaccine? Won’t the price by exorbitant since it is a new vaccine?
It is true that in the past new vaccines were initially more expensive and not necessarily covered by insurance. Because of the pandemic and the need to quickly increase immunity within the population, it is likely the vaccine will be free, covered by insurance or available at low cost.
Q: With so many different varieties of vaccines being produced by different pharmaceuticals, how will I know which one to choose?
At this point it is not known if all the different varieties of vaccines will be available. This is something that people should discuss with their healthcare provider as they will have access to information and should be able to help their patients choose what is best. Again, sources for more information include the CDC, major medical centers, and universities.
Q: I already had COVID-19 this year, so don’t I have immunity?
COVID-19 is still too new to know if contracting the virus and recovering provides immunity either in the short-term or long-term. Even if people have recovered from COVID-19, receiving a vaccination when available will likely be the recommendation.
The Network for Regional Healthcare Improvement (NRHI) is a national organization representing nearly 70 percent of the U.S. with its Regional Health Improvement Collaboratives (RHICs) and state partner membership. These multi-stakeholder organizations are working in their regions and collaborating across regions to transform the healthcare delivery system and achieve the “Triple Aim”—improving the patient experience of care, including quality and satisfaction; improving the health of populations; and reducing the per-capita cost of health care. To learn more visit nrhi.org.