From Bill Gates to Angela Merkel, experts and political leaders think the only way to return to normal after the pandemic is to develop a vaccine and immunize billions of people against coronavirus.
But as the world races to develop a coronavirus vaccine, policymakers may struggle to convince people to get immunized.
Genuine fears about debunked vaccine side-effects and mistrust in leaders, experts and the drugs industry have fueled rejection of vaccines among many in Europe, which was the most vaccine-skeptic region in the world in a 2019 survey.
The preliminary results of a survey being run by the Vaccine Confidence Project — which monitors public trust in vaccination programs worldwide — and ORB International show that between mid-March and mid-April of this year, one fifth of Swiss respondents and 18 percent of those in France would refuse a coronavirus vaccine. Among Austrians, the number is 16 percent, and 9 percent in Germany.
While this may not be enough to block efforts to reach so-called herd immunity — estimated at 60 to 70 percent — European governments know only too well how vaccine skepticism can derail national vaccination plans, as recent controversies have shown.
That puts decision-makers in a Catch-22 situation.
On one hand, a vaccine has to come when the risk of infection is still high, but if it comes too soon, people may not trust that it's safe.
German Health Minister Jens Spahn earlier this month rejected the idea that a future vaccine may be made mandatory in the country, saying a majority of people would want to get vaccinated as soon as it became available.
That does not include the world's top-ranked tennis player Novak Djokovic, who opposes vaccination and said he would have to make a decision if traveling to tournaments becomes contingent on getting vaccinated, according to the Guardian.
When it comes to other people's readiness for it, timing is of the essence, said Heidi Larson, director of the Vaccine Confidence Project.
“If they see there is still a threat — the second wave perhaps — they’re going to be more open to it,” she said. But if that appears to be waning, they may not want to take the risk of a new vaccine that we don’t know enough about, she noted.
In the U.K., 7 percent of those surveyed — representative of the country's population, according to Larson — said in mid-March they would refuse to be vaccinated against coronavirus. When the number of deaths rose two weeks later, that figure dropped to 5 percent. "Now that they see the numbers are coming down, it goes up to 9 percent saying they would refuse," Larson said.
Marco Cavaleri, head of Biological Health Threats and Vaccines Strategy at the European Medicines Agency, is well aware of the dilemma facing decision-makers in rushing out a vaccine and making sure it's safe.
“We have to be sure that this trade-off is not compromising the certainty that we need to have around the safety of the vaccine,” he told reporters Thursday. For that, the EU’s drug regulator has to work with vaccine developers to understand what kind of evidence they can provide in the shortest possible time, while giving sufficient reassurance that these vaccines are safe and effective, he said.
But that will not be enough to convince Marie Werbrègue, president of the anti-vax group Info Vaccins France.
She would refuse and advise against any vaccine that is developed because “I know it would not work, that it would be dangerous and not tested at all,” she said, claiming that some vaccine trials skipped completing animal tests before being given to people.
Werbrègue doesn’t believe the world is going through a pandemic.
“It’s a type of flu, like the others,” she said, adding that numbers are manipulated to scare people for political and financial purposes.
Social media is rife with theories that international groups created the virus to get people vaccinated, implicating the World Health Organization and Bill Gates as the main suspects, given the substantial funding the latter’s foundation provides to the former.
"It's confounding when you see that out there," Melinda Gates told POLITICO. "When there's more anxiety, and people have more time on their hands, they want to, you know, attack someone.”
People are more likely to latch onto conspiracy theories when times are uncertain “because they feed into a need of control and psychological certainty, and provide simple answers to complex questions,” said Sander van der Linden, a social psychologist at the University of Cambridge.
But David Salisbury, an associate fellow at Chatham House’s global health program, is not convinced these would deter people from getting vaccinated, because they understand the severity of the virus.
“If their perception of this virus is that it can kill them or make them extraordinarily ill, and the studies to date show the vaccine is safe, I think it would be a foolhardy choice to put yourself and your family at unnecessary risk,” he said.
But conspiracy theory experts are not so sure. Stephan Lewandowsky, a cognitive psychology professor at the University of Bristol, said there is a clear link between conspiracy theorists and anti-vaxxers.
“My best guess is that in Europe, most people will be delighted by the availability of the vaccine and will line up to get it so life can return to normal,” Lewandowsky said, but “we cannot be sure until the vaccination arrives on the scene.”
“You're always going to have this kind of alternative thinkers at the edges, and we have them in general, with vaccines,” said Larson at the Vaccine Confidence Project.
But there are also many who don’t believe in conspiracy theories, but have safety concerns and think the decisions about vaccination are top-down, without giving them a say in the matter. “Parents feel like they just want to ask some basic legitimate questions and, you know, they're being either judged or shunned,” she said.
Larson has written a book – called "Stuck" — about the issue, expected to be published this summer.
“One of my points is that we don’t have a misinformation problem, we have a relationship problem,” she said. Misinformation can be deleted, but the underlying distrust that has caused it remains, she said.
Italy is one of the countries that has struggled with that and in 2017 introduced a law that increased the number of mandatory vaccines to 10, mainly in response to a measles outbreak. The issue has become highly political, playing out in the last round of elections.
As the country cautiously emerges from the first wave of the pandemic, the debate on mandatory vaccination is certain to be a heated one.
The government is made up of a coalition between the 5Star Movement, which has long led a battle against the obligation to vaccinate, and the center-left Democratic Party, which increased the number of mandatory vaccinations when in power in 2017.
Health ministry officials said Health Minister Roberto Speranza, from the minority left-wing LeU party, is favorable to a legal obligation to vaccinate for the elderly and those with pre-existing conditions, when a vaccine comes to the market.
Pierpaolo Sileri of the 5Stars, deputy health minister and recovering coronavirus patient, said that he had “no doubt that such a vaccine should be mandatory,” according to La Repubblica.
But not everyone agrees.
Davide Barillari, a regional councilor in Lazio, thinks a vaccine is not the right way to go in this epidemic.
“There is no guarantee that the vaccine is safe and reliable, and the obligation is not the correct solution,” he told POLITICO. “The obligation seems an authoritarian response to a need for security that can be guaranteed in other ways.”
Elected for the 5Stars, Barillari was expelled from the movement in April for launching a website giving information on the coronavirus not endorsed by the party.
Larson warned that how public health authorities act in this pandemic is crucial, not just in stopping it, but in gaining — or further losing — people’s trust.
Since “we’re not going to have the vaccine for a while,” it’s a good time to start consulting with the people on how to go about it, she said.
“Either it could be used as a trust-building [time], or it can add to the litany of historical events where they felt betrayed or left out or excluded, which adds up to some of the contemporary distrust,” she said.
Judith Mischke contributed reporting.
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