Last year, the World Health Organization named vaccine hesitancy one of the top health threats. This year, a pandemic.
Like its predecessors SARS, Ebola and H1N1, experts say the novel coronavirus outbreak should serve to underscore the importance of vaccines.
So it’s understandable, then, that eyes have turned towards the anti-vaxxer community to see how they’re responding to COVID-19, which has shuttered entire countries and infected upwards of two million people around the world.
So far the response has been predictable if surprisingly quick to materialize, says Dr. Timothy Caulfield, research director at the University of Alberta’s Health Law Institute and author of The Vaccination Picture.
Anti-vaxxers have questioned whether it’s necessary to practise physical distancing, spread fear about COVID-19 being used to introduce “forced vaccinations,” and shared other far-out conspiracy theories like “Italy goes through this every year, we just don’t report on it.”
(For the record, Italy does not find itself in an annual position of having to pick who lives and who dies because it does not have enough life-saving ventilators for every person who needs one.)
“We really are living through a moment that should remind us what the world would be like without vaccines,” Caulfield says.
“Vaccines allow us to develop immunity, they allow us to not have to implement the kind of preventative strategies that we’re all living through right now.”
And while most experts will tell you changing the minds of hardcore anti-vaxxers is next to impossible, there is the possibility of nudging the vaccine hesitant — some 20 to 30 per cent of Canadians — in the direction of science, as Caulfield puts it.
So, he says, it’s important we make sure people get the vaccine information they need, while showing them how to avoid rampant misinformation as they devour headline after headline about COVID-19.
“People should be skeptical,” says Caulfield. “This is a time to turn to the trusted voices that are aggregating the science as it evolves.”
It’s the unknowns that Ted Kuntz thinks about.
Kuntz is the president of the board of Vaccine Choice Canada, an organization that describes itself as a non-profit that “empowers” people to make informed decisions, but that Caulfield — a vaccines expert — puts unequivocally in the anti-vaxxer category.
“I don’t think we really understand how transmissible it is, who’s really at risk,” says Kuntz. “We’re making pretty significant decisions, life-changing decisions, decisions that are affecting our economy, our health care, our education systems based on what appears to be an inadequate amount of information.”
There is a lot we do know:
- We know the average infected person is estimated to infect between two and four other people, a rate that is higher than influenza but lower than measles.
- We know the virus is spread through droplet transmission, like other respiratory viruses.
- We know the virus survives between several hours to a few days on surfaces.
- We know age isn’t the only risk.
- We know Black Americans are being killed by COVID-19 at rates much higher than other Americans.
- And we know the best way to protect yourself is by washing your hands (something Caulfield says he’s seen anti-vaxxers try to position as an alternative protective measure to vaccines).
Even still, Kuntz says he’s mostly concerned the rush to develop a coronavirus vaccine will mean “bypassing animal studies and not taking the time that ought to be taken in order to make sure the product is safe.”
Of course people want the vaccine to be developed as quickly as possible, says Caulfield. People are sick and dying.
“But the research community recognizes the importance of doing this right,” he says. “A vaccine that is not effective or a vaccine that has inappropriate risks associated with it is just going to create big problems long term.”
Once a vaccine is developed, that doesn’t mean it’s done and dusted, never to be monitored or tinkered with again, says Dr. Natasha Crowcroft, director of the Centre for Vaccine Preventable Diseases at the University of Toronto.
There are risks and benefits, she says. “It’s always a balance.”
What Crowcroft says we really need is a system in place after vaccines are approved to track their usage, which should be feasible now given Canada’s use of electronic medical records.
“We should have better data on health than we have on almost anything else, so I’m hoping that will help us be really, really vigilant on vaccine safety,” she says.
“We need to make sure our systems are as good as they can possibly be.”
Both Crowcroft and Caulfield hope science will emerge stronger from the coronavirus pandemic. After all, Caulfield says, “vaccines are probably the single greatest invention of biomedicine. They save millions of lives every single year.”
But thinking back to the vaccine response to the H1N1 pandemic in 2009, Crowcroft has some doubts.
She remembers the initial headlines evoking fears of the Spanish flu in 1918 repeating with H1N1, followed by coverage saying, “Oh, this isn’t as bad as we thought.” That meant interest in a vaccine had dwindled by the time one was created, so even though it spiked briefly after H1N1 killed a teenage boy, it dwindled again.
“Everybody wanted to get it and then everybody forgot and then the story went away,” she says, “ so the uptake of the pandemic vaccine was around 40 per cent.”
COVID-19 might be different because the conversation is different, Crowcroft says. While people initially seemed to view the risks from an individual perspective (remember the spring breakers who defied physical-distancing guidelines because they were young?), there is more of an understanding now that we stay home not just for ourselves but also for others.
“It’s very concrete,” Crowcroft says, in a way that changes the stakes. “It’s about doing something to protect my mother, my father, my grandfather.”
So, for now, she’s hopeful.
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“I really hope we see how important public health is, and how we need to look after it and not undermine it and cut it and suppress it.”