Vaccine Hesitancy

According to a recent Pew Research Report, 39% of people questioned “definitely or probably would not get a coronavirus vaccine,” and only 37% are comfortable enough to be first in line to get the vaccine. Everyone has to make their own personal decision and that decision is based on facts, but also on emotions, worldviews, and values.

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Vaccine Hesitancy

What’s behind the reluctance to take the Covid-19 vaccine? Anti-vaccination sentiment is nothing new. There are many reasons, including fringe conspiracies. The surrealness of our lives in 2020, a lack of hard information, skepticism and social media all gave rise to waves of conspiracies. 

One such conspiracy claims the vaccine contains microchips designed to alter our DNA and track our whereabouts. It even implicated Bill Gates in the narrative. But conspiracists and Covid-deniers are a small minority, as are ardent anti-vaxxers such as those who believe childhood vaccinations cause autism.

But now there’s a new group, who are neither conspiracists nor anti-vaxxers. To some, it’s a paradox that this group includes healthcare workers.

Anti-Covid-19 vaxxers

“I’m not an anti-vaxxer, but…”

The new group is anti-Covid-19 vaxxers. 

Reasons for Reluctance

It feels scary to inject an unknown substance into our bodies. Proponents are saying it’s safe now, but it’s understandable to worry about what’s as yet unknown.

Fear of adverse effects 

Some are not sure how the vaccine may affect their future fertility. Some say they do not want to be guinea pigs but might feel more comfortable in a few months after watching others and with real-world proof. Some believe the vaccine could cause future disease. It’s important for reporting agencies to be transparent about side effects.

Misinformation

One fear, that of being injected with the virus, is based on the understanding that most vaccines contain a version of the same germ or virus that causes the disease. But messenger RNA is not a germ or virus. mRNA teaches our cells to produce an immune response (antibodies).

Lack of information

Some who have been infected already believe it’s not needed because they have antibody protection. It’s not yet known how long antibody protection lasts. Can you be infected more than once? Cases have been recorded.

Novelty and rapid research and development 

Since vaccines typically take years, even decades, to develop, many are concerned at how fast the vaccines were rolled out and do not trust the accelerated process. Was safety compromised? Scientists say no. Researchers leveraged previous vaccine research and had newer technology as well as a lack of financial barriers.

Cultural mistrust of healthcare authorities

Mistrust in Latino and Black communities exists due to historic medical racism. Black males were lied to in the Tuskegee Syphilis Study for over 40 yrs, going back to 1932. 

According to a Pew Research Report here's the breakdown by race of who would definitely or probably get vaccinated:

  • 83% English-speaking Asian Americans 
  • 63% of Hispanic 
  • 61% of White adults. 
  • 42% of Black Americans 

The numbers speak volumes.

Herd immunity: What is it? 

Herd immunity is when a large percent of a population becomes immune to a disease, reducing the chance of person-to-person transmission by reducing the available hosts.

The more contagious a disease is, the more people in the community need immunity. Measles is one of the most contagious diseases, and according to the Mayo Clinic, 94% of the population must be immune, which is the threshold for measles. Polio, smallpox and diphtheria have been contained by herd immunity.

Originally the WHO said 60-70% but Dr. Anthony Fauci, head of the National Institute for Allergy and Infectious Diseases, has recently said herd immunity could take up to 85% vaccine coverage

If entire communities of people refuse the vaccine then theoretically they are susceptible to the disease spreading quickly.  It could predict future hotspots of an outbreak.

However, it has not been proven that the vaccine prevents transmission. It’s possible that immunized people can catch the virus, not become sick, but still pass it on to others.

nurses-against-the-covid-vaccine.jpg.2ff30bc37bb95ebdcd84d56f221cfb9f.jpg

Nurse Responsibility

What is important is that we as clinicians stay informed on the latest vaccine data. Our words and actions carry weight with others. Be a source of credible information, and articulate your point of view.

I am receiving my second dose in days, and it’s a personal risk/benefit decision. I am over 65, work in a hospital, and there’s a good chance I could get very, very sick if infected. 

Be Safe

Finally, be safe. I can’t recall the source, but somewhere in Europe, maybe France, a leader said “pretend you have the virus and act accordingly”  If everyone did that, we could reduce transmission by distancing and masking.

Are you planning to get vaccinated and why or why not?

Best wishes and stay healthy,

Nurse Beth

Author, "First-Year Nurse",  the ultimate insider's guide to helping new nurses succeed while avoiding first-year pitfalls.

References

Herd immunity and COVID-19 (coronavirus): What you need to know. nd. Mayoclinic.org Retrieved January 10 2021.

Funk, Cary. Tyson, Alec.  2020. Intent to Get a COVID-19 Vaccine Rises to 60% as Confidence in Research and Development Process Increases. Pewresearch.org Retrieved January 10, 2021.

McNeil Jr., Donald. How Much Herd Immunity Is Enough? 2020. nytimes.org. Retrieved January 10, 2021.

The Tuskegee Timeline. Reviewed 2020.  CDC.gov Retrieved January 10 2021.

Doshi, Peter. Will Covid-19 vaccines save lives? Current trials aren’t designed to tell us. 2020. Retrieved January 13, 2020.

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Nurse Beth

About Nurse Beth, MSN

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Hi! Nice to meet you! I especially love helping new nurses. I am currently a nurse writer with a background in Staff Development, Telemetry and ICU.

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Specializes in Ped ED, PICU, PEDS, M/S. SD.

As a nurse, once I can get it I will get it. As a Christian, most people I talk with that are reluctant to get it just plain don't trust the government, or any agency connected to it. I honestly can't blame them. I do try to talk logically with them. Their fear of the government is stronger then the fear of catching the disease and even dying.  

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Specializes in Emergency Room, CEN, TCRN.

I’ve already had covid, and there’s no evidence that the vaccine will work longer than my natural antibodies. I’m willing to bet we end up having to get annual vaccinations a la the flu, so I’ll hold off on the vaccine this round for a couple reasons.

First, I work nights and scheduling to get poked when I’m normally asleep or on my day off is bogus

second, they rushed this out with very little clinical trials. For all intents and purposes, the early adopters ARE the long term clinical trial. I guess I feel it a little bit prudent to see if there’s any negative effects from the volunteers who got it first before rushing to do the same.

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Specializes in Mental health, substance abuse, geriatrics, PCU.

I got the vaccine and didn't hesitate to. However I can understand people's reservations. My trust issue comes to the fact that big pharma has done a lot of crooked things over the years, look at Purdue and the opioid crisis, they knew how addictive the drugs were but withheld that information. Pfizer has had lawsuits before over withholding information on adverse effects of drugs they're developing.

That being said, after having covid once,  I really don't want to take the chance of having it again. Despite misgivings I felt there was more risk in not taking the vaccine, and I encourage others to get it as well. But I can understand why some people don't want to get it. 

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Specializes in ICU, urgent care, family practice.

Reason for me holding off on getting it is mostly due to lack of information. Im pregnant and initial research studies do not offer much information on how the vaccine affects pregnant/lactating moms. I couldn’t live with myself if something were to happen to my baby because I decided to experiment in the unknown. I took maternity leave early and will continue to abide by infection control recommendations until baby is out. Once that happens, I will seriously consider the vaccine prior to returning to RN job. 

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Specializes in ER, Pre-Op, PACU.

I think everyone has to make a decision that’s best for their body. If there is a valid reason to hold off or think about it....such as currently breast feeding, a medical condition that contraindicates it, etc. then that may be the choice that is best for them. I always tell my patients - you have to do what’s best for you and your body. Why would any of us be any different?

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Specializes in LTC, SCI/TBI Rehab,RX Research, Psych.

Most educated people (nurses or not) are opting out because this is NOT a vaccine, in the sense that we know vaccines to be...It is a Phase 1a product...this is a CLINICAL TRIAL.

What alarms me, is that no AE tracking from one patient to another is being done, like in formal clinical trials (yes--I have worked Pharm Research..and every participant is given a diary to track and report AE's / adverse events, symptoms not typically experienced prior to receiving the study drug)

No way would I allow a Phase 1a drug to be introduced into my system.

And as far as mistrust goes, I definitely tend to agree with that. Just this past October, I obtained my flu vaccine. I was given the typical consent to sign..."are you allergic to eggs, egg  products"...

Afterwards, I was given proof of vaccination for my records. 12 hours later, I had a reaction. I grabbed my record of vaccination, and see the name, "Flucelvax" on the paperwork.  --I "googled it", only to find that this variant was a MDCK formulation..The cell-based vaccine manufacturing process uses animal cells (Madin-Darby Canine Kidney, or MDCK cells) as a host for the growing flu viruses instead of fertilized chicken eggs. For the 2020-2021 season, the viruses provided to the manufacturer to be grown in cell culture are cell-derived rather than egg-derived.  --- Cocker Spaniel kidney cells--supposedly, to avoid a 'disruption in egg supply' - Really? Who is this drug company trying to fool.

So--Nope. No COVID "vaccine" for this nurse.

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Specializes in Psych.
5 minutes ago, yadda_yadda_yadda said:

What alarms me, is that no AE tracking from one patient to another is being done, like in formal clinical trials (yes--I have worked Pharm Research..and every participant is given a diary to track and report AE's / adverse events, symptoms not typically experienced prior to receiving the study drug)

I'm not sure if its the same thing, as I haven't engaged in something similar, but I was given a QR code to scan, which enrolled me in a symptom tracker. Every day, I was texted a symptom survey, asking about how I felt, any symptoms, including write-in sections for anything not listed. The code generated an account that contains my name, the vaccine batch, the facility that gave the vaccine, etc. I go for my second round in a couple days!

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I don't work as a nurse any longer. I am permanently disabled due to a progression in my EDS and Fibro as well as Prednisone causing many side effects, having taken it over 20 years due to my kidney transplants.

I won't take the vaccine because my transplant center won't approve it yet. They want to see the results of the trials John Hopkins is doing on transplant patients... their antibody level before and after and all that jazz.

Also, because of my autoimmune stuff, and mast cell reactions, and quite a few allergies we know of, from all the information that I have read, it isn't safe for me to take it.  I believe if I didn't have everything going on that I do have, I would end up getting the vaccine.

My dad plans on getting it. My dad's neighbor got her first dose yesterday because they have a list for those in the upper age bracket to sign up for at a couple of places here in my small town.

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Specializes in LTC, SCI/TBI Rehab,RX Research, Psych.

@ChickenHealer-- Good to finally hear from a recipient that a symptom tracker/ diary IS being done.

I'm not a conspiracy theorist by ANY means...but the dangerous deceit I experienced with receiving the MDCK version of a flu shot does make me think twice.

As a nurse of nearly 3 decades, I totally understand the need for a fast response to the pandemic, too...so, naturally, PEOPLE are needed...to get some sort of blanket of immunity out there.

You mention autoimmune issues as a hesitancy...I didn't disclose in my original post, my Dad passed away from MSA (Multiple Systemic Atrophy) in 2018...it was explained to him as an 'aggressive neuro-degenerative disease, best likened to Parkinson's Disease' --- so that hereditary component cause me to stop & pause, too.

 

Best of health to you ❤️

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I hesitated for three or four weeks for a few reasons, and here they are: I have a (less serious) autoimmune condition. I have a anaphylactic response to three different medications (not vaccine related). I don't feel particularly high risk with regard to serious covid illness. I don't like to be the first one to try anything. I had to make an appointment and go in on my day off to get the vaccine. I was worried about common side effects that might make me feel too sick to work or take care of my kids.

In the end, after a little more reading and asking around, I did get vaccinated with my first dose. My original plan was to ask my doctor about it, but time goes by too quickly ...or maybe I just waste too much time sitting around.

I felt sore, sweaty, weak, and trembley the day after I got the vaccine, but by the second day, I was fine. I heard the second dose can cause a more intense discomfort.

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Specializes in HD, Homecare, Med/Surg, Infectious Disease.
On 1/20/2021 at 12:56 AM, gere7404 said:

I’ve already had covid, and there’s no evidence that the vaccine will work longer than my natural antibodies. I’m willing to bet we end up having to get annual vaccinations a la the flu, so I’ll hold off on the vaccine this round for a couple reasons.

second, they rushed this out with very little clinical trials. For all intents and purposes, the early adopters ARE the long term clinical trial. I guess I feel it a little bit prudent to see if there’s any negative effects from the volunteers who got it first before rushing to do the same.

These are my exact thoughts. Pfizer’s & Moderna’s mRNA vaccines were tested in approx 78k people collectively (with only approx half of that receiving the vaccine). That is 0.0002% of the US pop. (using 2019 #s). In the world of science this says “the results seem promising but further research is needed before extrapolating findings as safe for worldwide human use.” I’m not willing to be part of a clinical trial & that is exactly what recipients are. 

I keep seeing people say “the technology was being researched since SARS & MERS.” The seeming benefit of mRNA has actually been researched much longer but vaccine technology suitable for use as a vaccine did not exist during SARS (2002) and MERS (emergence 2012 with 2 outbreaks later) (2, 1). The technology breakthrough by Moderna came about in 2018 and they ran into the same problem as Katalin Karikó, the Hungarian scientist originally advocating/researching use of mRNA: optimal doses produced extreme reaction of the animal immune system but lower doses were ineffective (2). Perhaps this is why people prone to allergic reactions may react severely (requiring an Epi-pen) or why people who are immunocompromised (referencing poster above) should not get this vaccine? 

My husband and I (healthy) have had COVID-19 in early Nov. Very mild cold s/sx for me (36yo) with about 14 days of anosmia & impaired taste. My husband (33yo) had mild SOB when sick which persists with prolonged talking, he says. Neither of us plan to be vaccinated. There is no proof the vaccine confers any improved immunity over illness. I plan to participate in donating convalescent plasma through the ARC if they decide my antibody levels are acceptable.

As healthcare personnel, we are educated to follow evidence-based practices. So far the evidence hasn’t proved anything other than that it’s shows promise at preventing severe illness but needs further testing (long term immunity, long term safety, immunocompromised population, pregnant women and children). When people who know I’m an RN ask me, I give them information to make their own informed decision. If they fall into a high-risk group for severe COVID-19, I usually say you'd likely benefit. But I also am not pleased to see healthcare providers seemingly guilting people into taking this vaccine with the “I did my part“ propaganda stickers. That is not appropriate.

1.https://jbiomedsci.biomedcentral.com/articles/10.1186/s12929-020-00695-2

2.https://www.statnews.com/2020/11/10/the-story-of-mrna-how-a-once-dismissed-idea-became-a-leading-technology-in-the-covid-vaccine-race/

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