#ElonExperts: A look at public hesitancy about the COVID-19 vaccine, and how to overcome it

Assistant Professor of Biology Jessica Merricks offers insight into why there is some hesitancy about the COVID-19 vaccine, and steps that the scientific and medical community can take to help overcome those challenges.

As COVID-19 vaccination efforts expand nationally, there are many among the U.S. population who are reluctant to receive one of the newly developed vaccines. That reluctance is based on many factors, including their views of the virus, the process and speed with which these vaccines were developed, the fear of potential side effects, and historical abuses of marginalized populations by the medical industry.

An Elon University Poll survey conducted in late January found that a growing number of North Carolinians are in favor of getting the COVID-19 vaccine, with nearly 60 percent of N.C. adults saying they have received the vaccine or will take it once it’s available. That rate was lower among Black residents and other people of color, Republicans and women.

We caught up with Jessica Merricks, assistant professor of biology, to get her take on the science behind the vaccine and its development, why certain populations may be more reluctant to take the vaccine, and what she’s looking for as vaccination efforts progress.

What is the goal of these vaccines – to lessen the effects if you do get COVID-19, to prevent the transmission of the virus or both?

While vaccines vary in terms of the way they are made, their ultimate goal is to help us build a defense against the virus. The vaccines by Moderna and Pfizer being administered around the country are mRNA vaccines, which teach our bodies to create a protein that looks like part of the virus. When our immune system comes across this protein in our blood, it initiates our body’s natural defense system, producing antibodies that will protect us if the real virus ever enters our body. The result: our body knows exactly how to fight COVID-19, meaning we will experience little or no mild/moderate symptoms of the disease, and no severe or life-threatening effects.

As more people become vaccinated, researchers will be able to tell us for sure just how effective the vaccine is for preventing transmission. Initial results are promising, but for now, we don’t know about the transmission part. In theory, vaccination should lower transmission rate because it reduces the viral load (the amount of virus in the body). As our body builds antibodies in response to vaccination, the virus should not be able to settle in and reproduce as well as it could in an unvaccinated person. The bottom line, vaccines are one tool in our toolkit to slow the transmission of COVID-19. We must continue to wear a mask and social distance into the near future.

How confident are you in the scientific process that was used to develop these COVID-19 vaccines? What gives you confidence in the process?

I think it’s normal and healthy for people to have a bit of skepticism about the development of the COVID-19 vaccines. Typically, it takes 10-15 years for a vaccine to make it to market, and only about 6 percent of proposed vaccines ever make it. Those are not great odds! However, it is important for people to understand that the technology behind the COVID-19 vaccines did not appear out of thin air.

Since SARS-CoV-2 is closely related to the virus that led to the SARS outbreak 20 years ago, scientists had two decades of knowledge about the physiology, genetics, and evolutionary history of this virus to work with. That knowledge, combined with access to the genome of the virus in early 2020, allowed for the speedy development of the vaccine.

Even though the vaccines were produced quickly, scientists and regulators did not cut corners. All of the vaccines that have been approved had to go through the same rigorous phases and trials as any other vaccine. The only difference here is many of the phases were allowed to happen concurrently instead of sequentially in order to ramp up production. With that said, I am very confident that the COVID-19 vaccines out there are well-researched, safe, and effective.

Mistrust of the vaccine is higher among some minority populations, including among Blacks. What are some of the roots of that mistrust, and what efforts have you seen to overcome that mistrust?

It is no secret that there have been significant problems between the Black Americans and the medical community. From the historical mistreatment of Black Americans (like the Tuskegee Syphilis study and the unauthorized use of Henrietta Lacks’ cells for cancer research), to the modern-day disparities in health care (like fewer individuals covered by health insurance, higher rates of heart disease, stroke, and female reproductive challenges), it is understandable that the Black community as a whole isn’t lining up to be a “guinea pig” for the COVID-19 vaccine. To this I say, I get it. Nothing can erase these facts. However, there is no biological reason that the vaccine will act differently in people of color. Because we are aa much higher risk for contracting COVID-19 and experiencing severe, life-threatening symptoms from the disease, it is crucial that our community get vaccinated.

Beyond just the Black community, I think many people feel hesitancy for two reasons: (1) misunderstanding about the way vaccines work and (2) fear about adverse reactions to the vaccine. To be clear: the COVID-19 vaccines cannot give a person COVID-19. They are safe for anyone who is healthy enough to take the flu vaccine. Unfortunately, rumors about adverse effects from the vaccine have many people believing that the shot will make them ill.

In reality, most people will experience a predictable set of mild symptoms after their second dose (things like headache, soreness, and fatigue). While temporarily inconvenient, these are great signs that the body is doing its job – building up immunity against COVID-19. These symptoms are mild in most cases, and in all cases, are far easier to deal with than full-blown COVID-19. A very small percentage of people have severe reactions, like anaphylaxis (an allergic reaction). Such a reaction is likely to happen very soon after injection, which is why recipients of the vaccines are required to wait at least 15 minutes before leaving the vaccine facility in order to get quick treatment if necessary.

I’m encouraged when I see people in my community post open and honest information about their own experiences with the vaccine. It’s great to hear the facts from the experts, but I think more people will trust the vaccine when they see their family and friends getting vaccinated. As soon as I am eligible, my bare arm will be all over social media!

Much attention has been placed upon variants in the virus that are more easily spread. Does that mean back to the drawing board to develop new vaccines, or is it possible to adapt those now in use?

Not necessarily back the drawing board. Viruses mutate all the time. That’s why we need a new flu shot every year. Due to the design of the COVID-19 vaccines, the hope is that they are general enough to work against some variations of the virus. Early results suggest that the vaccines currently being distributed work against the new variants, though they may be slightly less effective.

We have to recognize that we are shooting at a moving target, though. Drug companies are already looking into ways to stay in front of this rapidly evolving virus. Pfizer, Moderna, and Johnson & Johnson have already shared some of their ideas. One possibility is a “booster” shot, in which people who have already been vaccinated get a follow-up dose 6-12 months later. There are many possibilities out there and drug companies are wasting no time exploring them.

As we learn more about where specific variants are located and how they impact infection and transmission, researchers will continue to tweak the vaccine to maximize its impact. Even if vaccines are slightly less effective, as long as they prevent severe symptoms, hospitalizations, and death from COVID-19, they are doing their job.