Vaccine Hesitancy in the Age of the COVID-19 Pandemic: A Greater Reflection of a Dangerous and Declining Trust in Science and the Media, and What Can be Done

To believe or not to believe. To trust or not to trust. To take the vaccine or to not, leaving yourself and others more vulnerable to a viral infection. The answers are vested in the levels of confidence and faith in science and medical institutions, and just as formidably, through a reader’s ability to discern false claims from the truth in news and media. 

In the context of living two and a half years into a pandemic, where misleading claims and misinformation run rampant, the media has added yet another driving force for decisions made regarding the safety and efficacy of COVID-19 vaccines, and thereby the ultimate individual choice to accept this form of protection into one’s body. It is no longer safe to assume that scientists alone can instill or even restore trust within individuals. 

Those skeptical about the vaccine’s origin and safety are dubbed as ‘vaccine hesitant’. And with how ubiquitous COVID-19 and vaccines have become in our lives, it is no surprise how much attention these matters have received and how much attention we’ve given them. Yet this attention is often steered into confining echo chambers and other breeding grounds for advancing politically motivated agendas. And naturally, the immediacy of the issue lends individuals to make decisions based on heuristics and how quickly they are able to access information. 

American Pulitzer Prize winning investigative science journalist David Willman pointed out how simply hearing or knowing individuals affected by the virus can incite consciousness of the virus’s danger and immediacy. “You have a pathogen that’s everywhere,” said Willman. “So if your cousin, three counties away, is telling you on the phone, ‘Hey, ten people dropped dead on my block last week’, you’re going to care. Because you just wonder, how long is it going to take to get here?”

According to the World Health Organization (WHO), vaccine hesitancy was rated as one of the top ten threats to global health in 2019. The contentious issue, however, is no novel concept. In its infancy in 1798 when the smallpox vaccine was developed, vaccines sparked controversy. And importantly, our willingness to take vaccines consults our trust in science: another trend that has plummeted over recent decades. In the 1970s, 75% of Americans reported having trust in medical professionals. Today, only about a quarter report confidence in the healthcare system, according to The New England Journal of Medicine. 

But societal trust in healthcare is not the only facet to confidence in vaccines. Our readiness to take them also depends on sifting through hundreds of misleading and inflammatory headlines and developing the eye for what is true and what is, simply put, bologone. 

Julie Rovner, a health policy journalist for Kaiser Health News who covers vaccine hesitancy and a number of other controversial health issues, cites a number of factors. “People are vaccine hesitant, or accepting, depending on what the people around them think and what their doctors tell them,” said Rovner. “You get it from healthcare practitioners and from friends, neighbors, relatives. There are communities of vaccine hesitancy,” continued Rovner. 

Osteopathic physician Dr. Joseph Mercola, who touts natural supplements and berates COVID-19 vaccines for its withheld data by governmental institutions, is one of them. But he is also infamous for spreading COVID-19 misinformation. “COVID-19 vaccines are the single most overhyped and oversold vaccines in history, primarily because of pharmaceutical and political influence,” said Mercola. Instead of placing the burden of protection on vaccines, he assigns individuals to eliminate all vegetable oils and most processed foods to develop a strong immune system against infection. 

“Optimizing your metabolic health creates authentically effective immune resilience,” said Mercola, citing his book Fat for Fuel and Effortless Healing. While stronger immune health typically leads individuals to more robust protection from viral infections, it overlooks individuals with immunocompromised systems or other underlying health issues. For those with such backgrounds, Mercola presupposes individuals maintaining a perpetually healthy state for which would provide them with enhanced immunity. 

But things aren’t that simple, especially when it comes to health, and proclaiming those views only perpetuates misunderstanding and distrust in how viruses work and why it disproportionately affects individuals in underserved communities at higher rates. It does a disservice to scientists working hard in the lab, physicians on the front lines, and high risk communities who would benefit the most from vaccine protection. The very communities that possess deeply-embedded distrust towards scientific institutions.

Accumulation of such sources that reflect and reaffirm pre-existing beliefs intensify inherent biases. “We live in a hyper-polarized society and that fragmentation is amplified by all sorts of forces, including social media,” said Willman. “Whether it’s coincidental or causal, the pandemic has probably accentuated this.” 

And the presence of alternative facts floating in the ether complicates matters further. Ed Avol, a Professor of Clinical Population and Public Health Sciences at the University of Southern California, noted how this added factor creates the trifecta responsible for vaccine hesitancy. “In recent years, in this country and elsewhere, but primarily in this country, we have this emergence of alternative facts: if you don’t like the information you make up your own. And if people believe it, then that’s another thing to deal with.” 

If individuals are provided with information that does not clearly illustrate how it will safeguard their interests or sense of self-preservation, they consequently construct facts that restore their sense of security and help them make sense of their own confusion. To do so, intuition comes into play–a dangerous result of lack of transparency whilst communicating science.

In fact, the lack of transparency from the scientific community is perhaps one of the most supplanting aspects for combating misinformation and promoting understanding of science. According to a New York Times article, the Center for Disease Control and Prevention (CDC) isn’t publishing large portions of the Covid data it has collected, which, if published, could reveal the populations at highest risk and help state and local health officials better target their efforts to bring the virus under control. 

Other reasons that individuals cite for vaccine hesitancy include the lack of long-term data and the speed of development and authorization for use. My stepfather Chris Jimenez, who labels himself as vaccine hesitant, echoed these views. “This pandemic came out of nowhere and all of a sudden there was a cure,” said Jimenez. “To me, there wasn’t enough empirical data or real-world testing. It was just approved for emergency use, and I didn’t want to take something that would end up hurting people.” However, Willman noted it is simply not feasible to wait years and extensive trials during a global crisis. COVID-19 vaccines went through an accelerated approval process after completing required and standard phases of vaccine development and testing. Yet, the public seems to miss out on important information, partly attributed to deficient communication coming out of the science realm.

“No long-term effects can possibly be known because these are novel vaccines. Our health agencies are hiding negative data about the vaccines,” said Mercola. But some of this concealment also stems from the “fear that some of the information might be misinterpreted,” said Kristen Nordlund, a spokeswoman for the CDC. 

So, the question remains: what can be done about all of this? Perhaps we must consider how, then, to mitigate the possibility of misinterpretation of data. Mostly, because it is counterproductive to the very fear outlined in their argument. Concealing or curbing pertinent information on the virus and its surrounding vaccine development only foments skepticism, apprehension, and hence, vaccine hesitancy. It is then necessary to enumerate systematic changes critical for promoting understanding and restoring trust in science and the platforms that convey relevant news about COVID-19 and vaccine developments.

Working to restore trust in science and media precedes the ability to reduce incidences of vaccine hesitancy. A study by the Gerald R. Ford School of Public Policy’s Science, Technology, and Public Policy Program found two main causes of public mistrust: limitations and failures in scientific and technical institutions, and institutionalized mistreatment of marginalized communities.

And with the U.S. performing significantly lower on pandemic management and response compared to other western countries with similar levels of preparedness, markedly improving institutional trust is especially critical for now and the future. “The Lancet study said that the countries that did the best in the pandemic were those that had the most trust in government,” said Rovner. It is only plausible that we find solutions for how we might reconcile past failures and reinvigorate a newfound trust in science.

Media literacy:

Media literacy and science literacy are joined at the hip. One cannot exist without the other. Put simply, the world needs to understand how to navigate an increasingly polarizing climate to combat misguided, or even worse, uninformed decision-making. Willman urges that in order to fully grapple with the news being consumed at hand, especially news that presents purported scientific claims, consumers must ask the question, ‘What is the basis of assertion?’ 

Of course, this places a level of responsibility, perhaps even a burden, on the consumer to think more critically and to duly challenge the information conveyed. But it is nonetheless a responsibility that is warranted for those that decide to take the step of consuming news in the first place. You accept the burden when you accept the task. Thankfully, health-related journalists are there to make individuals’ lives easier when reading news on complex scientific and health policy related topics. Rovner is one who believes that informed decision-making is guided by being thorough and accurate as a journalist. “My goal is to give people actionable, correct information for them to be responsible citizens,” said Rovner, reflecting on her career as a health policy journalist. “I try to bring complicated information to lay people and explain it in terms that they can understand.”

Finding ways to detect misinformation is another way to mitigate the spread of inaccurate or groundless information. “There is an inability to tell reliable information from unreliable information,” said Rovner. For consumers navigating news outlets inundated with COVID-19 information, mastering the art of diversifying sources, finding credible information, and checking our own biases is critical to restoring a balanced news climate. 

(insert visual of how to curb the spread of misinformation)

We must also approach science news with an analytical mindset, and the first steps to do so include heightening our literacy in science. “At a fundamental level, it is to find out what’s happening and understand it well enough to be able to translate it in a way that a lay readership would understand,” said Willman. Avol mirrored these views in how scientists should communicate more effectively and powerfully. “It’s a very different setting when you’re talking about scientific results in a conference than when you’re trying to present scientific information and take home messages to the public.”

Transparency of science and governmental institutions: 

To overlook science communication and its deficits would be omitting a critical feature that helps explain the genesis of COVID-19 confusion. Unless you have a doctorate, education, or self-developed expertise in science, understanding science or knowing when it is appropriate to challenge is a difficult feat. It is a subject filled with complex concepts and technical language. In improving the health of public trust in science, scientists should be willing to traverse their comfortable territory to the media where their studies are relayed. 

By informing the public of scientific processes and insights and keeping us in the know throughout the ever-evolving and lengthy studies that is research, scientists can actively work to promote engagement and more informed decision-making that considers both individual and public health. Their involvement in countering misinformation would also help policymakers avoid introducing harmful policies. 

(insert visual of how vaccine development works here). 

One of the single most important, yet overlooked, facets of scientific inquiry, is its dynamic nature. “Evolving information is a cornerstone of science, but it’s understandably challenging, if not downright frustrating for the public,” said Avol. “In science, some things are absolutes. But [scientists] don’t mind finding out that hypotheses are wrong or need to be adjusted, or that based on new evidence, we need to change them,” continued Avol. 

As data continues to be collected about the novel coronavirus and emerging mutations, scientists must first illuminate the public that data collection is an ongoing process and hypotheses can be subject to change. Then, it would be fitting for scientists to elucidate any changes made to initial assertions. It is essential they put communication at the forefront of their priorities to maintain the integrity of science and to provide context, especially in the midst of a pandemic. Only with the knowledge of how to interpret science, its structure, and its processes are we able to then critically scrutinize it. 

“The way we improve trust is being clear about what the evidence shows; trying to explain it in a way that sort of demystifies what we think we understand. But also explaining that we don’t have all the answers,” said Avol. “We are continuing to do the research and learn more. We learn more about, for example, vaccine hesitancy by studying the population who are both hesitant and who are conforming, and then learn something about who is getting sick, who is not getting sick.” 

There is a collective interest for scientists and journalists to promote transparency and understanding of science and COVID-19.”We’re all entitled to our own opinions, but we’re also entitled to the facts behind it. So we need that transparency,” said Willman. 

Each participant that contributes to COVID-19 reporting and its participation provides a form of feedback and evaluation of how well journalists and scientists are communicating relevant information on COVID-19 and vaccines. Making data more accessible by clear and effective communication mitigates misinformation and encourages the formation of opinion-networks. For the public’s sake, a greater comprehension in science creates a more informed and consequently healthier society; and with that, comes reinvigorated trust in science and those that convey its news and fundamental discoveries.