(source: cidrap.umn.edu)

Phyllis Kimber Wilcox | Black Voice News

America is gaining ground regarding the numbers of people who have chosen to be vaccinated. Although many have chosen to do so, there remain many who have not. As a result, vaccine hesitancy is being discussed everywhere.

What does  “hesitancy” mean and how will it impact efforts to stop the pandemic? 

Vaccine hesitancy is described as an unwillingness to take a vaccine or vaccines. Lately, the term is also being used to describe those who have received the first dose of one of the available COVID-19 vaccines but who aren’t returning for the follow-up dose.

There are concerns the unwillingness of people to be vaccinated or to receive full doses of the available vaccines will prevent the development of herd immunity. What constitutes herd immunity differs, but current estimates are that between seventy and eighty percent of the population should be vaccinated to reach the goal of herd immunity.

Hesitancy to be vaccinated has not just affected members of the general population but also members of Congress. According to an article in  The Hill only seventy five percent of the members of Congress have been vaccinated, slowing efforts to ease Capitol coronavirus restrictions.

Choices

The three COVID-19 vaccines authorized for use in the U.S. include Pfizer’s Biontech, Moderna, and Johnson & Johnson. (source: health.wusf.usf.edu)

There are three COVID-19 vaccines available for use in the United States. All three have different efficacy rates as well as vaccination requirements:

Pfizer’s vaccine requires two shots and is 95 percent effective—although the Centers for Disease Control and Prevention (CDC) study shows a smaller effective rate of 90 percent. This vaccine was recently authorized by the Food and Drug Administration (FDA) for those between the ages of 12 and 15 years.

The Moderna vaccine  requires two shots and is 94.1 percent effective although it is less effective for  patients sixty years old and older. Efficacy in this age group is only 86.4  percent.

The Johnson & Johnson vaccine only requires one shot and has a 64 percent overall efficacy, though it has proven to be more effective, 82 percent, against severe COVID-19 disease in South Africa where the B1.351 variant was first detected.

Additional Concern Over Johnson & Johnson

Recently, the FDA paused the use of the Johnson and Johnson vaccines over concerns it can cause blood clots in rare cases—a safety label has been added to the vaccine to warn of this possibility. Lately, the  FDA is investigating the death of a Michigan woman who received the Johnson & Johnson vaccine. According to an article in clickondetroit, “More than 6.8 million doses of the Johnson & Johnson vaccine have been administered in the U.S., and these adverse events appear to be extremely rare.” 

There have also been production problems with the Johnson & Johnson vaccine including problems with contamination and sanitation  at the Baltimore factory. 

How much the continuing challenges with the Johnson & Johnson vaccine has impacted COVID-19 vaccine hesitancy is unknown.  

There is also interest around low income and rural communities receiving the Johnson & Johnson vaccine which requires one shot but whose efficacy rate is much lower versus other vaccines which have been distributed to those in higher income brackets.

Vaccine types were distributed disproportionately across communities. (source: aarp.com)

Alex Reed, a data analyst with the Black Voice News, recently spoke about the difference.

“California has actually published a very thorough vaccine dashboard. [In] this dashboard they’re listing not necessarily where—as in locations—all of their vaccines are going; but they’re setting it out by quartiles, vaccine equity metric quartiles. The vaccine equity metric is actually a combination of two things.” 

The first is a Health Equity Metric, which is a whole other project under the auspices of the  California Department of Public Health. “It looks at each individual community and how it stacks up against other communities across all of these health data points such as obesity, access to clinics, insurance, smoking rates, all those types of things. It [also] looks at age, number of people in the home who do not speak English, and so forth. And then, it says, ‘Your community is  healthier or less healthy than ninety-five percent of other communities.’”

According to Reed, the government has taken the Health Equity Metric and combined it with some of their COVID-19  data. Based on this information, she explained, they produced the vaccine equity metric, published and labelled it by quartiles—one through four—from the least healthy to most healthy. The numbers reflect the percentages of people that are fully vaccinated or have had the first shot in each of these quartiles.

“If you look closely at the state’s vaccine dashboard, you will notice the least healthy communities in the first quartile are trailing the healthiest [communities] in the fourth quartile by ten or fifteen percent.” She noted the CDC has some pretty extensive COVID-19 dashboards as well. 

According to Reed, while you cannot see where the vaccines are distributed on the state’s vaccine dashboard, they have unpublished tables which show vaccine requests by county–this is reflected in the COVID-19 dashboard she created for Black Voice News titled, “COVID and Black California: How has COVID-19 Impacted Black Bodies Over the Past Year.” 

Reed noted the CDC has published administration rates using  the same metrics or quartiles and while you cannot see the rates by county on its dashboard, you can see them by quartiles. The most vulnerable and least healthy communities are those which have received the highest rate of the Johnson & Johnson vaccine.

Data shows lower and rural communities received more Johnson & Johnson vaccines than higher-income communities. (source: blackvoicenews.com)

Skipping the Second Dose

According to The New York Times eight percent of those who received a first dose of the currently available vaccines have not returned for the second dose.

Meanwhile, the California Department of Public Health reports, “The state is tracking individuals that are beyond the 42-day window for their second dose, but the data is not readily available.”

Equity Worldwide

On May  5, 2021 President Biden signaled his willingness to temporarily suspend  patents on the coronavirus vaccines to make them readily available to nations struggling in the grip of the pandemic.

In a statement US trade representative Katherine Tai noted,  “The Administration believes strongly in intellectual property protections, but in service of ending this pandemic, supports the waiver of those protections for COVID-19 vaccines. We will actively participate in . . . negotiations at the World Trade Organization needed to make that happen.”

Individual Choice

I spoke with Thomas (a pseudonym), a young man in his twenties about his concerns with the vaccine. He said, “At first it was a no.”

He chuckled to himself “No. I’m good. I’m only going to do it if it’s mandatory…You know. It’s been a serious situation and if jobs were like, ‘No,  you can’t work unless you have it,’ then I would be like ok, I’ll get it.”

That has been Thomas’ attitude since he first heard about the COVID-19 vaccines. But, his attitude toward getting vaccinated is beginning to shift.  

“Now I’m more leaning toward the yes because number one—loved ones. My grandmas on both sides, I haven’t seen them in a minute and the only way that I’mma be able to see them is to get this [shot] and it’s been some time since COVID has been going on.”

Thomas continued, “People have been getting the shot and they’ve been talking about what shots to get. So, I feel a little bit more comfortable, and I know a few people, a friend or even family members [who have gotten it]. My grandparents have gotten it so I feel a little bit more comfortable.”

(source: Phyllis Kimber Wilcox)

Thomas’ change of mind may be due in part to his mother. “Actually, my mom said the same thing when her mom asked, ‘Hey, when are you going to get it [the vaccine] so I can see you?’” Time is flying, Thomas insisted. “So, we’re all just thinking about making it happen. I’m leaning more to yes now.”

Phyllis Kimber-Wilcox is a reporter for Black Voice News. Her interests are the intersections of historic events with contemporary realities and their impacts on the persistent social, structural and economic barriers which continue to adversely affect and limit Black lives with an eye toward community-based  solutions.