Trump, Biden tout vaccine efforts as public hesitation to get immunized persists

WASHINGTON (SBG) — President Donald Trump and President-elect Joe Biden both underscored the importance of coronavirus vaccines Tuesday as the federal government confronted the enormous challenge of immunizing hundreds of millions of Americans in a matter of months, even as public doubts about vaccination run high.

“The numbers [of coronavirus cases] should skyrocket downward,” Trump said at a White House vaccine summit.

Conspicuously absent from the event were any members of Biden’s transition team. Taking questions from reporters after his prepared remarks, Trump veered into baseless conspiracy theories about election fraud and urged state legislatures and judges to overturn election results.

"We're going to have to see who the next administration is because we won in those swing states,” Trump said falsely when asked why Biden’s aides were not invited. “Hopefully the next administration will be the Trump administration.”

Around the same time in Delaware, Biden delivered a speech on his plan to combat the pandemic, including an aggressive effort to ramp up vaccination. He committed to administering 100 million vaccine doses in his first 100 days in office, and he urged Congress to provide sufficient funding.

“This will be the most efficient mass vaccination plan in U.S. history. I credit everyone who has gotten us to this point, but developing the vaccine is one herculean task,” Biden said. “Distributing it is another. And vaccines in a vial only work if they are injected into the arms of people, especially those most at risk.”

White House officials said Monday that one of the primary purposes of the summit was “to instill confidence in both of those processes so that Americans know that the vaccine is safe.” However, the event drew some criticism for seemingly advancing President Trump’s political priorities and his effort to claim personal credit for the rapid development of vaccines.

“The summit looks like an attempt to take full credit for something for which it is only partially responsible, and not an effort to promote public health or get the American people on board with efforts to contain the pandemic,” said Peter Loge, a former FDA communications adviser and director of the Project on Ethics in Political Communication at George Washington University.

Beyond remarks by President Trump and Vice President Mike Pence, the summit featured appearances by federal and state officials discussing the development, distribution, and administration of vaccines. Representatives from UPS, FedEx, CVS, Walgreens, and other private companies involved in the logistics of shipping and delivering the vaccines also spoke, although executives from Pfizer and Moderna—the first two companies to seek authorization for vaccines—were not present.

Public health experts say a concerted communications campaign to educate the public about coronavirus vaccines is essential. However, even before Trump’s comments veered off-topic into political controversy, some predicted the summit would fall short of persuading those who are still reluctant to take one.

“Especially in this year of disinformation and mistrust, it’s going to take a whole lot more than a bunch of high-level politicians and career scientists in a meeting to get people to trust the vaccine process,” said Dr. Eli Rosenberg, an epidemiologist at the University at Albany who is advising New York Gov. Andrew Cuomo on vaccine distribution.

Earlier Tuesday, the Food and Drug Administration posted its initial review of Pfizer’s trial data online, confirming the vaccine provides strong protection against the virus. An independent expert panel will convene Thursday to debate those findings and decide whether to recommend that the FDA provide emergency authorization to begin distributing it.

The FDA typically follows that panel’s recommendations, but a final decision will likely come within days after the meeting. If authorized, millions of Americans could receive the first of two doses of the Pfizer vaccine by the end of the year. Federal officials have recommended health care workers and patients in assisted living facilities be the first groups to get immunized, but each state will determine its own prioritization plan.

The FDA advisory panel will meet again next week to consider authorization for Moderna’s vaccine, which has shown similarly promising early trial results. Several other vaccine candidates are in trials now and could seek emergency authorization soon.

If Pfizer and Moderna’s vaccines are authorized in the U.S., officials hope to get 20 million doses administered this month, and the Trump administration has projected most of the country could be immunized by next summer. Experts say getting the pandemic under control will require convincing 70% to 80% of Americans to take a vaccine, and that could prove difficult.

“The first thing is we have to get the full approval and explain to people what vaccines do,” said Scott Ratzan, a distinguished lecturer at the City University of New York School of Public Health.

Hours before Tuesday’s summit, British health authorities began administering Pfizer’s vaccine to the elderly and nursing home workers. Despite pressure from President Trump, FDA officials have defended the slower U.S. review process as necessary for ensuring the efficacy and safety of vaccines, as well as strengthening public confidence in the results.

Although health officials have emphasized that no corners have been cut in fast-tracking the authorization process, the unprecedented speed of the development and testing of these vaccines has left some questions unanswered. It is unclear how long the immunity provided by the shots will last or if any long-term complications could emerge, and testing has so far been relatively limited on the elderly and children.

Rosenberg acknowledged much is still unknown about several factors, including how effectively the vaccines protect against asymptomatic transmission, but existing immunology research suggests the vaccines should provide lasting immunity against the virus. Also, if any severe side effects emerge in the general population, he expects they will be quickly detected and addressed.

“People feel pretty confident we’ll probably have pretty long-term protection, and the cost of inaction is worse than the cost of the vaccine, even with those uncertainties,” he said.

According to Ratzan, officials must be clear with the public about the availability and efficacy of the vaccines, as well as the need for continued mitigation efforts even after they are distributed. His team has done surveys in New York City and found desire to take a vaccine is still far below the levels necessary to achieve herd immunity.

“We have to figure out how to reach these people,” he said. “These are not vaccine deniers or people who think the earth is flat.”

A Pew Research Center survey conducted in the last two weeks of November found Americans’ willingness to take a vaccine has bounced back from a relative low point in September, with 60% of adults now saying they would definitely or probably get vaccinated. However, about half of those who currently would not take a vaccine said they might change their minds as more information is released. Confidence in the vaccine research and development process has jumped 10 points since September, though most Americans would still be uncomfortable with being among the first to take it.

Intention to take a vaccine has increased across all gender, race, economic, and age groups, but some striking disparities persist. Nearly three-quarters of Democrats are willing to get vaccinated, but just half of Republicans. Those with higher incomes and postgraduate degrees are far more likely to want to get vaccinated than lower-income adults and those without college degrees. Only 42% of Black Americans say they would get a vaccine, compared to 61% of white adults and 83% of Asian Americans.

Despite the likely imminent distribution of effective vaccines, the Pew survey showed 71% of Americans believe the worst of the pandemic is still to come. Partisan differences are growing deeper, with 84% of Democrats saying the outbreak poses a major threat to public health but only 43% of Republicans saying the same.

Ratzan’s research has shown similar racial differences among New York City residents. Black survey respondents cited a long history of mistreatment and dishonesty by the government, including the Tuskegee study in which Black men were misled for decades about being treated for syphilis.

“Those disparities are huge, and we can’t communicate the same way to people who have been distrustful of government for legitimate reasons,” he said.

An Ipsos global survey released last month found concerns about coronavirus vaccines are widespread beyond U.S. borders, as well. Only about half of adults in France and two-thirds in Spain, Germany, Italy, and Japan said they would take a vaccine if it was available, and potential side effects and the speed of vaccine trials were the top reasons for refusing.

In Russia, where a vaccine was approved in August without large-scale trials, one poll showed 59% of residents were unwilling to take the shot, doubting the credibility of President Vladimir Putin’s government. According to The New York Times, only about 100,000 of the 140 million people in Russia have been vaccinated so far.

Part of the challenge presented by the timing of this process in the U.S. is that many of the Trump administration officials appealing to Americans to trust them will have little to no role in the distribution of the vaccines to the general public. Most people who are not in the highest-risk categories will be receiving the vaccine after Biden’s team takes over in January.

Biden unveiled his nominees and appointees for key public health positions at the event in Delaware Tuesday. That team includes Dr. Anthony Fauci, who has led the National Institute of Allergy and Infectious Diseases for decades, as chief medical officer, as well as California Attorney General Xavier Becerra, former Surgeon General Vivek Murthy, and Dr. Rochelle Walensky.

Experts say overcoming public skepticism about vaccines will require a broad, multi-faceted messaging effort that extends far beyond politicians giving speeches. Messages will need to be tailored to different audiences and delivered through different mediums to reach those who would be least willing to take a vaccine.

“Whatever media people respond to, that’s where we need to meet people,” Rosenberg said.

Former Presidents Barack Obama, George W. Bush, and Bill Clinton have offered to get vaccinated on live television—like Elvis Presley did with the polio vaccine in the 1960s—as has Biden. The White House said Monday Trump is willing to do the same, but it is unclear if he would be advised to be among the first to take the vaccine since he already had the virus and recovered.

“Political and public health leaders taking the vaccine publicly would help reassure the public the vaccine is safe... Leading media figures, especially those initially skeptical of the pandemic, could persuade other initial skeptics in the public to take the vaccine as well,” Loge said.

Virginia Gov. Ralph Northam, who is a doctor, participated in a virtual town hall Monday aimed at dispelling myths about coronavirus vaccination. He stressed the transparency of the process and stated he would be willing to take a vaccine as soon as it is available.

"We want to work together to make sure everyone can understand this is safe, it's effective, and that we're going to distribute it equitably," Northam said.

Other states like California and New York have established independent panels to review vaccine data before they distribute the drugs to their residents. Officials said those reviews are intended to increase confidence in the vaccines and should not noticeably delay distribution.

Societal pressure could also help encourage vaccine use. Some officials and private businesses have discussed requiring proof of vaccination through an app or document to participate in certain activities, like international air travel. Such requirements could present legal and ethical challenges, though.

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However it is done, Rosenberg said convincing Americans to take a vaccine is vital to getting life back to normal, and failure to do so would put the strategy for containing the virus at risk. Some might see it as a personal choice, but refusing to take the shot could put others in danger and keep the coronavirus circulating among the public longer than necessary.

“There is a beyond-you-and-yourself altruistic value, and we want everybody to be vaccinated so they can help protect their communities,” Rosenberg said.