How to Deal with Vaccine Hesitancy

The baby is coughing, gagging, gasping for air as I enter the exam room. I see him sitting up and leaning forward, his little ribs showing with every breath, too tired to even cry. He has whooping cough, a once common childhood disease now rarely seen thanks to childhood vaccinations. In the ER we quickly got to work, giving oxygen, X-rays, drawing blood, and starting IV antibiotics, as the parents guiltily looked on knowing that vaccinating their child could have prevented this.

Why is vaccination such an emotional topic? Recently friends have confided in me that they feared visiting their families in the U.S. due to refusals to be vaccinated and the rise of Covid variants.

Arguing with them, pleading with them, threatening not to visit did not seem to make a difference. I admit, having seen my front-line colleagues get sick, suffer long term side effects, and even die from Covid, I have a difficult time reconciling their stance, but I am trying to understand their point of view and clarify some common misconceptions.

The first step is to address their concerns – and to treat the person with respect. Having concerns is legitimate. Be curious. Accusing them of “not caring about me/my family/others” or of being anti-science is not likely to bring about understanding or change anyone’s mind about getting vaccinated.

The official messaging around vaccination has been the idea of collective responsibility – that it benefits everyone to reach at least a 70% vaccination rate to achieve “herd immunity”. While this may resonate with some, the perceived personal risk outweighs this “greater good” mentality for others. It may be more effective to appeal to how the Covid vaccine can help protect their immediate family and themselves personally, as they begin to travel and interact with more people, especially as more infectious and deadly variant strains are on the rise.

In order to make an informed decision, it’s imperative to arm ourselves with the facts.

Here are 8 questions and perceived risks around the Covid vaccine.

1) Can I get Covid from the vaccine?

No. The vaccine does not contain the virus, so it cannot cause an infection. It contains mRNA which codes for proteins that guide our immune cells to attack the virus. This mRNA fragment cannot enter the nucleus or become incorporated into our own DNA.

2) Can the vaccine cause infertility?

No. The vaccine creates antibodies against the protein spike around the coronavirus so that our immune cells can specifically target it. It cannot attack our own reproductive system and there is absolutely no evidence to indicate that it can affect fertility.

3) What if I’ve already had Covid-19?

It is recommended to get the vaccine even if you have had Covid in the past, as it is unclear how long immunity lasts after getting Covid.

4) Will the vaccine turn my PCR test or Antigen test positive?

No. Tests for Covid infections check for viral RNA or proteins in the saliva or nasopharynx. The mRNA and proteins created by the vaccine are rapidly degraded near the injection site, leaving only the antibodies that can mount an immune response if it encounters the virus.

5) Are the vaccines effective against Covid variants?

Yes. The Pfizer, Moderna, and AstraZeneca vaccines are highly effective against variants, including the currently predominant Delta variant, preventing hospitalization by 92-96%.

6) Did they take shortcuts with vaccine development?

No. The mRNA vaccine is not new. Scientists have been developing this technology for the last 14 or so years, with other coronaviruses like SARS and MERS – and they are now working on mRNA vaccines for HIV and even cancer. When Covid-19 came along, the viral RNA was quickly sequenced and so existing technology was rapidly adapted to the current outbreak. The reason why the vaccine became available in record time was because there was a huge outpouring of funding from various governments, no shortage of volunteers (10 times the usual clinical data was collected), and so the vaccine was released with high confidence that it was safe and effective.

7) Why shouldn’t I just “wait and see”?