“In certain communities, the low rates could mean that the vaccine is not as effective as it could be, and so diseases continue to take hold,” she said.
There are other worries. Noel Brewer, a professor at the Gillings School of Global Public Health at the University of North Carolina who studies why people choose to get vaccinated, told me that he hates the name of the program that accelerated work on the vaccines. “Warp speed” was a good way to emphasize its speedy development — but emphasizing speed could also sow doubt about the vaccine’s quality. In September, a poll by the Kaiser Family Foundation found that two-thirds of Americans worried that President Trump was rushing the vaccines for political reasons.
Brewer also fears a slide into partisan warfare. “We don’t have much history with vaccination being a right or left issue — vaccination is pretty well embraced across the political spectrum,” he said. But on the right, there is a strong resistance to government mandates, which might play into increased skepticism about getting vaccinated.
South Korea’s public health officials have been praised for the transparent way they investigated and shut down misinformation about the flu vaccine, but rates of vaccination remain low — only 19 million people have gotten the flu shot, far short of the goal of 30 million. Still, Bruce Gellin, the president of global immunization at the Sabin Vaccine Institute, told me that Americans should allow scientists, rather than politicians, to take the lead in communicating about vaccines, as the Koreans did.
“If you do the math, you can anticipate that strokes and heart attacks will occur within days and weeks of being vaccinated, and since these are common occurrences, every media market will have a story about this — the person was fine, and then following vaccination they had a stroke,” Gellin told me. “That speaks to the need to keep our eyes open for things like this — to anticipate them and to look into them.”
Preparing for these incidents requires setting up monitoring systems early and quickly and transparently investigating problems in a way that solidifies public trust — in other words, exactly the sort of competence that has been missing from the Trump administration’s coronavirus plans.
I expect the Biden administration to be more rigorous and transparent. And Brewer told me that making the vaccines free and easy for Americans to get will be a much more effective way of promoting their use than devising some clever public relations campaign.