From Moscow to Hong Kong to Pittsburgh, scientists around the world have spent the last several months racing to develop a COVID-19 vaccine. According to the World Health Organization, a total of 18 candidate vaccines are now in clinical trials with human subjects, and 129 vaccines are in the pipeline. A safe, effective vaccine could emerge as early as this winter or the beginning of 2021, Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, forecasted earlier this month.
For billions of people around the world, this is great news. New vaccines, which normally take more than a decade to develop, are no easy feat. A COVID-19 vaccine could unlock society again; allow nations to lift travel restrictions; and herald the return of concerts, live sports, and hugging your grandmother.
But what happens if a large portion of the population simply refuses to take the COVID-19 vaccine? According to a YouGov poll released in May, while more than half (55%) of Americans say they will get a vaccine, nearly 1 in 5 (or 19%) say they will opt out. And more than a quarter (26%) reported that they aren’t sure.
Both Fauci and Bill Gates have admitted that widespread public adoption of the COVID-19 vaccine could be a future obstacle in the United States. If enough people refuse to take the COVID-19 vaccine, the U.S. will have trouble achieving herd immunity—which occurs when a sufficient percentage of people are vaccinated against a virus or are immune after recovering from it, according to the CDC.
Scientists interviewed by Nautilus estimated that anywhere from 60%-80% of a population will need to be immunized against COVID-19, or recovered from the virus, to achieve herd immunity.
But let’s say the anti-vaccination movement—which dates back to protests of the smallpox vaccine during Victorian-era England—ends up having a minimal impact during this pandemic. Even if most everybody in a country received the vaccination against COVID-19, scientists doubt that the coronavirus will simply flitter away once people get their shots.
Finding a coronavirus vaccine and maintaining immunity
Scientists warn that we still don’t have a clear picture of how immunity from COVID-19 works and how long it lasts. Some studies have suggested that those with mild or asymptomatic cases of COVID-19 have fewer antibodies in their system, and they tend to fade fast. While there are no clinical cases of people getting reinfected with the coronavirus, there’s evidence to suggest that immunity from COVID-19 won’t be permanent.
“In most strains of seasonal coronaviruses, the antibodies last only one or two years,” Dr. Eran Bendavid, an associate professor of medicine at Stanford University, said in an interview with Nautilus.
A vaccine against the current strain of COVID-19 may not work for future strains of the virus. Which means that the vaccine could be similar to a flu shot, in that it needs to be taken annually.
The percentage of vaccine uptake needed for COVID-19 herd immunity could also vary from country to country and even city to city. According to Bendavid, factors like population density, age structure, and vulnerability in terms of demographics also come into play.
Densely populated cities like Los Angeles and New York City will need a higher percentage of people to get vaccinated than sparsely populated areas in West Virginia or Montana. Countries with large older populations, such as Italy, will also require a larger number of people to be vaccinated.
To further complicate matters, it’s unlikely that a COVID-19 vaccine will work on everyone.
“Please note that it’s likely that not all the vaccines being developed will work in all age groups, and may not work on the immunocompromised. Hence the importance of herd immunity. Much science is still not known,” Dr. Noni MacDonald, a founding member of the WHO’s Global Advisory Committee on Vaccine Safety, wrote in an email to Nautilus.
And more importantly, the production of the COVID-19 vaccine will likely be very limited at first.
“To me, the No. 1 challenge is the ability to manufacture billions of doses,” said Bendavid.
It’s more likely that countries will prioritize delivering the vaccine to highly vulnerable populations, like the elderly and healthcare workers, a number of scientists told Nautilus.
Finally, the unprecedented nature of the COVID-19 pandemic means there’s still a great deal of uncertainty about the road ahead. Vaccines for polio and tuberculosis took decades to develop and deploy. But for the coronavirus, every part of the standard vaccine development process has been expedited.
“We have never done a mass global vaccine campaign in such a short timeframe,” said MacDonald.
The role of anti-vaxxers
Dr. Paula Cannon, a virologist at the University of Southern California, says she’s more concerned about the impact of the anti-vax movement now in July than she was three months ago, back in April. After states issued orders making mask-wearing mandatory in public, anti-mask protests erupted nationwide and incidents of people refusing to wear masks in public flooded social media. Shifts in messaging from the CDC and the WHO on masks, asymptomatic transmission, the use of hydroxychloroquine, and other major factors surrounding the virus has led to confusion.
“I’ve tried to understand the basis of the anti-vax movement, and my non-expert reading on it is that a lot of it stems from a lack of transparency, either from the government or pharma companies, and that then leads to concerns about safety and a belief that things that are being covered up,” Cannon said in an interview with Nautilus.
As scientists grow in their understanding of the virus, they may find that some of their initial findings about it were untrue.
“My typical day involves getting new, updated information and changing my mind. I’m very comfortable with getting new and updated guidelines and adjusting what I think as a result,” said Cannon.
But the very nature of scientific inquiry, which relies on testing assumptions that may turn out to be wrong, isn’t understood by most of the general public. “Experts have not thought about how [the scientific approach] can be perceived as something sinister. Rather than the actual fact, which is that we’re learning new things at the speed of light about the virus,” said Cannon.
This growing distrust over science and experts has only added fuel to the global anti-vax movement, which has found a new foe in the still to be released COVID-19 vaccine. Before the pandemic, anti-vaccination activists normally targeted parents of infants and young children. Their primary message was that the recommended schedule of immunizations most people receive at birth or before enrolling in school can cause autism or SIDs (sudden infant death syndrome).
There is no proof that vaccines cause the wide-scale harm that the anti-vax movement claims they are capable of unleashing. Numerous studies have found no link between autism and the MMR (measles, mumps, rubella) vaccine, which is one of the movement’s targets. The Lancet later retracted a 1998 paper by British gastroenterologist Andrew Wakefield, which linked the MMR vaccines to autism, due to several procedural mistakes and ethical violations.
Even if Wakefield’s claims were true, the numbers don’t add up. Roughly 92% of U.S. children up to 35 months old received the MMR vaccine in 2017, according to the CDC. Less than 2% of U.S. children have been diagnosed with autism, a CDC survey found.
But the pandemic has now broadened the potential reach of the anti-vax movement from mostly parents to practically everyone. And the anti-vax movement has found natural allies in those who oppose stay-at-home orders and the wearing of masks—and those who support President Donald Trump.
“But there is a segment of the anti-vaccination movement on the far right, drawn to its libertarian streak of distrusting the government, and there exists at least one prominent bridge between leftist anti-vaxxers and the political right in the United States: Donald Trump,” wrote Jonathan Jarry of McGill University.
Anti-vax Facebook groups continue to thrive. While the platform has taken steps to make anti-vaccine groups and pages harder to find, it hasn’t banned them completely. The “Stop Mandatory Lockdown, Testing, Tracking and Vaccination” Facebook group, run by anti-vax activist Larry Cook, has more than 190,000 members. The group’s screening questionnaire states, “This is a Pro-God, Pro-Constitution, Pro-Trump, Anti-Vaccine Group”.
Cook, a QAnon conspiracy theorist, was also the second leading anti-vax advertiser on Facebook, before the platform banned such ads in March. Members discuss a wide range of COVID-19 conspiracy theories in the group, such as that Bill Gates wants to use COVID-19 vaccines to microchip the world or that the Deep State wants to mandate COVID-19 vaccines to control the population.
Anti-vax sentiment frequently surfaces in Facebook pages related to lifting lockdown orders or resisting masks. In the “Open Texas” Facebook group , one member asks how many other members are planning on getting the vaccine. A deluge of comments followed, most making it clear they weren’t planning on getting inoculated.
“No COVID vaccine! I don’t get the flu shot, not getting this one either,” wrote one member of Open Texas.”
While the suspicion over vaccines isn’t unique to the United States, the stakes are considerably more urgent in the country: the U.S. currently has the highest number of COVID-19 cases and the most number of deaths in the world.
Professor David Isaacs, author of Defeating the Ministers of Death: The Compelling History of Vaccination, calls aversion to vaccines a “first world” problem. Vaccine hesitancy is more likely in wealthy countries like the U.S. and Australia, where people have never witnessed the devastating impact of infectious diseases in action.
“Interestingly, vaccine hesitancy is probably more likely when people have never seen the disease being prevented,” Isaacs wrote in an email to Nautilus.
But as cases continue to rise in the U.S., especially in states like Arizona and Mississippi that previously had low exposure to the virus, that could change. More people will find out that they, or someone they love, have contracted the virus.
“I think it is highly likely that, if a vaccine does become available, the major problem will be adequate supply, not vaccine hesitancy,” Isaacs said. “The whole world will want the vaccine.”
Maybe even those who have no desire for a vaccine right now will want to hop in line once the option is actually available. But then again, maybe not.
Read more on the coronavirus vaccine:
- If the coronavirus mutates, will a potential vaccine still be effective against it?
- Even a successful COVID-19 vaccine might not end the pandemic
- Until now, what’s the quickest a vaccine has ever been developed?
- When a COVID-19 vaccine comes out, who will have first priority?
- The immunity provided from a coronavirus vaccine might only be temporary
- Trump said the U.S. has 2 million coronavirus vaccines ‘ready to go,’ but nobody else is backing him up
- Could old vaccines for tuberculosis and polio help fight COVID-19?