It’s too soon to declare vaccine victory — four strategies for continued progress

With the successful development and distribution of new vaccines, there is hope in the United States that the acute phase of the SARS-CoV-2 pandemic may soon end. 

As of President Biden’s 100th day in office on April 29, more than 99 million adults in the United States had been fully vaccinated (30 percent of the entire population), and more than 143 million (43 percent of the entire population) have had their first dose of COVID-19 vaccine. Fully two-thirds of American adults embrace vaccines and the “moveable middle” of persons delaying a decision has shrunk by more than half to 15 percent. Black, Latinx and Native American populations have recently moved toward much higher acceptance of vaccines, though more progress is still needed. In another positive development, social media platforms have made public commitments to remove, inform and reduce misleading vaccine-related content and bring these efforts to scale. At the same time, the U.S. government and its allies have become more aggressive in tracking and countering Russian and Chinese online disinformation campaigns aiming to undermine confidence in Western vaccines.

Nevertheless, public confidence and trust — in vaccines, authorities and science — continue to fall significantly short of what is required to exit the pandemic crisis, at home and abroad. And more is needed to battle misinformation. As the United States has shifted from a scarcity of vaccines to an abundance, we increasingly see a major source of resistance coming from Republican voters and white evangelicals. Over one-third of Republicans and 28 percent of white evangelicals claim they will not accept a vaccine. That number rises to nearly one-half of Republican male voters, with the greatest resistance concentrated among the young and those living in rural settings

Internationally, much work remains to build public trust and confidence. The recent pauses in the use of the AstraZeneca vaccine in European countries and the Johnson & Johnson vaccine in the U.S. to investigate rare but potentially dangerous side effects set back popular confidence in these critically important vaccines in the United States, but also had dramatic, damaging impact on confidence in lower and lower middle-income countries. 

What is at stake is fundamentally a matter of U.S. national security and ultimately global health security. If Americans are to be safe and sustainably healthy, if they are to achieve renewed economic prosperity and social stability, and if the United States is to resume a global leadership role, we will need to achieve high vaccine coverage at home and engage more effectively internationally. We simply have to do much better to reach those who remain hesitant or resistant and to redress the forces of misinformation. 

What does that mean in practice? To move the United States forward in building vaccine confidence and supporting its many domestic and international partners, the Center for Strategic and International Studies and London School of Hygiene & Tropical Medicine high-level panel on vaccine confidence and misinformation recommends bolstering efforts in several critical areas: 

  • Innovation. Vaccines should be delivered along with other health and social services that address the negative economic impacts that have left millions unemployed and unable to afford housing, food and other necessities. Enlisting trusted community leaders will be essential in advancing such efforts. 
  • Collaboration between mainstream and digital media platforms and the medical and scientific communities can interrupt the spread of misinformation and increase the availability of accurate and engaging content.
  • Engagement with key social and economic sectors beyond health. More conversations are needed across educational institutions, businesses, healthcare providers, the agricultural sector, and the security, law enforcement, and military communities to engage their respective communities in dialogue about vaccines in the context of post-pandemic recovery. A top line priority needs to be creating hyperlocal strategies to win over skeptical Republicans and evangelicals while continuing fruitful engagement with Black, Latinx and Native American populations. Vaccines could go the way of masks in America, and become highly politicized, if proactive listening and engagement with these groups does not occur. Fortunately, Republican elected leaders and opinion makers are increasingly stepping forward publicly and privately in defense of vaccines. Those initiatives will be bolstered significantly if other trusted local messengers — the family doctor or nurse, community faith leaders and family members — join in also.
  •  U.S. global influence can be leveraged to shape a coordinated international approach to address the shared concerns of bolstering vaccine confidence and mitigating misinformation. The case that vaccine confidence and misinformation are matters of global security should be systematically incorporated into high-level dialogues at the UN Security Council, the G7 and G20, the Quad (United States, India, Japan, and Australia), and the renewed U.S.-European transatlantic relationship.

We are entering this next phase amid both peril and optimism, buoyed by the swift progress in vaccinating Americans. But we must be aware of how much work still lies ahead to win acceptance of vaccines, interrupt the negative impacts of misinformation, achieve the needed high levels of vaccination in a timely way, and, at the end of the day, outrace dangerous viral variants.

J. Stephen Morrison is senior vice president at Center for Strategic and International Studies (CSIS), where he directs the Global Health Policy Center. Heidi J. Larson is a professor of Anthropology and Risk and director of the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine (LSHTM). Katherine E. Bliss is a senior fellow with the CSIS Global Health Policy Center.

Tags AstraZeneca COVID-19 vaccine Deployment of COVID-19 vaccines Joe Biden johnson & johnson misinformation Vaccination Vaccine Vaccine hesitancy

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