Chairman's Desk

Overcoming vaccine hesitancy is the next big challenge in returning to ‘normal’

This article first appeared in the Toronto Star on May 23, 2021.

From the beginning of this bloody thing, even with uncertainty and confusion on all fronts, one thing was always known: vaccines would save the day.

Everything else — from PPE to stimulus — has simply been to tide us over, to keep us safe and save our lives until that wondrous day arrives when our country can truly return to “normal.”

Yet for all their promise, a stockpile of viable vaccines is only half the battle. Although those of us desperate for a jab cannot fathom it, many people simply refuse to join the ranks of the COVID inoculated.

Last month, NPR released a poll revealing that one in four Americans say they would refuse a COVID-19 vaccine if offered one.

In Canada, the picture is only slightly less grim. An Abacus poll from April found that eight per cent of Canadians said they “will never take” a COVID-19 vaccine, while 28 per cent would rather wait or would prefer not to take the vaccine. The NPR-Abacus findings are apples to oranges, but that level of hesitancy response does not inspire hope for the prime minister’s “one-shot summer.”

In the U.S., vaccine hesitancy has been somewhat of a bogeyman, as in a recent New York Times headline that made the stakes crystal clear: “Reaching ‘Herd Immunity’ Is Unlikely in the U.S., Experts Now Believe.” Given the centrality of herd immunity to the country’s vision of a post-COVID future, the headline editor may well have gone with: “Abandon Hope, All Ye Who Enter Here.”

Earlier this year, I wrote about the unique challenge a vaccination drive presents for our times. In an era of misinformation, distrust in institutions and anti-vax quackery, I argued, it would be harder than ever to get the job done. Since then, a rising tide of news stories and missteps by different levels of government have further eroded confidence in the process.

Blessedly, this unique challenge is being met with inventive solutions — a combination of incentives, social pressures and targeted outreach.

Consider the incentives. Facing a mammoth problem of human motivation, different organizations and leaders have come up with some very large carrots to move things along.

In a bid to get its campus inoculated, the University of Lethbridge has created a prize draw for vaccinated students that offers a chance to win free tuition for the fall term. The State of Ohio has taken this approach even further, with Republican Gov. Mike DeWine establishing a million-dollar lottery for vaccinated adults.

Around the world, some have chosen to focus on the stick, rather than the carrot. In Jakarta, the government has established a fine equivalent to $355 for residents who refuse a COVID-19 vaccine, especially hefty in a country where nearly 10 per cent of the population lives on one dollar a day.

Ultimately, vaccine hesitancy speaks to the slipperiest of social phenomena: trust. When it comes to human nature, trust is truly a riddle, wrapped in a mystery, inside an enigma. That’s because it’s the product of so many disparate considerations: a society’s political culture, its history, its relationship with truth and crucially, an individual or group’s role within that culture.

Battling vaccine hesitancy, the most important solutions are those that recognize all these root factors — because simple incentives can only go so far when the issue is structural.

Health advocates in the U.S. have argued that skepticism among some Black Americans is driven in part by a history of abuse and marginalization by the medical community. Long-term solutions, they say, must address the structures of a health care system that leaves them behind.

While some in Canada suggest that a comparable history is driving vaccine hesitancy in Indigenous communities, there’s little evidence to that effect. It is more a matter of reaching people where they are — through Facebook and community radio for instance — and providing the right information.

Overall, it appears our culture and history make Canadians less likely to resist a vaccine in the long-term. So, while eight per cent “never taking” a vaccine seems disheartening, remember that we have tools at our disposal to reach the malleable 28 per cent who would “rather wait/prefer not to.” If we can use them effectively, even the eight per cent can’t hold us back from a return to our normal lives. Amen.