Now That We Have an Effective Vaccine for COVID-19, Will It Also Inoculate Us Against the Virus of Indifference?

I know that I not alone when I say that have been become completely covidized (1)∗ over the past 9 months. Accordingly, my spirits were lifted when I heard that news that both Pfizer and Moderna had announced encouraging results with their ribonucleic acid (RNA) vaccine candidates against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, I quickly came down from my vaccine high when I read that results of the latest survey from the STAT-Harris Poll (n = 1,954 adults), which revealed that only 6 in 10 Americans indicated that they were somewhat or very likely to get a vaccine if being vaccinated would lower their risk of becoming infected by 50% (2). What was more perplexing, at least to me, is that nearly two-thirds of the people who were surveyed reported they would be willing to get a vaccine if the vaccine lowered the risk of contracting SARS-CoV-2 by 75%. In other words, a 50% increase in vaccine efficacy vaccine would have only resulted in a 6% increase in the willingness of the people to receive the vaccine. One wonders whether another 6% of people would have indicated that they would receive the vaccine if it was 100% effective against SARS-CoV-2.

Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite the availability of vaccination services (3). In 2019, the World Health Organization listed vaccine hesitancy as among the top 10 threats to global health in 2019. As with most public health issues, there are a variety of factors that influence vaccine hesitancy, including contextual influences (e.g., religion, culture, sex, and/or influential leaders), individual and group influences (e.g., perceived risk and/or benefit, trust in health care providers), and vaccine- and/or vaccination-specific issues (e.g., introduction of a new vaccine) (3). Then there is the pragmatic issue that nobody really likes having a needle (no matter how small) jabbed in their arm. Not surprisingly, studies have shown that vaccine hesitancy is not restricted to a specific region or continent, but is a problem worldwide (3).

I was deeply saddened by the tragic loss of 2,958 human lives during the terrorist attacks on September 11, 2001. As an American, I was proud of the way in which my country pulled together in support of the people whose family members were lost, as well as in outpouring of support for the people of New York City, especially the first responders whose bravery and humanism were on display every hour of every day. Today I am equally saddened by the knowledge that the daily loss of lives from coronavirus disease-2019 (COVID-19) worldwide is 4× greater than that from the terrorist attacks on September 11. Yet for reasons that are unclear, the sense of tragedy from COVID-19–related deaths seems different somehow. There is a growing public desensitization to the enormity of the crisis that we are all facing. Although the pandemic has united us in some of the ways that the September 11 terrorist attacks brought us all together, the sheer duration of the social distancing and social isolation imposed by the pandemic has pulled us apart and isolated us from our communities in a way that most of us have never experienced before.

Soon we will be asked to take a novel RNA vaccine against an enemy we cannot see. Although the RNA vaccines appear to be safe in carefully monitored clinical trials, the stark reality is that we know very little about the long-term safety of RNA vaccines (4). There will be no shortage of people with vaccine hesitancy. Pope Francis warned recently that “indifference is a virus that is dangerously contagious in our time . . . for it is indifference that paralyzes and impedes us from doing what is right even when we know that it is right” (5). Science has given us the opportunity to eradicate the SARS-CoV-2 virus and to put an end to the pandemic that has cost so many lives and destroyed so many families and economies. My hope is that we can overcome our hesitancies and preconceived biases, and that we pull together and vaccinate against SARS-CoV-2. In doing so, we will also be inoculating against the virus of indifference that will impede us from preventing future loss of life if we do nothing to end the pandemic. I would like to close this “Editor’s Page” with the words of Pope Francis, not because I am Catholic (which I am not), but because I believe it is the single best advice that I have read thus far for we can get to the other side of the pandemic: “To everyone: let us not think only of our interests, our vested interests. Let us welcome this time of trial as an opportunity to prepare for our collective future. . . . Because without an all-embracing vision, there will be no future for anyone” (5).