If you think political ideology is the reason someone is reluctant to get vaccinated, you could be wrong.
Public surveys have found fear of side effects, lack of time to get a shot, hearing scary anti-vaccine stories and a deep distrust in government or the medical industry are among a long list of factors that also play a role — often the main reason for vaccine hesitancy or opposition that will never change.
Full Food and Drug Administration approval of a COVID-19 vaccine was a notable boost to getting some of those with vaccine hesitance to roll up their sleeves. More people have opted in since Pfizer reached that approval benchmark in August, with Moderna and Johnson & Johnson versions expected to follow shortly. Some have been swayed by the more complete safety and efficacy data gathered in clinical studies and the experience of those vaccinated under emergency use authorization.
But WCVB in Boston found the minds of unvaccinated people sometimes remained unchanged even after Pfizer got FDA approval. One reason cited was a sense the vaccine was still largely experimental because it was created and approved quickly for emergency use as part of then-President Donald Trump’s Operation Warp Speed.
What drives the decision on COVID-19 vaccination may also vary depending on age and other demographics, including race, experts say.
A study from Augusta University that included mostly Black young adults ages 18 to 29 found reluctance to get vaccinated was based largely on two factors: belief they wouldn’t get very sick and experiencing housing insecurity. In a press release, the researchers noted those with tenuous housing may lack familiarity with medical services in their community because of poverty. The study called housing insecurity “a prominent factor” and said it “may be associated with lower socioeconomic circumstances, including working in frontline jobs that may increase potential exposure and limit the ability to take protective precautions.”
A new report for Brookings Institution suggests any links between an area’s politics and its vaccination rate “is weaker” for the elderly and nursing home residents, according to authors Sarah Reber, David M. Rubenstein fellow in economic studies, and Cyrus Kosar, assistant professor of health policy, research and practice at Brown University School of Public Health.
The Brookings researchers cite “more traditional sources” of vaccine hesitation among older adults and facility residents, including lack of trust in the medical system, concern about side effects and how well the vaccines work, as well as barriers to access. Those who hesitate are apt to be leery of vaccines in general, including flu shots, Reber told the Deseret News.
Meanwhile, younger adults of all races may simply consider themselves unlikely to have severe illness and see no need to subject themselves to the process or inconvenience of becoming vaccinated.
When QuoteWizard.com looked into the U.S. Census Bureau’s Household Pulse Survey vaccine hesitancy data for all 50 states, it also found more than a third of unvaccinated respondents listed mistrust of government as at least one of their reasons. And 20% don’t view COVID-19 as a threat.
Risk and reward for older adults
Trust is often pointed to as a really important factor in whether or not someone gets a vaccine, Reber said.
She believes how well facilities do in getting people vaccinated is one issue, though generally nursing homes have good access to vaccines. And facility residents are also likely similar to older adults in the community who simply eschew vaccines in general. They may worry about side effects or doubt they work or figure the illness isn’t that bad.
Black residents “are particularly likely to be in higher-risk facilities where vaccination rates among both residents and staff are low,” the Brookings Institution report says. And Black people are also more apt to mistrust a medical system some view as rife with inequality.
But with one vaccine approved for those over 16 and others in the process, long-term care facilities will have to overcome skepticism by unvaccinated staff or risk losing federal Medicare and Medicaid funds, President Joe Biden announced last week.
It’s a mandate critics call unfair. “Focusing only on nursing homes will cause vaccine-hesitant workers to flee to other health care providers and leave many centers without adequate staff to care for residents. It will make an already difficult workforce shortage even worse,” Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living, told CNN.
“While younger, unvaccinated adults are making up an increasing share of new hospital visits, ‘the vast majority of people dying from COVID-19 are people who are older and unvaccinated,’ “ David Dowdy, an infectious disease epidemiologist at Johns Hopkins University, told The New York Times.
Other countries are also challenged by vaccine hesitancy among seniors, though the United States has more unvaccinated older adults than Britain, Canada and Spain, while rates in Italy and France are similar, according to a New York Times analysis. Japan has low vaccination rates among its older adults, a fact blamed primarily on shortages.
As for America, “Low elderly vaccination rates in Arkansas, Florida, Idaho, Louisiana and Nevada have coincided with surging rates of hospitalization and death,” the Times reported.
Caution or politics?
A Utah doctor told the Deseret News by email that he couldn’t wait to get his own vaccination, but would not recommend it for his teenage sons at this point. And he opposes mandates because of “rare but significant side effects, particularly in young males, that being myocarditis and pericarditis.” He said since most male teenagers would have mild COVID-19 and are unlikely to develop dangerous multisystem inflammatory syndrome, which creates severe illness, he considers the decision “purely a risk-benefit ratio.”
The QuoteWizard analysis found 37% of those who are unvaccinated are simply in a holding pattern, waiting to see if the vaccines prove to be safe. If they become satisfied on that score, they’re likely to join the ranks of those who do get vaccinated.
That doesn’t mean politics doesn't play a role in some people’s COVID-19 vaccine decision.
In an analysis for the Washington Post, Philip Bump noted that “it is not the case that every blue state is doing well and every red state terribly. Nevada has seen the fourth-most deaths relative to its population during this period, for example. Three of the 10 states that have had the fewest per capita deaths are ones that voted for Trump and have relatively low vaccination rates: Iowa, Nebraska and South Dakota. But the pattern is consistent across all three metrics: 18 or 19 of the 25 hardest-hit states are ones that voted for Trump, and 18 or 19 of the 25 states with the best numbers are ones that voted for Biden.