COVID vaccines will be market realities within a matter of months, but as pharmaceutical companies inch closer to mass production, the American public inches further back from a level of trust that would allow the elixirs to sufficiently quell the virus.
Lieutenant Governor Josh Green said Hawai‘i’s expected timeline for the arrival of the first vaccines remains late December 2020 or early January of next year. Those will be reserved for the most at-risk populations across the islands, including healthcare workers, first responders, and the elderly.
The rest of the population will receive access in the months to come, though Green said the state won’t mandate anyone get the vaccination, and a sizable number of Hawai‘i residents are projected to opt-out — at least initially.
“We expect between 50 and 70 percent of people to accept the vaccination within the first year. If we have a vaccine with (a high rate of success), it will make a big difference statewide,” Green said. “If it falls short of that, we still run the risk of (coronavirus) outbreaks.”
“If the vaccine is safe, everyone should take it,” he continued, “but it’s still a personal choice. We can’t tell anyone to take a vaccine if they don’t want to.”
The Lieutenant Governor’s projection for statewide participation in the vaccination program puts Hawai‘i in line with the rest of the country, or perhaps even slanting slightly more optimistic about the potential of a COVID vaccine than is much of the mainland.
According to a survey by the Pew Research Center, faith in the COVID vaccination process declined as summer slipped into fall. In May of 2020, the number of all adults who said they would definitely or probably get the vaccine was 72%. Four months later, that number had dropped to 51%.
The politicizing of the issue during a contentious election year has been noted as a potential factor in the American public’s crisis of confidence when it comes to a coronavirus vaccine. But numbers offered by Pew show equal decline along partisan lines.
Democrats who said they would definitely or probably receive the vaccination dropped from 79% to 58%, while Republicans flipped from 65% to 44%. The data would indicate that concern around the vaccine then — or at least the increase in concern during the four-month period in question — resides in the medical arena rather than the political.
Pharmaceutical companies Pfizer and BioNTech announced Monday that Phase-3 human trials of their joint vaccine — the current leader in the clubhouse in the race to mass-production — show an effectiveness rate of more than 90% in protecting the uninfected from coronavirus.
While promising, the sample size is small and the research is not complete. However, given the circumstances of the global pandemic, the companies are expected to apply for emergency use authorization via the US Food and Drug Administration (FDA) as early as next week.
Even if Pfizer’s vaccine, and the several others to follow, can maintain a 90% success rate, it won’t matter if the public isn’t confident enough to take them.
“It’s still too new so more research is needed, and I would wait at least a year before getting a vaccine,” said Patty Kilpatrick-Carlson, a 55-year-old resident of Puna. “I have asthma, and I still would wait the year before getting vaccinated.”
Standard vaccines like those for polio and MMR (measles, mumps, rubella) are widely trusted by the majority of the American public, though a significant minority of anti-vaccination advocates have emerged in recent years. What makes coronavirus vaccines unique, as well as less palatable even to those who trust the vaccination process, is how quickly medical researchers are pushing them from the lab into the community.
The process of vaccine production and verification laid out by the Centers for Disease Control and Prevention (CDC) typically takes years. With COVID-19, the timetable has been months.
The Vaccine Adverse Events Reporting System (VAERS), which tracks side effects in individuals subsequent to vaccinations, will remain involved as companies roll out coronavirus vaccines for US distribution. But VAERS is, by nature, a reactive line of defense, not a proactive one.
As part of Operation Warp Speed — the US Department of Health and Human Services umbrella, under which COVID vaccine protocol is accelerated — the federal government says that steps in the verification of a vaccine’s efficacy/safety aren’t skipped, just realigned to occur simultaneously. Industrial production will likely begin before that verification process is complete, which HHS asserts is normal.
No matter how considered the government’s realignment process is, though, Green said public concern over speeding up the process is warranted.
“It was rushed to market,” he said. “We will vet it for safety. That causes pause, and it should.”
Green expects more than one vaccine will be chosen and distributed by Hawai‘i when the time comes. He said being an avid believer in the efficacy and necessity of common vaccines — which, as a licensed physician, Green is — makes it all the more vital that the state government proves successful in its vetting processes.
“If we did see an unfortunate outcome from this vaccine, which is being pushed to market quickly, I don’t want people to lose faith in regular vaccines, things like MMR and meningitis,” the Lieutenant Governor said. “I don’t want people to lose faith in pediatric care.”
Green traveled to Samoa in 2019 to help treat a measles outbreak he described as “absolutely tragic.” If the American public and the people of Hawai‘i were to lose faith in the vaccination system, he fears the same result Samoa suffered could eventually replicate itself here.
“We’ll be as safe as we can and as careful as we can,” he continued. “I personally will take the vaccine as soon as I know it’s safe. I even already had COVID, and I’m going to be vaccinated. If people feel more comfortable waiting, that’s OK. But as long as a vaccine meets our safety profile, I will encourage people to get vaccinated. The larger the number who do will mean more lives saved.”
Billye Lindsey, a 58-year-old living in Kamuela, has assumed thinking along the same lines. He said he listens to medical professionals, his personal doctor and Green in particular, and when they deem a vaccine safe and right for him, he won’t hesitate.
Lindsey, who described himself as an essential worker who is often in close quarters with both locals and those traveling from out of state, said the virus has become such a big part of life that it must be addressed. He’s seeing more tourists and more community spread across the Big Island in recent weeks. Those factors, along with his size and age, are why he said he’s pro a COVID vaccine. But he doesn’t expect everyone to be.
“Some will watch. Some will lay low,” he said. “I’m not sure, and I don’t hold no grudge on others’ decisions.”
People in Hawai‘i uninterested in taking the vaccine site their ages, their relative good health, distrust in the COVID vaccine process, or religious beliefs as among several reasons why.
Green said he understands those arguments but added that younger, healthier people wouldn’t necessarily be taking the vaccine for themselves. They’d be doing it instead for their loved ones.
“You might never suffer ill effects from COVID if you’re young and healthy, but you likely have a grandparent somewhere you love who it could be bad for. And some kids have suffered,” Green explained. “Young people (who get vaccinated) are doing it for their family members and co-workers, so I recommend everyone think about that.”
He added that more participation in COVID vaccination programs will create herd immunity sooner and get Hawai‘i more quickly back on track economically.
“Hawai‘i is facing an existential crisis if we don’t control COVID, and could suffer for many years,” Green said.