Covid-19 Vaccine Success Hinges on More Than Skepticism

6 min readDec 9, 2020

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Several surveys have estimated that the US population’s willingness to accept a coronavirus vaccine a little more than 60%. Reluctance centers around the usual suspicions of vaccines, the newness of this one, the speed of development, and its perceived association with Donald Trump. I even heard one conservative talk show host say he wouldn’t get one because he doesn’t trust anything from the government now. But the roadblocks to getting more than half of the US population vaccinated go deeper than public mistrust and acceptance.

Two Shots Required

All but one of the vaccines in development requires two separate shots, weeks apart. It is hard enough to get people to accept one injection, let alone come back later for the second one. Imagine mild to moderate side effects that may occur like fever, fatigue, muscle aches, and or swelling at the injection sites. Many folks might conclude that the first one was so unpleasant that they would opt out of a second. I can only imagine rumors on social media stating you only need one shot to be effective, which is untrue.

Refrigeration

Pfizer’s vaccine requires a storage temperature colder than Antarctica, minus 70 degrees Celsius. Moderna’s vaccine, thought to be the next up for approval, only requires everyday freezer storage temperatures. There is already a shortage of dry ice and ultra-cold freezers (This is concerning as these requirements have been known for months). I understand that Pfizer’s vaccine may be placed in a regular freezer for a few days and at room temperature for a few hours before administration. But these storage requirements will be a significant and expensive challenge, particularly for rural areas.

Triaging of Vaccine Candidates

The Trump administration has purchased and reserved 100 million doses of the Pfizer vaccine. That is less than one-third of the population. Critics are already complaining that won’t be enough, and the estimated vaccination dates of the general population have now been pushed back from spring to summer 2021. In Florida, healthcare workers and nursing home residents are in Group I. However, EMS and firefighter first responders complain they were omitted here. They argue that they are as much, if not more, first-line responders who directly contact infected patients. They make a good case.

Lack of Confidence in Government

The federal response so far to the virus has been tardy and inconsistent. Even at this late juncture in the pandemic, readily available and free testing is lacking. Most public health authorities have given up on contact tracing. The public officials tell us to wear masks or risk more lockdowns. Mask compliance has grown in most endemic urban areas, but the viral spread continues to rage, and lockdowns have been re-issued. There is an emerging sense of civil disobedience and outrage at government hypocrisy over these Draconian measures. Mostly Democratic governors and mayors have been caught defying their mandates. A Riverside County sheriff has publicly stated he will not enforce them. A recent dramatic video plea by a Southern California restaurant owner about being mandated out of business while a Hollywood film crew shoots and eats next door to her is particularly poignant. There is no good science to say that eating outdoors is high risk. “Science” has also failed in its estimate of the dangers of in-school learning. Thus it is no wonder the public is skeptical of the state and federal government’s abilities to fairly and expeditiously administer a vaccine.

Side Effects

In the Phase III trials of the three major approved, or nearly approved, vaccines, side effects have been minimal. However, testing only involved tens of thousands of patients. It will require at least tens of millions of vaccinated people before severe side effects might be seen.

It took 25% of the population being vaccinated for the H1N1 (swine) flu in 1976 before a significant incidence of Guillain-Barré syndrome was noted. This debilitating and sometimes fatal neurological syndrome has continued to plague flu vaccines to a much smaller extent on rare occasions. The public has a right to be skeptical. Medicine and public health have always been a balancing act between potential risks and rewards. As a fellow physician once told me about adopting a new procedure or treatment, “I don’t want to be first, and I don’t want to be last.” I am 72 years old and immunocompromised. I will be in Group II for vaccination in Florida. Barring some disastrous side effects that might be seen while Group I is being vaccinated, I plan on taking the vaccine. I urge everyone else to do so as well.

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