Building Vaccine Confidence: Q&A with Our Vaccine Expert, Karen Ernst

We spoke with The Task Force’s Voices for Vaccines Director Karen Ernst about the latest rumors and misinformation regarding the COVID-19 vaccine, and how experts can improve their approach to build trust within communities to ensure that people are safely and comfortably vaccinated. The Voices for Vaccines (VFV) program is a parent-led initiative supported by scientists, doctors, and public health officials to provide parents clear, science-based information about vaccines and vaccine-preventable diseases, as well as foster discussion about vaccinations. 

Ernst is a former teacher and mother of three children.

What is the latest vaccine rumor going around the world?

One of the most long lasting rumors about the COVID-19 vaccine in particular is that it can affect fertility. Initially when the vaccine was first available for people 65 and older, fertility was not a concern. However, now that it’s available for people who are 16 and older, it makes sense that people of childbearing age would be concerned. There have been a few hypotheses about this, of course none of which have played out to be true.

One of the emerging myths surrounding childhood immunizations emerging right now is that vaccines are somehow related to Sudden Infant Death Syndrome (SIDS). I feel that SIDS is the new “autism” in vaccine hesitancy, because SIDS is diagnosed when no cause has been found. This makes it easy to blame vaccines for SIDS, and this is a particularly sticky rumor right now because it’s actively being pushed out by purveyors of misinformation.

How are these rumors spread?

Before we had social media, regular mainstream media were the channels by which rumors were spread. There was a particular TV special in the 1980s called “Shot in the Dark,” which was about the DTP (diphtheria, tetanus toxoids and pertussis)

vaccine that raised a lot of questions about certain negative side effects that were a result of the old wholesale pertussis vaccine. This resulted in changing to a safer pertussis vaccine and even helped create the National Vaccine Injury Compensation Program. While there were negative side effects back then, they were reported on in an honest and comprehensive manner to affect positive change.

Today, with social media, one does not need a marketing arm to promote their agenda. What we are seeing is that a lot of the people are spreading false information through their personal social media channels in order to sell something, such as  supplements, a video series, essential oils, or even cardboard protest signs.

Why do some people vehemently cling to falsehoods instead of listening to and trusting the science?

There are a lot of different reasons, one being that some people know the truth but simply enjoy spreading falsehoods. But I don’t think that is the case with the majority. Some people genuinely enjoy being a part of a comforting and close knit community in

the anti-vax world and they develop an identity around being a part of the contrary. It gives them purpose, brings them companionship and importance. And a lot of them have gotten here because at some point in their life, the medical community failed them somehow. Some women feel traumatized by their birthing experience, and that leads them to distrusting medical professionals and seeking out the anti-vaccine world. Some doctors feel dismissed by colleagues and look to go out on their own, but the recurring theme is that people felt like they weren’t taken seriously, except by that welcoming community in the anti-vax world. I think we can’t dismiss people for not understanding or believing in the science, when science may have been at some point the cause of their mistrust.

What can experts do to increase trust in science and vaccines?

What experts can do is really to talk like regular people. One thing I’ve always heard from parents who spoke to doctors about vaccine hesitancy is that when the doctor talked about vaccinating their own children, it made a difference. What a lot of people

really want is that personal connection. They want to understand the science, people are interested in learning how these vaccines work, as we’ve seen this past pandemic year. Good, non-condescending, plain language explanations of the science from a regular person as opposed to a “wonky-nerd-scientist” and delivered with empathy goes a long way in assuaging fears and easing uncertainty.

How did the reports of blood clots impact the perception of vaccines?

I think it’s perfectly natural and human when you hear about the rarest side effect, that you are certain that you’ll get it. The same way that you go buy a lottery ticket and feel certain that this ticket is going to be the winning one. Well, neither of those is

probably going to be true. Human beings are terrible at assessing risk, and scientists are terrible at communicating about risk. I personally like to use social math to explain the odds of having a side effect, like when I talk about blood clots from the Johnson & Johnson/Janssen COVID-19 vaccine I say “you’re twice as likely to become an Olympian than to get a blood clot.” Helping people put this risk into perspective really helps.

Also, this is a great opportunity for people to understand just how thorough and sensitive our vaccine safety monitoring systems are. To catch six out of the 7 million people vaccinated is amazing, and this only happened because we were actively looking for and being very, very thorough. This is what we want people to take away, and this level of safety monitoring is not only true for the COVID vaccines, but for every vaccine produced.

The riskiest thing that people are going to do when it comes to getting their COVID-19 vaccine is driving to the site to get their COVID-19 vaccine.

How do we reach different groups of people with varying levels of vaccine confidence?

You have to set different, incremental and realistic goals for these groups and the individuals within them. The obvious goal might be to get someone to get their vaccine, but a different and more realistic goal might simply be for a hesitant person to

understand why others have opted to get vaccinated, even if they themselves are still hesitant.

If we set these realistic and incremental goals, that’s how we can measure change. We still have to be empathetic to their uncertainty, really listen to the reasons individuals have for hesitancy, understand that it’s ok for them to have questions. It’s important to take the pressure off getting vaccinated and aim to have discussions that incrementally affect change in hesitant people. By being a safe place to have these open discussions about hesitancy, hesitant people will likely return to have further conversations that will move that needle forward a bit more.

In my personal experience, my 27-year-old stepson called me and asked “I should get the vaccine, right?” Now he came to me as a mom, not as an expert. Essentially he wasn’t sure, and wanted to discuss it. Of course I said yes, you should get the vaccine, and when he asked me why, my reasons were “because I am your stepmother and I love you, and I wouldn’t advise you to do anything that would hurt you. You have a pregnant wife, and I want her to be protected, and because I want to see you and hug you.”

I didn’t start off with science, I started off with our shared values. People just need empathy and reassurance, so start there. Give people time to understand, work through their uncertainties, and keep the conversation going.

Working with community leaders and small community-based groups goes a long way too. In particular, faith-based organizations are great. In Minnesota, Somali-Americans were very hesitant to get the MMR vaccine until their local Imams jumped in and advised them to get it. It was so important to frame that discussion the Imams had with their groups within the value system of Islam and during Ramaddan particulary. This is an example of how  people are micro-influencers and can speak to their communities in a way that the CDC or the WHO can’t. And many of these smaller groups are not only well connected in their communities, but they know how to work effectively and fast. Working with such groups and leaders goes a long way toward affecting change, keeping the conversation going, and building trust in the science.

We’re at the point that everyone has to have conversations with everyone about getting vaccinated. We can’t lean on the CDC or political leaders and celebrities, we need to talk directly to the ones we love so we can protect them and ourselves, that’s how we’ll reach the last bit of the population.

Header photo: Photo credit Shutterstock.

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