Nidhi Bhaskar
Providence, Rhode Island

 

Photo by CDC on Pexels

Four years before the COVID-19 pandemic, I was registering community members at a local health fair. An elderly man in line mentioned that he would never receive a flu shot because his healthy cousin had died of an aneurysm after receiving one. I spoke up, trying to dispel his misconceptions by sharing some facts about vaccines, but he simply scoffed and said that he pitied anyone who would willingly inject “God knows what” into their bodies.

This experience stuck with me years later. As the final phases of COVID-19 vaccine trials began, many spoke excitedly about the prospect of achieving herd immunity, while others stated that they preferred to “wait it out.” As a future physician, getting the vaccine seemed incontestable to me. After all, I had the privilege of learning from and working with scientists and physicians involved in conducting vital research. I marveled at the power that biomedical technology and digital networks offered. I spent countless hours serving as a regional coordinator for GetUsPPE, organizing shipments of personal protective equipment from areas of excess to healthcare systems facing deficits. As my team tried to respond to the overwhelming requests from frontline workers, we counted down the days until mass vaccination efforts began.

However, to most Americans, the processes behind vaccine development seemed intangible, occurring behind closed doors, high up in the ivory towers of academic research. Existing distrust in the medical field was amplified as misinformation spread like wildfire, until there were soon many more doses of the vaccine than people who wanted to get vaccinated. Perhaps most jarring was disregard for the concerns of vaccine-hesitant individuals. From the outpouring of satire written about vaccine skeptics to the value judgments drawn between the vaccinated and dreaded “anti-vaxxers,” mainstream media seemed dominated by people and perspectives that derided the vaccine-hesitant.¹

Though I live in the Northeast, where vaccine uptake was among the highest, my roots lie in Missouri. I grew up alongside friends and relatives who remain skeptical about the vaccine. My social media feeds regularly vacillate between the perspectives of people who advocate for a universal vaccine mandate to those who distrust the vaccine entirely. Most importantly, I have had the opportunity to listen to the concerns of vaccine-hesitant family and friends firsthand throughout the pandemic. And as I listened, I learned that many of them shared worries that I could not always assuage, ranging from concerns about undiscovered long term-effects from never-before-used mRNA vaccine technology to the precedents set by workplace vaccine mandates.

Transformed perspectives hold the greatest potential to transform the outcomes of future pandemics. Beyond the span of the COVID-19 pandemic, the American public is facing a concurrent pandemic of the mind and emotions fueled by a digital age rife with misinformation. Of the unvaccinated, over 42% cited distrust in the healthcare system as a primary contributor to their vaccination status.² If we, as healthcare providers and communicators, wish to do better in the next pandemic, we must rebuild trust through open conversations that foster accountability and restore confidence in the healthcare system. After all, trust is a sentiment that takes tremendous effort to build but can be shattered quickly. From the legacies of historical events such as the Tuskegee syphilis study to the modern-day paucity of preventive care in low-income and systematically underfunded communities, both the healthcare system and the government have previously undermined public trust.^3,4 It is difficult to expect individuals to place trust in a system that has so often met their skepticism with derision.

Moving forward, it is essential to recognize the inefficacies of systems that unnecessarily politicize vaccination and other healthcare issues. Discourse that condescends vaccine-hesitant individuals into compliance will not address underlying hesitancies, but rather will deepen existing divides. Despite the plethora of available medical technologies, if trust cannot be built on the individual level, population health efforts will continue to falter—in this pandemic and the next. Medical technologies cannot save lives without accounting for the makeup and fabric of individual communities. The next pandemic cannot solely be fought with an outpouring of facts and sophisticated technologies but must embrace pragmatism and culturally tailored exchanges. As healthcare providers, we must, of course, lead by example; but our efforts to rebuild trust in medicine and the future of scientific progress lie in our ability to empathize with and make space for others to freely express and discuss their concerns without fear of condescension.

The next time I encounter someone who states that they are hesitant to get vaccinated or skeptical about medical technologies, I will first try to put my own biases aside and ask, “Why?”

 

References

1. Molyneux, W. “Oh my fucking god, get the fucking vaccine already, you fucking fucks,” McSweeney’s Internet Tendency, September 2, 2021.
2. Monte, LM. “Household pulse survey shows many don’t trust COVID vaccine, worry about side effects.” United States Census Bureau, last modified April 12, 2022. Retrieved May 23, 2022.
3. Park, J. “Historical Origins of the Tuskegee Experiment: The Dilemma of Public Health in the United States.” Ui sahak 2017;26(3):545-578.
4. Warren, RC, et al. “Trustworthiness before trust—Covid-19 vaccine trials and the Black community,” New England Journal of Medicine 2020;383(22):e121.

 

---

 

NIDHI BHASKAR is a first-year medical student at the Warren Alpert Medical School of Brown University. An alumna of Brown’s public policy concentration and the University of Oxford’s medical anthropology program, Bhaskar hopes to combine the practice of medicine with the creation of patient-centered health policy.

 

Winter 2023  |  Sections  | Covid-19