Misinformation Isn’t Going Away, So Offer Convenience and Clear Communication About Vaccines

At a webinar hosted by RealClearHealth, I spoke on how “vaccines are one of the few truly cost-effective health care interventions.” When evaluated across a range of preventable transmittable diseases, studies demonstrate that vaccines are worth more than their cost, and increase life expectancy and quality of life. But vaccines are only effective if they are used.

There are many reasons for vaccine hesitancy, and they all contribute to lower rates of vaccination even in high-risk people for whom getting vaccinated has a large potential benefit. Misinformation, and a lack of trust in science or the healthcare system are related to vaccine hesitancy; unfortunately, those are very hard to fix fully. There is no one way to raise vaccination rates, but there is evidence that a variety of methods can make it easier to get people vaccinated, even in the face of misinformation and bad actors who would undermine scientific progress. There are ways to encourage people to use this preventive care.

In reality, there is no medical intervention that does not involve risk; that includes drugs, surgery … all of it. Every decision we make about our healthcare is a two-sided calculation of risk and benefit. First, what is the risk of doing nothing and second, what is the risk and benefit of the treatment. This involves accepting a degree of uncertainty in the outcome because the evidence is imperfect. The data we have about a drug when it is first approved is the least information we will ever have about it, more is to be learned in post market study or from real world evidence generation. Furthermore, clinical trials don’t include all types of people who will take the treatment, often certain races and ethnicities are underrepresented. No individual person’s response or side effects are accurately described in a clinical trial of hundreds or thousands of people.

So, we rely on health care providers, scientific institutions and often trusted people in our community or friend group when deciding to get a vaccine or other preventive care treatment. We know that misinformation and lack of trust in healthcare and science is not helpful, but we also know what has worked in the past.

There have been many analyses of the factors that contributed to a high percentage of the population getting vaccinated for COVID-19 that can be carried forward today. These lessons from this great national tragedy of the pandemic followed by the triumph of a technology that dramatically reduced the death rates from COVID-19 are a success that can be built on. One of the critical factors that led to successfully vaccinating people during the pandemic was eliminating cost sharing and providing access in convenient places. Trust in the medical profession as well as others communicating about the vaccine is also associated with less vaccine hesitancy.

It is well established that making preventive care convenient is a way to increase treatment and diagnoses of underlying disease. This includes having care available in pharmacies, workplaces, and community events.

Another avenue to improve vaccination rates are clear guidelines, for the public, clear guidelines help deputize the patient to know when it is time to seek out preventive care. During the pandemic people knew at what age and with what risk factors they were eligible for a shot. Most middle-aged people know the magic age when it is time to get a mammogram or a colonoscopy because the guidelines are clear and well communicated. Our health providers have a high burden placed on them already, adding extra layers of complication to a vaccine recommendation is passing responsibility from the delegated authority to the individual provider.

But clear communication and guidelines do not mean that there is a one-size fits all. The age for a vaccine or other preventive service may vary depending on certain risks. That was clearly communicated in the COVID-19 pandemic and people were able to understand and show up when it was their turn. For some higher risk groups the vaccine may have benefit at an earlier age, the same goes for cancer screenings and mental health intervention. As we gain a wealth of data about differences in health outcomes and risks of disease in different population, as we did in the pandemic, we should use that information to create guidelines that meet all patients’ needs. 

The growing distrust in medicines is not a new phenomenon. Yet, its prevalence and rise following the highly politicized COVID-19 vaccine debate presents a new challenge for public health. Of course everyone, from public health officials to doctors and vaccine developers, should emphasize truth, transparency, and the scientific method to encourage the better utilization of vaccines and save both dollars and lives. People are smart and good consumers of information, clear communication about the risks and what the available evidence indicates about a treatment is a way to build trust.

But as we continue to live in the cloud of misinformation, we have to use the other tools we have: convenient access to care, clear and targeted guidelines, clear communication about risk and benefit and trusted intermediaries to encourage the use of lifesaving vaccines for individual and public health.

Kirsten Axelsen is a nonresident fellow at the American Enterprise Institute (AEI), where she focuses primarily on domestic and international pharmaceutical policy. In addition to her AEI work, Ms. Axelsen is a consultant to biopharmaceutical and other life science companies.