null Overcoming vaccine hesitancy

Our best hope of charting a course to a post-pandemic world

By Ian Popple

Source: Health E-News. After achieving the monumental feat of developing and approving, not one, but two COVID-19 vaccines in under a year, the focus has now shifted to immunization – arguably the most important phase of the pandemic yet. “Ensuring effective and equitable delivery of these vaccines is our best hope of charting a course to a post-pandemic world,” says Dr. Don Sheppard, Chair of the Department of Microbiology and Immunology at McGill University’s Faculty of Medicine and Health Sciences and Director of the McGill Interdisciplinary Initiative in Infection and Immunity (MI4).

Failing to administer the vaccine to enough people to achieve herd immunity – the point at which the virus is unable to find enough hosts to spread – would be akin to falling at the finish line of a marathon. Yet there are significant barriers to vaccination, ranging from logistical challenges associated with distribution, to public resistance rooted in cultural attitudes.

Overcoming barriers in a real-world setting

“MI4 launched a call for proposals in the fall with the aim of developing strategies to overcome these barriers in a real-world setting,” says Dr. Sheppard, who is also a senior scientist with the Research Institute of the McGill University Health Centre (RI-MUHC) Infectious Diseases and Immunity in Global Health Program. Six studies were selected and received grants of up to $100,000 each from MI4, supported by the fundraising efforts of the McGill University Health Centre (MUHC) Foundation, McGill University Advancement and the Jewish General Hospital Foundation, who are proud to have their vibrant researchers and related communities collaborating under the MI4 umbrella.

Considering what the world has been through over the past year, it would seem incredible that anyone is on the fence about embracing a potential solution. Yet, studies suggest many remain unconvinced about vaccination. Research published in the fall of last year found that only 39% of Canadians would take a vaccine as soon as one became available, down from 46% in July.

Vaccination against COVID-19 coronavirus
Vaccination against COVID-19 coronavirus

“Fast track does not mean shortcut”

One of the reasons for this vaccine hesitancy is a perceived safety concern related to the speed at which these vaccines have been developed. Vaccines commonly take between 10 and 15 years to reach the market. Mumps reset the bar in the 1960’s, at just four years. But the rapid spread, and staggering death toll, of COVID-19 helped fast track the development of several vaccines in record time. “Many aspects of the approval process, such as administrative reviews, were started early so as not to delay the process, and factories were built to mass produce the vaccine while it was still under development,” explains Dr. Sheppard. “It’s important for people to understand that fast track does not mean shortcut.”

Unfortunately, as the old saying goes, a lie can travel halfway around the world, while the truth is still putting on shoes. That is particularly true today, when misinformation can be shared to a massive social network at the click of a button. “Vaccine hesitancy is, to a large extent, rooted in a lack of trust in social institutions, including science itself,” says Dr. Ian Gold, Professor of Philosophy and Psychiatry at McGill, who is leading one of the new MI4 projects. Gold’s study aims to overcome this by developing a trust-based strategy for increasing vaccine uptake. Dr. Inés Colmegna, McGill Associate Professor based in the Division of Rheumatology at the MUHC, aims to address similar fears and misconceptions by adapting strategies learned through influenza vaccination campaigns.

The other MI4 studies, funded through the new initiative, are focused on specific demographic groups. A study led by Dr. Zeev Rosberger, McGill Associate Professor in the Departments of Oncology, Psychiatry and Psychology at the Lady Davis Institute of the Jewish General Hospital, aims to encourage altruistic behaviour in the relatively low-risk 20-to-40-year age group. Dr. Moshe Ben-Shoshan, Assistant Professor in Pediatrics based at the Montreal Children’s Hospital, is leading a study focused on children and Dr. Abhinav Sharma, McGill Assistant Professor based in the Division of Cardiology at the MUHC, aims to encourage vaccination in cardiovascular patients and other high-risk individuals.

Drs. Don Sheppard, Inés Colmegna, Moshe Ben-Shoshan, Abhinav Sharma and Nadine Kronfli are members of the Research Institute of the MUHC
Drs. Don Sheppard, Inés Colmegna, Moshe Ben-Shoshan, Abhinav Sharma and Nadine Kronfli are members of the Research Institute of the MUHC

Interventions that could increase uptake

The last of the six newly funded projects aims to shed light on the spread of coronavirus in Canada’s correctional facilities – an area that has received too little attention. “Prisons are congregate settings, very much like long-term care facilities, where the virus can spread easily among inmates, guards and support staff, and into surrounding communities,” explains principal investigator Dr. Nadine Kronfli, McGill Assistant Professor based in the Division of Infectious Diseases at the MUHC. “While vaccine uptake rates have been historically low in Canada’s prisons, studies have shown that vaccination programs have the potential to increase uptake if partnered with educational intervention.” Dr. Kronfli will determine what form this educational intervention should take to be effective, including who should be delivering the information. Anecdotal evidence suggests that nurses or inmate peers may be best suited to do so in correctional settings.

Each of these studies has a timeframe of just six months, which should allow the results to provide real and actionable insight that can improve Canada’s vaccination program this year and help bring an end to the pandemic. As Dr. Gold, explains: “These COVID-19 vaccines have covered a vast distance from the lab bench, where it began, but this effort will do nothing to alleviate the pandemic if the vaccine doesn’t cover the final inches to the recipient’s arm.”

January 26, 2021