Just over 6 billion doses of COVID-19 vaccines had administered worldwide by the end of September 2021, but the world remains far short of having 70 percent of the population fully vaccinated.
While wealth was clearly a factor, as 75 percent had been used in high- and upper-middle income countries—which constitute half of the global population—and 25 percent were distributed in low- and low-middle income countries that make up the other half, there are many skeptics who refuse to get vaccinated because of political manipulation.
In New Jersey, 8,002,478 people or 90 percent of the state has received at least one COVID-19 vaccine dose. Overall, 6,693,376 people or 75 percent of New Jersey’s population are considered fully vaccinated.
Additionally, 3,147,530 people or 35 percent of New Jersey’s population have received a booster dose but public health officials still grapple with the hesitance that many Americans exhibit toward the COVID vaccines.
Alabama, Wyoming, Mississippi, Louisiana, Idaho, Arkansas, Tennessee, Georgia, North Dakota, and Indiana all report fewer that 55 percent of the population are considered fully vaccinated.
Missouri, South Carolina, Montana, Oklahoma, Kentucky, West Virginia and Ohio have fewer than 60 percent of the population fully vaccinated.
North Carolina has 60.6 percent and Texas has 61.2 percent of the population fully vaccinated, leaving Florida (66.7%) and Virginia (72.9%) as the only former Confederate states that tried to breakaway from republic during the Civil War with numbers approaching acceptable levels of protection.
During a discussion titled “Nudging the Vaccine Hesitant,” a panel of experts gathered to weigh the efficacy and ethics of public health “nudges,” small interventions that may push people into a specific action, in the COVID-19 pandemic.
The event, hosted by the Center for Ethics and Human Values (CEHV), featured Mark C. Navin, professor of philosophy at Oakland University, Kristen Carpenter, assistant professor of clinical psychiatry and behavioral health in Ohio State’s College of Medicine, and Myriam Shaw Ojeda, assistant professor of pharmacy practice and science in the College of Pharmacy. The event was organized by Trevor Hedberg from CEHV and the College of Pharmacy.
“Some nudges, in some contexts, can be very effective,” Navin said. A complicator in the case of the pandemic, however, is that there is a disagreement about whether vaccines are a public health matter or one of individual health. In the case of individual health, the chief value is informed consent.
This is where the issue of nudges becomes more complex, said Shaw Ojeda. If nudges are meant to be small interventions, how informed can a patient truly be?
“How do we work with people in a way that promotes equity or does not infringe on a person’s ability to make a decision? How do you educate a patient fairly?” she asked.
In addition to questions about informed consent, the panel considered how effective nudges have been since the pandemic began. One example is the state’s Vax-A-Million sweepstakes, where vaccinated Ohio residents were entered into a weekly lottery for the chance to win $1 million or a college scholarship.
“I was in a meeting a week after the lottery was announced and we saw a spike,” said Shaw Ojeda, who worked on the state’s vaccination campaign. “We saw a spike in vaccine uptake but that spike was not sustainable. It lasted for the duration of the program and then it went away.”
While the gains these programs make are not sustainable, Carpenter was quick to say that even a small increase in the vaccination rate is meaningful for the state and the country.
“One percent, two percent, three percent, we’re still talking about millions of people,” she said. “I don’t think we should dismiss these small gains. If you can’t celebrate, it’s too hard. So if I see that even one person has made the choice to get vaccinated, fantastic.”
All three panelists mentioned the polio vaccine and how it is considered a highly successful vaccine rollout. Navin was skeptical of this assessment.
“There’s good reason to think that there was a lot more socialization toward conformity, towards obedience,” he said. “We lived in an especially white, suburban, middle-class life where both political parties were not polarized. And so we had a sort of bipartisan conformity in the culture.”
Carpenter agreed, suggesting that the polio vaccine would encounter the same problems the COVID-19 vaccine does today, due in large part to mistrust of public health officials.
“There is misinformation and distrust of the system,” she said. “And some of that distrust is warranted when you think about what has been done to various communities, in medicine. But I think [during the polio epidemic] there was trust that the government would do right by the public. … I don’t know that we have the tools to combat that now.”
Shaw Ojeda agreed that some communities had good reason to question public health measures in the past, adding that trust must be rebuilt, especially with historically disadvantaged groups.
“We are going to deal with this pandemic for the immediate future,” she said. “Hopefully it will pass but, in the meantime, what are the lessons we’re learning here?”