With the recent news of a COVID-19 vaccine available to the public, it seems more valuable than ever to take a whirlwind tour of the history of vaccines and the current development of the COVID-19 vaccine. The Pfizer/BioNTech vaccine that was developed in less than one year is remarkable, not only because of the speed at which it was produced, but also because of the efficacy of preventing the disease—with a 95% effectiveness rate. In this first post in a series of posts about vaccines, let’s take a closer look at the demographics of that much talked about Pfizer vaccine trial, the public’s willingness to get the vaccine, and how we can trust the medicine in a time of rampant misinformation.

Race and Ethnicity in the Pfizer Trials

The 95% statistic that has been in the news is a slight generalization, since some groups of people saw better outcomes from the vaccine than others; however, all groups saw significant benefits. Of the more than 40,000 people included in the late stage trials by Pfizer, about 9% were Black or African American. Indeed, the Black community was slightly underrepresented in this study compared to the national proportion of the Black community in the U.S (roughly 13%). Furthermore, Hispanics and Latinos, compared to the percentage in the United States, were overrepresented (approximately 26% of individuals in the Pfizer vaccine study were Hispanic or Latino; U.S. census data reports Hispanics and Latinos make up about 18% of the population). Despite the slight over and underrepresentation of some groups, the wide success of the vaccine eliminates many of the concerns that have arisen throughout history when medications and treatments have been tested on minority communities.

The effectiveness of the vaccine, coupled with the diverse populations that were in the trial, emphasizes the value of the results and gives us cause to be hopeful for 2021 after a bleak 2020.

The overrepresentation of the Latino community, I suspect, is due to where the trial was conducted. This minor detail, which on the surface may seem trivial, actually gets at an important detail about the way in which Pfizer/BioNTech carried out the study. It was a truly global effort. Participants in the vaccine trials were not just people living in the United States. The vaccine was also tested in Argentina, Brazil, and South Africa. Roughly 1 in 5 participants was from Argentina or Brazil (21.4%). All that is to say, an implicitly and explicitly biased American healthcare system was at least slightly reduced by the worldwide design of the trials. 

Public Opinion of the COVID-19 Vaccine

Despite the reported success, which has been reviewed by independent medical experts outside of Pfizer and BioNTech, there is much skepticism across the country about the vaccine and public health initiatives. Such concern is unfortunate because it will take an entire community effort to stop the spread of the virus. For months the mantra has been clear: wear a mask, physical distance, and stay at home as much as possible. Yet it has also been confusing: city officials say one thing, governors and local representatives say another, and the president and his team offer still other recommendations

So while it is good that a recent poll from the Kaiser Family Foundation, a non-profit dedicated to covering national health issues, has shown an increase in those definitely or probably wanting to get vaccinated, now up to 71% compared to 63% in September, there is still reason to be concerned about what the support will actually be, once the vaccine is available more generally.

70% can seem like the magic number we are aiming for; after all, scientists widely agree that 70% of the population must be immune to reach the coveted state of herd immunity—the point at which transmission of the virus dramatically drops. But it is a more complex situation than that.

The poll shows that about 2 in 5 people (41%) responded that they will definitely get vaccinated. Some are more hesitant; 30% responded that they will probably get the vaccine. Add them up and they achieve that 71% statistic, so there is not as much definitive support than may appear at first glance. It will be important as we head into the new year to be patient when it comes to the vaccine; it will take time for the vast majority of us to get vaccinated and some friends and family may be more willing than others to trust the vaccine.  

Vaccine News and Next Steps

As more news coverage about the elderly and healthcare workers getting vaccinated appears in our newspapers, TV networks, social media feeds, and family stories, support for the vaccine will shift positively and negatively. Early news coming from Great Britain raised concerns about the safety of the vaccine when two people reported severe allergic reactions. But public health officials and scientists have since revised their recommendations and clarified confusion about the safety of the vaccine. 

Concern and hesitation about the COVID-19 vaccine is understandable and justified. There is a long history of questionable ethics, abuse of patients, and despicable actions from doctors and researchers in America and abroad. In this short series of blog posts about vaccines, I am sure we will encounter some of these tragic stories. But I would also like to share some other fantastic achievements throughout history that shine a light on the immense public health benefits vaccination has had for everyone. These historical anecdotes are not to overshadow or discount the inequity in healthcare that goes back centuries, but I think it does a good job to show how we as a society have changed, the progress we have made, and where we can still do better in the future.