Trust in a Potential COVID-19 Vaccine

[Prof. Maya Goldenberg sitting at a desk, speaking ot the camera.]

Canada’s plans for reopening society depend a lot on a COVID-19 vaccine to protect the public by generating herd immunity. But how is that going to go?

My name is Maya Goldenberg. I’m an associate professor of philosophy at the University of Guelph. I work in philosophy of science and medicine,and I have expertise in vaccine hesitancy and public resistance to science.

Vaccine hesitancy is typically thought to stem from people’s problematic relationship with science, whether it’s poor understanding of science, science denialism, or a disregard of scientific experts by people who think they know better.

I have a different view based on my own research. I see vaccine hesitancy as a symptom of poor public trust in scientific institutions and scientific governance. The public will accept vaccines to the extent that they think the governing bodies in charge of public health and safety are doing their jobs well and are adequately working to protect the best interests and well-being of the public. Governments need to convey this.

Vaccine hesitancy also isn’t about vaccines alone; it’s about vaccine mandates too. Vaccine mandates have always been a political flashpoint when those who don’t want
vaccines cannot easily opt out. These mandates need to be crafted carefully in order to minimize public pushback. They also need to be equitable to make sure that they don’t further entrench social disparities and injustices.

The case for creating a COVID-19 vaccine looks very good. Scientists have been quick to sequence the genome and the virus is not as tricky as some past viruses that have eluded vaccines, like HIV. Researchers are using new and interesting techniques for vaccine development. The promise of a vaccine in 18 months is very ambitious. At the same time, a lot of resources have been put into development and the testing and approval can be expedited because of the urgency of this vaccine. The political will to develop the vaccine seems to be there. The challenge will be to bring the public along to accept the vaccines.

The newness of the vaccine and the speed of its production will be sticking points. Members of the public will be concerned about current weaknesses in the systems of bringing health products to market. Clinical trials are fairly short so we don’t get much in terms of long-term data. Approval is really not sufficiently arm’s length from the manufacturers’ interests and safety surveillance once biotechnologies are introduced to markets are pretty weak.

To counter the risks, Health Canada will need review panelists without financial conflicts of interests, and surveillance needs to be much stronger. The public also needs to know that this is being done.

The new coronavirus vaccine will be rushed to market as soon as possible, as one should do during a health emergency. But this will lead to reasonable public concern about whether rapid testing and approval cuts important safety corners. Many people want the vaccine so they can return to their previous routines and livelihoods but we also know that this vaccine is very political. The U.S. and China are both vying to be first.

The lesson for building public trust is that politics cannot compromise safety. There will be misinformation on the Internet and the same kind of protest that we’re seeing now regarding lockdowns will likely happen regarding the possibility of vaccine mandates to return to work orto school.

The key to countering public mistrust and anxiety over the COVID-19 vaccine is first to create a really safe vaccine, to communicate this transparently to the public too. Speed cannot compromise rigor in testing and the public needs to hear this commitment from the leadership.

The second is to really work to maintain good public relations between scientific bodies, government and the public. At the moment, Canada’s enjoying very high trust
in government response to the COVID-19 pandemic and high levels of public appreciation and trust in health professionals. This is because the government has been communicating effectively regarding the lockdown and has put good communicators, like Chief Officer of Public Health Teresa Tam, into the public eye. The government has also been reasonably responsive to weak points in pandemic response, like the spread of the virus in nursing homes and loss of income in many households. The public sees a socially responsive and scientifically informed government and this increases public trust.

The prospect of a COVID-19 vaccine available to Canadians should be part of the government communications right now, so that the public get used to this idea and be ready for future health decisions. Members of the public are learning a lot about how science is done. Our newsfeeds are full of pandemic modeling, basic reproduction numbers, expert opinions and disagreements between experts.

The public can similarly be educated on how vaccines are developed, tested and approved and subject to safety surveillance. The public should know about the different vaccine trials. They should learn about how many will fail and discover why one or several are thought to be superior products that are worth public health investment and worth personal health investment by getting vaccinated.

Thank you.