The time to address vaccine skepticism among Texans is now

As America and the world welcomed the first coronavirus vaccination in England this week, recent national polling in the U.S. finds continued skepticism among Americans about whether or not they will ultimately get vaccinated, with the share of Americans willing to get a coronavirus vaccine ranging between 45% and 61%, according to Washington Post reporting. Polling in Texas tells a similar story, but also points toward means of addressing the public health threat posed by resistance to vaccination. 

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Don't know/No opinion21%

University of Texas / Texas Tribune polling from October found 42% of Texas voters saying that they would get a coronavirus vaccine if it was available at a low cost. This, of course, implies that the majority of Texans, approximately 58%, were either unwilling or unsure whether or not they will get a coronavirus vaccine — and more unwilling (36%) than unsure (21%). The public health implications of this are dire. Governor Greg Abbott has made it clear that no one should expect further statewide restrictions in an effort to slow the spread of the COVID-19 virus while Texans await distribution of vaccines. The strategy in Texas thus far, appears to be a reactive, whack-a-mole effort to mitigate the damages of the virus as best as possible until the vaccine can be widely distributed.

The reliance on widespread vaccination in the not-too-near future to stop the spread of the virus requires addressing the very real threat posed by widespread resistance to vaccination. Public opinion polling in Texas provides valuable information about how to go about attacking skepticism that is largely based on misinformation or exaggerated fears. 

The goal of widespread vaccination is to achieve what medical experts call population immunity or, in public parlance, “herd immunity.” According to the CDC, herd immunity is “when enough people have protection—either from previous infection or vaccination—that it is unlikely a virus or bacteria can spread and cause disease.” However, the CDC also says that there is no clear consensus on what share of the population will need to get vaccinated in order to achieve herd immunity to COVID-19. If vaccinations, and in turn, herd immunity, are to be the primary mitigation strategy in Texas, the time to begin chipping away at that skepticism is past due.

Vaccine skepticism appears to be more prevalent among some groups than others. According to UT/TT polling, the Texans most likely to reject or resist vaccinations include: Rural, Black, politically independent, Republican, female, middle aged, and older Texans.

Texans Most Unwilling (or Unsure) About Getting a Coronavirus Vaccine
(October 2020 University of Texas / Texas Tribune Polling)

Group Unwilling Unsure Total
Rural 50% 22% 72%
Black 54% 17% 71%
Independents 44% 24% 68%
Republicans 43% 19% 62%
Women 38% 24% 62%
30-44 years old 46% 15% 61%
45-64 years old 36% 23% 59%
65+ 30% 27% 57%
Overall 36% 21% 57%
White 34% 22% 56%
Suburban 33% 23% 56%
Hispanic 29% 24% 53%
Men 33% 19% 52%
Urban 32% 18% 50%
18-29 years old 30% 20% 50%
Democrats 25% 24% 49%

It’s helpful to know that skepticism is concentrated in some identifiable social groups. Our ability to identify these pockets of resistance enables us to design and implement strategies for overcoming resistance to the measures that are necessary to stem the spread of the virus. Health officials, politicians, and even celebrities can be carefully and selectively chosen and deployed to communicate the importance of vaccinations to those populations currently most skeptical.

While some of this skepticism is immediate and explicable, like concerns over the vaccine’s safety, or skepticism towards vaccines writ large, other sources of skepticism are surely more multifaceted and complex. For example, distrust of the medical establishment and the historical prominence of the Tuskegee experiments, in which the progression of syphilis was studied in Black men without treatment, and without continued consent after the study had ended, are widely cited as contributing to higher levels of vaccine skepticism among Black Americans. This is a complex and politically sensitive set of attitudes that require equally complex and strategic communication and outreach measures.

However complex the sources of reluctance to be vaccinated against COVID-19, the time to begin working on those attitudes is now. There will be an increase in the share of people willing to get vaccinated as time goes on. Celebrities and politicians will get publicly vaccinated; more work and leisure activities will require vaccination as a cost of entry; more people engaging in more activities will increase the cost of non-compliance among those who hold out; and more people getting vaccinated safely will all lead to higher adoption rates over time. But the current levels of skepticism are too high to wait for the acceptance of vaccination to spread organically. We are fortunate to have data that tells us where the resistance exists now – we need to recognize that data as another tool for fighting the COVID-19 pandemic, sooner rather than later.