America still hasn’t settled the mask war, and now they’re about to enter the vaccine war.

This isn’t a new war in America, there’s been a growing distrust for vaccines in America for at least a decade. This isn’t just a concern of Black Americans, although Black Americans’ distrust for vaccines is measurably the strongest.

A Gallup poll released in November showed 58% of the adults surveyed were willing to be vaccinated, up from 50% in September. However, an October Harris Poll found only 43% of Black individuals said they would take the vaccine as soon as it becomes available.

The level of mistrust of Black Americans of the medical system and of vaccines is motivated by generations of systemic medical racism and predatory experimentation on Black people, including the often-noted Tuskegee Experiment. Considering the deep mistrust of Black Americans in the country’s medical system, getting them to change their minds about taking a Covid-19 exam will involve a serious undertaking.

This overall level of mistrust of the COVID-19 vaccine must be addressed if the country is to reach “herd immunity,” the point at which the virus will quit spreading like wildfire. Infectious disease expert Dr. Michael Osterholm says herd immunity can be reached when at least 60% of the population is immune. With that number, reaching herd immunity seems rather attainable, however you need to consider that no vaccine will be perfectly effective.

While the Pfizer and Moderna vaccines seeking emergency approval in America have touted 90%-plus efficacy, Dr. Anthony Fauci, director of the National Institute of Allergies and Infectious Diseases, says he would be optimistic with a vaccine that is 75% effective. That means at least 80% of the U.S. population (60% divided by 75%) must be vaccinated if the virus is to be tamped down to the point where enough people will feel safe to patronize service establishments and travel so the country and economy can return to some semblance of normal.

Hard Work Ahead

How can America possibly convince its citizens to take the COVID vaccine?

Given the power of the anti-vaccine movement, “we have a lot of work to do” to educate said Fauci. “It’s not going to be easy,” he said. “Anyone [who] thinks it will be easy is not facing reality. It’s going to be very difficult.” Building trust in a new vaccine starts with ensuring a transparent, science-based regulatory process. Despite political pressure by the Trump White House, career professionals at the Food and Drug Administration, backed by a few political appointees, have taken steps to ensure evidence-based review of candidate vaccines in recent weeks.

Educational campaign

Fauci said the government has a vaccine education program to counteract anti-vaccine messages. Definitely it’s something that’s needed but it’s difficult to find proof that the program exists.

According to Dr. Saad Omer, director of the Yale Institute for Global Health, the federal government has allocated $250 million for communication about Covid-19. The Trump administration originally earmarked the funds for a Department of Health and Human Services advertising campaign to counteract “Covid despair,” which has since been canceled. Omer hopes that money will be reallocated for a program to inform people about the vaccine. Such a campaign was recommended by the National Academies of Science, Engineering and Medicine. Unfortunately, so far there has been minimal investment in such a campaign and other efforts to increase confidence in a vaccine.

According to Omer, who has researched vaccine acceptance in many populations and countries, a national vaccine communication and education campaign needs to fulfill three goals: It must restore trust in vaccines, be national in scope and — at the same time — engage local communities, particularly communities of color.

Here are a few strategies that he believes could help reach the country’s immunizations goals.

*Leverage trusted vaccine endorsers In a survey conducted by Omer and his colleagues, he found that coronavirus vaccine endorsed by Dr. Fauci increased a willingness to take the vaccine among Democrats, Republicans and independents. A study conducted by the NAACP, found that endorsement of the vaccine by Pres. Trump would reduce the number of Black Americans who would be willing to take the vaccine. Omer’s group suggested joint bi-partisan endorsements by prominent Republicans and Democrats along with prominent scientific leaders would go a long way.

*Recognizing that the mistrust by ethnic and racial minority groups will be difficult to overcome, but must be addressed directly. He suggests using a similar approach as above, pairing a community validator (e.g. a Black church leader) with an expert (e.g. a Black physician) with roots in the same community. Organizations with deep roots in the communities (such as the NAACP or other Civil Rights groups) are also recommended as essential partners in such an effort.

*Involve health-care providers Research consistently identifies health-care providers as the most trusted source of vaccine information, which makes them indispensable resources for ensuring a high uptake of the Covid vaccine. However, Omer says it’s important that these providers be trained on “evidenced-based technique” for effectively communicating with patients around this issue. Some of these techniques include “implicit cues,” that they expect patients to get vaccinated. Communicating social norms by implying that most other patients get vaccinated or that vaccination is what most previous patients have chosen. When patients still decline to make sure they counsel the patient on the consequences of vaccine refusal.

Incentives and Sanctions

If you can’t convince people to get vaccinated through an educational campaign, forget about it, and go another direction. Incentives and sanctions are an intervention strategy that can be effective without getting a person to change their opinion about vaccines.

Incentive programs provide people with monetary or monetary rewards for getting the vaccine and sanction programs enact monetary or nonmonetary penalties for failure to get the vaccine. So far, sanctions have proven among the most effective strategies for getting people to wear masks. If there’s a sign on a store, restaurant, or other place of business that says “mask required for entry” – the sanction – and you want something that’s inside enough, you’ll put on the mask to enter.

Sanctions are also a practice used in our public-school systems to make sure students who don’t have their current vaccines aren’t allowed to attend school. It’s highly likely that at some point, students will be required to have their COVID vaccine in order to attend schools. Similarly, it could be expected that employers will require their employees to have a COVID vaccine in order to come to work or to be hired.

Incentives for getting the COVID vaccine, particularly monetary incentives, are growing in popularity as a concept.

John K. Delaney, a candidate for the 2020 Democratic presidential nomination, served as a congressman from Maryland from 2013 to 2019. In a recent editorial in The Washington Post, he called for a monetary incentive as a way to increase the uptake of the COVID vaccine. As a part of the next stimulus package, Delaney proposes paying every American $1,500 to get vaccinated. Send proof of vaccination, receive a $1,500 check.

“The vaccines are likely to arrive at the same moment Washington is, belatedly, taking up much-needed stimulus legislation. The timing couldn’t be better,” wrote Delaney. “Money would go into Americans’ pockets just when the U.S. economy can begin fully reopening with a vaccinated population that can go about their daily lives without fear of catching the disease or infecting others.”

So, despite the expected price of approximately $383 billion if every American adult over 18 took advantage of the program, Delaney says his proposal would be the fiscally responsible thing to do, bring the economy back, and save lives.

Economists will point out that any vaccine payment scheme will overcompensate, since most of those getting the shots – and the money – would have taken the vaccine without the incentive. Others will object that a vaccine payment scheme rewards people for being unwilling to change their views.

Both of these objections may be valid, but if Congress is going to send out another set of stimulus checks, why not get something more specific in return, concludes Delaney.

The question remains: would $1,500 be a large enough incentive to get Americans to herd immunity?

Let us know what you think about the efficacy of any of these ideas. You can comment at Facebook.com/TheCommunityVoice or at www.communityvoiceks.com.