AMES, Iowa – The Food and Drug Administration granted emergency use authorization for the first of several COVID-19 vaccines seeking its approval. As distribution begins, Iowa State University experts are available to comment on the safety of the vaccine, the history of such rollouts and the reason some people may refuse to get vaccinated.
David Verhoeven, an assistant professor of veterinary microbiology and preventive medicine, works with animal vaccine companies to help manufacture initial vaccines for testing. He has contributed to research related to swine diseases as well as flu and coronavirus in humans. His expertise includes mRNA vaccines, a relatively new approach used by Pfizer/BioNTech and Moderna to produce their COVID-19 vaccines.
“The mRNA vaccines are a new class of vaccine that appears to work much better than the more traditional DNA vaccines,” Verhoeven said. “The mRNA vaccines induce both humoral and cellular immunity while the DNA only generates strong cellular immunity.”
Verhoeven noted some uncertainty regarding the long-term effects of the mRNA vaccines, simply because they’re so new. However, the early clinical data look promising.
“The clinical trials suggest they are well tolerated outside the first day when you might feel a little sick from them as your body mounts a response to the vaccine that clears up,” he said.
Changing attitudes about vaccines
There are many reasons some people will choose not to get the COVID-19 vaccine. Alison Phillips, an associate professor of psychology, says the decision is often influenced by beliefs and emotions. For example, some people may believe the vaccine poses a greater risk than the disease. Those beliefs are often shaped by personal experiences or groups and individuals they identify with or see as authority figures, she said.
Fear and uncertainty surrounding the pandemic will likely exacerbate the emotional response to the vaccine. Even if people feel the vaccine is necessary, Phillips says they may not get vaccinated because of their fears. Encouraging people to get it will require different strategies.
“The most effective strategy will depend on someone’s reason to not get vaccinated. For those who are strongly against the vaccine, the only strategy may be enforcement. That means work, school, healthcare, the ability to travel or even receiving stimulus funds would be contingent on vaccination,” Phillips said.
Other strategies might include incentivizing or paying people to get the vaccine as well as educational and persuasion campaigns. Phillips says strongly held anti-vaccine beliefs may be too difficult to change on a large-scale or cost-effective manner.
History of vaccines in the U.S.
Many people did not trust the smallpox vaccine when it was first introduced in the late 1770s, but much of that distrust stemmed from a lack of understanding and science, said Amy Bix, a professor of history. Today, there is no shortage of information, but the challenge is battling misinformation about the safety of vaccines, which is easily shared online and on social media.
Bix, who studies the history of science and medicine, says educational campaigns and publicity events aimed at combatting misinformation are similar to what we have seen throughout history. For example, Elvis Presley received the polio vaccine on The Ed Sullivan Show prior to his performance in 1956, which led many people to get vaccinated.
However, Bix says the rollout of the COVID-19 vaccine is unlike any other for two reasons.
“The speed with which they have developed the COVID-19 vaccine is really unprecedented as well as the idea of vaccinating adults as well as kids. With polio and other childhood vaccines there is a natural gateway that the government could request children be vaccinated before starting school,” Bix said. “Vaccinating adults will be a bit trickier, because there is not an adult equivalent to school that they funnel through.”
Shaping the narrative
The surge in COVID-19 cases and deaths should make a compelling argument for getting the vaccine, but Michael Dahlstrom, director of ISU’s Greenlee School of Journalism and Communication, says personal experiences and narratives about the vaccine are just as important.
Dahlstrom’s research has examined the effectiveness of narratives in sharing scientific information with the public. As the COVID-19 vaccine becomes more widely available to the public, health agencies must be transparent about the approval process and the science behind the vaccine, Dahlstrom said. That information needs to be supported by personal stories from those who have received the vaccine and benefited from the protection.
“Stories are the default mode of human thought,” Dahlstrom said. “Science uncovers the abstract truths about the world, but stories show how those truths can be applied at the scale of human experience. Stories about science are powerful because they intrinsically build more connections to other aspects of your life.”
Advances in nanovaccines
Balaji Narasimhan, director of the Nanovaccine Institute at Iowa State, an Anson Marston Distinguished Professor in Engineering and the Vlasta Klima Balloun Faculty Chair in Chemical and Biological Engineering, is leading a team of researchers at Iowa State and the University of Iowa working on the development of a needle-free, single-does nanovaccine that will not require refrigeration.
Narasimhan says the work has the potential to address an urgent public need as well as overcome some limitations of the vaccines now seeking emergency authorization. The Nanovaccine Institute recently received $2 million in federal CARES Act funding from the state of Iowa to support the research.
“While it is wonderful that there are several first generation COVID-19 vaccines that will become available soon, there are multiple opportunities for improved next generation vaccines, in terms of their ability to induce long-lived protective immunity, prevent transmission, and be stored at room temperature for long periods of time,” Narasimhan said. “Nanovaccines can provide these important advancements in the next phase of our fight against COVID-19.”
Nanovaccines against a virus work by loading viral proteins into nanoparticles. Those nanoparticles are about 300 billionths of a meter across and are made from biodegradable polymers. The nanoparticles are incorporated into a nasal spray and delivered with a sniff. Exposure to the nanovaccine triggers the immune system to attack the virus.