I am saddened by the headlines Arkansas has made nationally related to our poor rates of covid-19 vaccination and surging case numbers from the Delta variant. As a public health professional living and working in this state, I feel personal responsibility to improve the health of Arkansans. I am disheartened by the fact that many residents of our state refuse to protect their health and the health of their community by being vaccinated for covid-19.
I frequently hear that covid-19 vaccines were developed too rapidly and we cannot trust the science behind them. The technology behind the mRNA vaccines, which in the case of covid-19, acts to provide our bodies with an immunologic blueprint to fight infection, has been around for more than three decades. The first study of mRNA in mice was reported as early as 1990 and many vaccine platforms have been developed since then. Scientists had a large body of research when developing the covid-19 vaccines.
A related concern is the clinical trials were done too rapidly. Vaccine clinical trials all have similar designs. Participants are randomly assigned to receive whatever vaccine is being tested or a placebo (an inert compound that does nothing to the body). To assess the effectiveness of the vaccine, researchers must wait until enough participants are exposed to whatever infectious disease the vaccine targets. Sometimes, in the case of more rare infectious agents, this can take time. However, because covid-19 was circulating in the general population at such high levels during the time when the vaccines were being tested, researchers were able to identify infections in both the vaccinated and unvaccinated groups very quickly.
Other reasons why the vaccine was developed so quickly include unprecedented cooperation among researchers across the world in sharing data and conducting multi-site clinical trials, high level of participation among clinical trial volunteers, and significant funding from both government and industry.
People have also expressed concern about possible side effects from the covid-19 vaccines. There has not been enough time to monitor long-term effects of the various vaccines available, but we can make some confident assertions based on what we know about the safety of the vaccines. One reaction that some younger vaccinated individuals experience is myocarditis, a swelling of the heart. However, the vast majority of myocarditis cases are mild, resolve fairly quickly and have only been documented at a rate of about 41 per million vaccine doses (0.004 percent).
Other side effects, including pain at the injection site and flu-like symptoms, have been documented with greater frequency than myocarditis but are still relatively mild and are consistent with other vaccines routinely administered, such as measles, mumps and rubella (MMR), tetanus and viral hepatitis.
Obviously, everyone can make his or her own choice whether to get vaccinated. Importantly, there are many vaccines required by states for children to attend school, so there is a strong precedent for state and local government creating public health mandates around vaccine administration.
Some of the pushback against covid-19 vaccination seems to assume that individual decisions to get vaccinated are personal and therefore should not be subject to social pressures. However, the primary rationale behind public health guidance to vaccinate as many people as possible is based on the idea of achieving herd immunity. This means that enough individuals become immune to a disease, through infection or vaccination, so that person-to-person transmission becomes more rare. For individuals who already had covid-19, we still do not know how long immunity from previous infection lasts, so the Centers for Disease Control and Prevention strongly recommends vaccination even for individuals who previously had covid-19.
Changes in normative behaviors to improve public health have been effective in the U.S. before. Changes in social norms have been extremely influential in reducing rates of smoking. When the science became clear that secondhand smoke was a threat to public health, states across the country began banning smoking in public places.
While public health is acutely aware of and concerned with individual rights, such rights must be weighed within the context of the right to live a healthy life. In the case of exposure to secondhand smoke, our society has determined that the rights of smokers to smoke in public do not supersede the rights of nonsmokers to avoid exposure to something that can harm their health.
A similar case can be made with covid-19 vaccination. While individuals have the right to refuse vaccination, they do not have the right to put others' health at risk. Therefore, if someone chooses not to get vaccinated, they should follow public health guidance to wear masks and social-distance so as not to potentially expose others in their community to covid-19.
Public health is concerned with protecting the health and well-being of all members of society. To do this effectively, we must be willing to adopt a "we're all in this together" mentality. Let's look to the interests of all Arkansans and get vaccinated so we can finally get to the other side of this pandemic.
Nick Zaller, Ph.D., is a professor at the Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences. The views are those of the author and do not necessarily reflect those of UAMS.