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Vaccination Rates Slow in the U.S.: What’s Behind Vaccine Hesitancy?

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If getting vaccinated can protect you, your friends and family, and maybe even the world, why would anyone hesitate to get it? Beyond the right-wing media fueled conspiracy theories and the dangerous pre-existing undercurrent of anti-vax sentiment, there are some understandable reasons based on people’s real experience with our profit-driven, grossly unequal system generally and the healthcare industry specifically. 

No Trust in For-Profit American Healthcare

Ironically, as a nurse I have heard patients reference the fact that the vaccine is free as evidence that there must be something wrong with it. Common, but essential medicines like insulin and epi-pens are priced out of reach, so how can this new, high-tech vaccine really be free? And how free is free? People expect that there will be hidden costs they didn’t know to ask about and have no control over. This well grounded fear is a result of surprise medical bills which happen every day and are a significant source of medical debt.

The well-documented history of racist, sexist, bigoted research and treatment programs by our institutions of public health also contributes to vaccine hesitancy. For 40 years, the Centers for Disease Control and Prevention (CDC) supported the criminal Tuskegee study of untreated syphilis—researchers told Black men in Alabama they were being treated for the disease when in fact they were being studied to determine what happens when syphilis is left untreated. This is the very same CDC that alongside Trump, Republican governors, and the entire political establishment totally failed to contain the spread of Covid, with flip-flopping and confusing guidance. Hot spots of infection still continue to emerge, especially in the South and West. Why, then, should anyone trust the CDC’s recommendations? 

What we are seeing is the emergence of two Americas: large concentrations of people in the South and rural areas are unvaccinated and actively vaccine resistant, many succumbing to conspiracy theories about the vaccine. But these ideas can only spread in the context of a completely discredited medical and political system.

Only a socialist analysis can validate this skepticism and provide a credible explanation: it is true that profit is the only goal of the pharmaceutical, health insurance, and hospital corporations. We agree that the institutions of government, who everywhere prioritized reopening economies over science-informed pandemic response, leading to hundreds of thousands of unnecessary deaths, do not deserve our confidence. But a grossly ineffective vaccine would not stabilize the economy. Only 0.1% of new COVID hospitalizations, and 0.8% of deaths in the U.S. are among vaccinated people. In other words, nearly everyone dying and getting seriously sick is unvaccinated; the vaccine works. The speed, quality, and price of the vaccine are simply an admission by the capitalist class that they need us, a lot of us, to do the work that makes them money. Turns out, workers are essential.

A Socialist Response to the Pandemic

If development, production, and distribution of the vaccine are primarily in the interest of the capitalist class, what would a working class solution look like? 

A widespread public health campaign, with easily digestible information in multiple languages, and participation from all levels of government, educational institutions, and unions should be launched to educate people about how the vaccine was developed, how it works, how you get it, and how effective it has proven to be. Outreach should be done in communities with low vaccination rates to answer questions about the vaccine and dispel myths. All workers and students should be guaranteed time off with no loss of pay or grade penalties to receive the shot and recover for days after if need be.

Fundamentally though, we need an improved Medicare for All system so everyone in the U.S. could access high quality care, free at the point of service. With such a system, we all would have long-term relationships with healthcare professionals whose recommendations we trusted. With tens of millions uninsured and a general underinvestment in primary care in the U.S., this type of trusting relationship with familiar faces in healthcare who could encourage getting the vaccine is not a reality for many. Over time, improved Medicare for All would improve health overall, close the racial and income gaps in health outcomes, and restore dignity and respect to healthcare in the U.S.

Even the best healthcare professionals cannot provide effective medication, vaccines, and treatments without a network of ethical, unbiased research, development, and production facilities behind them. We cannot control what we do not own: the pharmaceutical corporations who are making billions off of vaccines that were developed by hard-working healthcare workers and scientists must be taken into public ownership and democratically controlled. 

Scientific research must be freed from its reliance on corporate funding. We need massive re-investment in education generally and science education particularly. 

Until the climate catastrophe is seriously addressed, and rampant deforestation halted in its tracks (one of the key drivers of infectious disease), the next pandemic will continue to lurk just around the bend. Extreme heat and pollution too will worsen health outcomes. A for-profit healthcare system was failing before and has come near collapse under COVID. Now is the time for a restructuring of healthcare, dramatic action on the climate, and the end of the for-profit system that brought us here in the first place. 

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