an interview that aired during last night’s Aspen Ideas Festival broadcast, Dr. Anthony Fauci expressed doubt that the United States would achieve herd immunity if a coronavirus vaccine became available. A major reason is the alarming number of Americans who oppose vaccination.
A coronavirus vaccine isn’t available yet, but three are in phase 3 clinical trials and more than 125 are in development. There’s no guarantee, however, that any of them will be effective in 100% of people who get it — the best humans have accomplished is 97% to 98%, with the measles vaccine. In the interview, Fauci, a member of the White House coronavirus task force, said he’d “settle” for a coronavirus vaccine that was only 70% to 75% effective, which he said would bring us to the “herd immunity level.”
A population achieves herd immunity when the proportion of people who are immune to a disease passes a certain threshold, making it extremely difficult for the disease to spread even if it is reintroduced. The threshold is different for every disease, but as Tara Haelle wrote in Elemental, experts estimate that it’s about 60% to 80% for Covid-19.
Herd immunity can be achieved in two ways: Either everyone gets vaccinated, or enough people get infected with Covid-19 and — crucially — manage to recover. Since Covid-19 can be fatal, the latter is not a great option. Widespread vaccination is a safe way to establish herd immunity that doesn’t involve the risk of people dying — it has succeeded for measles, mumps, polio, and chickenpox — but it’s only going to work if enough people actually get vaccinated.
Unfortunately, anti-vaccination sentiment is strong in the United States and has seen a surge during the pandemic.
A CNN poll conducted in May showed that one-third of Americans would not get a coronavirus vaccine if it was available. It also revealed that 81% of Democrats and 64% of independent voters polled would try to get a vaccine if it existed, while only 51% of Republicans would do the same. Regular polls conducted by the CUNY Graduate School of Public Health and Health Policy have shown similar trends: The latest data, from May, showed that 31% of those polled would immediately get a vaccine, while 12% would reject a vaccine outright, according to The BMJ. In California, a hotbed of vaccine opposition, anti-vaccination advocates have staged regular protests at the state capitol, at which Judy Mikovits, the discredited doctor and anti-vaccination activist behind the widely debunked Plandemic conspiracy documentary, has been a guest speaker.
In the interview on Sunday, Fauci expressed his often-repeated concerns about anti-vaccination in the United States. “There is a general anti-science, anti-authority, anti-vaccine feeling among some people in this country — an alarmingly large percentage of people, relatively speaking,” he said.
Anti-vaccination advocates make up a small but very vocal minority around the world, including in Australia, Canada, and the U.K. Suspicions about racism in vaccination trials have been stoked by the clinical trials of a new coronavirus vaccine in South Africa, adding a layer of complexity to the opposition to vaccines.
In an interview last week, Stanford University law professor Michelle Mello pointed out that it will not “be immediately salient that [anti-vaxxers are] not willing to be vaccinated,” pointing to the likelihood that a limited number of doses will be available at first. “Because so many people will want vaccines when they become available,” she says, “the question in the near to medium term is not must everyone get them, but who gets to access them?” In May, Emily Mullin wrote in OneZero about the ways in which the government might have to triage its distribution of the vaccine.
Fauci, for his part, said he was “cautiously optimistic” that a vaccine will be available by the end of this year or the beginning of 2021. He pointed out that several vaccine companies have said that hundreds of millions of doses could be available by the beginning of 2021, and up to a billion doses could be made available by 2022. Though triaging will likely have to happen early on, eventually there could be more than enough doses for every American to have one.
Herd immunity is possible and could protect everyone in the United States — if the vast majority of people choose to cooperate. But as long as we are divided along ideological lines, we remain vulnerable to the spread of what could, eventually, become a preventable disease.