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NEW ORLEANS, LA. - Janelle Witten lives in Gastonia, North Carolina with her husband and six-year-old son. Throughout the coronavirus pandemic, she and her family have responsibly adhered to guidelines from health organizations like the U.S. Centers for Disease Control and Prevention (CDC). They have remained socially distant when in the presence of those outside their family, washed their hands and worn their masks.
But even though Witten believes COVID-19 is a real threat, she said she will not get the vaccine when it is made available to the public.
"I'm not against vaccines, and I give my son all the suggested vaccinations," she told VOA, "but we're not getting this COVID vaccine any time soon. It's just too new."
Witten isn't alone. An October poll conducted by the Kaiser Family Foundation found that 62% of American adults were concerned about the Trump administration pressuring the Food and Drug Administration (FDA) to approve a coronavirus vaccine before the presidential election.
A poll released last week showed that among African Americans - who suffer one of the highest mortality rates from the virus of any racial group - only 14% trust that a COVID vaccination will be safe. One explanation for this distrust may be the tragic history of Blacks being subjected to unethical medical experiments by the government, dating back to the 1930s.
This is the challenge health policymakers face as two U.S. pharmaceutical companies - Pfizer and Moderna - announced positive early results last month from their Phase III clinical trials, paving the way for doses of the vaccine to be available to select members of the American public as early as this month.
Indeed, U.S. regulators are under pressure from the White House to speed up the review process, as Britain on Wednesday granted emergency authorization to Pfizer's coronavirus vaccine - leaping ahead of the United States and the European Union countries in allowing mass inoculations against the lethal disease.
While many are celebrating the news of Pfizer and Moderna's success, some experts and advocacy groups are already focused on the next step: ensuring a sufficient percentage of the population (between 70% and 90%, according to Johns Hopkins University) is immunized.
"A vaccine is only effective if people feel safe getting vaccinated," explained Dr. Paul Offit, Director of the Vaccine Education Center at the Children's Hospital of Philadelphia, "And right now there is a significant number of Americans who say they are hesitant."
'Warp speed'
President Trump has called his administration's effort to quickly develop and distribute a COVID-19 vaccination "Operation Warp Speed." But for Witten and many other Americans, the emphasis on speed is concerning.
"It just doesn't sound safe," she said. "The speed it's being created and certified -- how do we know what the long-term effects will be if we don't give them time to show up?"
Offit, who serves on the Advisory Committee on Immunization Practices to the CDC told VOA that he believes the skepticism many Americans are feeling at the moment is healthy.
"It's a positive thing to be vigilant about what we put into our bodies," Offit said, "But there's a difference between skepticism and cynicism."
To Offit, the difference is in how one responds to real data. Vaccine opponents, he says, are cynical -- against any type of vaccination, and often motivated by conspiracy theory instead of science.
A number of anti-vaccine groups highly suspicious of government and some religious sects opposed to vaccines in general are certain to reject the coronavirus vaccines when they are distributed beginning later this month.
But they make up a relatively small percentage of those hesitant to receive the coronavirus vaccine. In contrast, skeptics -- a much larger group, he hopes -- simply want to wait for data before they make a decision on inoculation.
That data will come this month when three of the country's premier vaccine safety panels release their findings on Pfizer and Moderna's most recent trial studies. Offit explained that while the trials have been much shorter than for past vaccines, Americans should feel confident following the groups' recommendations.
"Tens of thousands of individuals would receive the vaccine in a normal Phase III trial," he said. "That's exactly what we have here. Thirty thousand people have received the Moderna vaccination while forty thousand have received Pfizer's."
While he feels confident in the sample size, Offit admitted the length of these trials is shorter compared to others -- a necessary difference during these unique times.
"Earlier this century, the human papillomavirus vaccine was in Phase III trials for seven years," Offit said, "But, in the case of COVID-19, more than [270,600] Americans have already died. Do we really want to wait seven years for a vaccination?"
Is a speedy vaccine safe?
But Americans hesitant to get the vaccine say it is the potential side effects they are most worried about.
Christy Cusimano lives in St. Bernard, Louisiana and does not plan on getting the vaccination until there is more data to make her comfortable it is safe.
"I trust science," she said, "but I prefer a wait and see approach."
Offit insists that if the vaccine is approved, there is no need to wait. He said a recommended vaccine will mean it will have proven to be effective in preventing COVID-19 for at least a few months. If that's the case, he said, it likely will be effective for longer, as well, with no major side effects.
Pfizer and its German partner, BioNTech reported that their vaccine was more than 90% effective while Moderna announced its experimental coronavirus vaccine is nearly 95% effective.
"If the vaccine is approved, you'll know that it was administered safely to tens of thousands of people without any serious adverse effect," said Offit. "Will an adverse effect be revealed if it's administered to tens of millions of people? Will it cause an issue three decades from now? Probably not, but no trial can tell us that for sure."
Offit said it's necessary to weigh the potential risks against the potential benefits. Assuming the vaccine is approved, the benefits can be substantial.
"If a significant number of people get an approved vaccine, we can save hundreds of thousands of lives. Potentially even more than that," he said.
Social Responsibility
Health experts have said a Data and Safety Monitoring Board (DSMB), the Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee (VRBPAC), and the Advisory Committee on Immunization Practices to the Centers for Disease Control are all reliable panels made of independent scientists and statistical experts with the power to halt a clinical trial or to fast-track it.
"The people on these panels wouldn't recommend the vaccine for the public if they wouldn't also recommend it for their own families," Offit said. "If they get behind a vaccination, you can trust it."
Moncef Slaoui, the chief science advisor to Operation Warp Speed, recently said in an interview with The Washington Post that "there is a social responsibility here for everybody to really think hard before deciding not to take the vaccine."
As the vaccine is rushing closer to reality, more Americans appear to be embracing that responsibility. A Gallup poll released last month showed that 58% of adults surveyed were now willing to be vaccinated -- up from 50% in Gallup's September poll.
"I was hesitant at first about the COVID-19 vaccine because there's just not a lot of digestible information out there on it," said Kat Schweitzer, who lives in New Orleans. "I think it's the reason a lot of people are unsure if they'll get vaccinated. But as soon as I read about it I realized that if the scientists and doctors say it's safe, it's important I get it."
Though progress has been made, health experts and immunization advocates still have a long way to go in convincing enough remaining skeptics to get vaccinated.
"Even if it's approved, I don't trust the FDA and these other health organizations," Witten said. "They approve so many things I find questionable. I want long-term data they just don't have yet."