In early December, the Centers for Disease Control and Prevention (CDC) confirmed that health care workers (HCWs) will be among the first people (along with long-term care residents) to get the COVID-19 vaccine in the U.S. This was decided based on what will likely save the most lives and most effectively reduce the strain on the health care system.[i] For many health care workers, the reality of soon getting a vaccine that was developed so quickly is scary – a CDC survey conducted in September and October found that only 63 percent of health care providers are on board with getting vaccinated right away.[ii]
Your fear is valid.
Most vaccines are developed over a few years; with COVID-19 first being reported just a year ago, many people are concerned about if a vaccine developed in such a short time frame can truly be safe. And without years of trials it is difficult to predict long-term side effects. Most people, and especially health care workers, have been living and working with high degrees of uncertainty for a long time now. The state of the pandemic changes daily and recommendations from government officials fluctuate as well, so it’s understandable to feel hesitant about the vaccine in its first phase beyond trials.
Though the development process has been sped up, the aspects involving safety haven’t been compromised. This vaccine has been fast tracked for a few reasons. Researchers typically need years to secure funding and get approvals, but given the nature of COVID-19, emergency funding was made available to begin these processes immediately. And by exploring many different vaccines in the beginning (95 by the end of April 2020),[iii] we didn’t have to start over after some failed. Many manufacturers have overlapped steps – for instance, some combined the first two phases of trials and jumped right to testing in hundreds of people (Phase II) instead of starting with a smaller group (Phase I). New technology and shortening administrative procedures have also helped accelerate things, but the steps needed to ensure safety haven’t been altered. While we can’t fully determine long-term side effects in such a short timeframe, long-term side effects from vaccines are rare and mRNA vaccines (like the two currently in Phase III) may be even safer because they don’t contain the virus at all. In testing so far, side effects have been short-lived and occur within the first few days of getting vaccinated.[iv] The side effects are similar to those of the flu shot and like all vaccines, there is a minor chance that some people will have more severe reactions, although it is impossible to contract COVID-19 from the vaccine.
Because COVID-19 has become heavily politicized, some have worries about the government or manufacturers playing a role in getting a vaccine pushed out before it’s ready. Dr. José Romero, head of the CDC’s Advisory Committee on Immunization Practices, has stated: “I’ve had no contact with the [Trump] Administration or with pharmaceutical companies influencing my decision. No shortcuts should be taken for this vaccine, and it should be scrutinized the same way we would advise any other vaccine for prevention of infectious diseases.”[v] If you’re still hesitant, there may be more in-depth information coming – some health care experts are calling for drug companies to publicly release trial data. Data from Pfizer’s trials has already been released and the Food and Drug Administration (FDA) is expected to formally approve it for emergency use by mid-December[vi].
Your resentment and anger are valid.
With a limited number of vaccines being released in the first round, it makes sense to vaccinate HCWs first – considering the amount of exposure to the virus, HCWs are a vulnerable population. But throughout the nine months, many HCWs haven’t felt taken care of in terms of proper PPE, reasonable working hours, and test availability. If the events of this year have diminished your trust in oversight and the government, it may feel like you’re being used as a guinea pig rather than being protected.
Whether or not the vaccine will be mandatory for HCWs is still to be decided, which some feel would be an infringement on their personal rights. This discussion isn’t new – a 2009 article, “Mandatory Vaccination of Health Care Workers: Whose Rights Should Come First?” outlines the difficulty in balancing the rights of HCWs to choose vaccination with the best interest of public health. The author concludes that choosing to work in the health care field means doing everything possible to improve patient health and in turn, being vaccinated.[vii] Recently, the American Nurses Association (ANA) updated their Immunizations position statement in light of COVID-19, clarifying that ANA does not support any exemptions unless medically necessary.
It’s okay if you’re mad, frustrated, or hurt – decisions are being made about you that you may not agree with, which can make you feel like your opinions and health don’t matter. If you need some help coping with overwhelming anger, check out this article on 10 Healthy Ways to Release Rage.
So what can you do?
While waiting for more evidence on the vaccine and guidance from government officials, it’s important to manage your stress and anxiety.
- Do your research. Fear is often based in the unknown, so learn as much as you can. Consider what is worrying you, whether it’s the side effects, how recommendation decisions are being made, or uncertainty about how the vaccine works, and make sure you’re informed. The CDC’s COVID-19 Vaccines page is a great place to start.
- Stay up to date. Keep yourself in the loop as progress is made with the vaccines and further decisions are being made about distribution. Be careful to not get sucked into consuming too much news or social media – stick to a vetted vaccine tracker.
- Look towards officials you trust. American voters say they trust their personal physician, Dr. Anthony Fauci (Director of the National Institute of Allergy and Infectious Diseases), and the Food and Drug Administration regarding vaccine safety.[viii] The Centers for Disease Control and Prevention and World Health Organization are also reputable sources. As the Administration changes in January, some individuals to follow on the federal level include Xavier Becerra, nominee for Health and Human Services chief; Dr. Rochelle Walensky, expert on virus testing, prevention, and treatment and nominee for Director of the CDC; and Dr. Vivek Murthy, formerly the 19th U.S. Surgeon General and nominated to be the 21st.
- Think about the benefits compared to the risks. We don’t know everything, but so far leading trials have been safe. Under an Emergency Use Authorization (EUA), known and potential benefits must outweigh the known and potential risks before a vaccine will be approved for use. The vaccine will help you develop immunity to the virus that causes COVID-19 so that you’re able to naturally fight it if exposed in the future as well as build up herd immunity.
- Make decisions in your best interest. If the anxiety surrounding vaccination is too much to cope with, it’s okay to ask for some time off and step away from it all for a bit. The vaccine may end up being mandatory for HCWs – if you aren’t comfortable with that, you may choose to leave the profession entirely. Feeling overwhelmed and not sure what to do? Check out Is the Mental Health Burden of Your Job Becoming Too Much? for some options.
2020 has been a difficult year and figuring out how vaccine distribution will work seems to be the next big stressor that will impact healthcare workers before the general population. If you’re finding it difficult to cope with the uncertainty and stress, take a mental health screen – you may be experiencing symptoms of a mental health condition. Need some support? You can be connected to a trained crisis counselor 24/7 by reaching out to Magellan Health’s COVID-19 first responder crisis line at (800) 327-7451, the Disaster Distress Helpline at (800) 985-5990, or the Crisis Text Line by texting MHA to 741-741.
[i] Huang, P. (2020, November 5). First COVID-19 vaccine doses to go to health workers, say CDC advisers. NPR. https://www.npr.org/sections/health-shots/2020/11/05/931844298/first-covid-19-vaccine-doses-to-go-to-health-workers-say-cdc-advisers
[ii] Oliver, C. (2020). Evidence to recommendations framework: Values, acceptability, and feasibility domains. [PowerPoint slides]. CDC. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2020-11/COVID-03-Oliver.pdf
[iii] Thompson, S.A. (2020, April 3). How long will a vaccine really take? The New York Times. https://www.nytimes.com/interactive/2020/04/30/opinion/coronavirus-covid-vaccine.html
[iv] West Virginia Department of Health & Human Resources. COVID-19 vaccine: Frequently asked questions. https://dhhr.wv.gov/COVID-19/Documents/COVID-19%20Vaccine%20FAQ.pdf
[v] Huang, P. (2020, November 5). First COVID-19 vaccine doses to go to health workers, say CDC advisers. NPR. https://www.npr.org/sections/health-shots/2020/11/05/931844298/first-covid-19-vaccine-doses-to-go-to-health-workers-say-cdc-advisers
[vi] Thomas, K., Weiland, N., & LaFraniere, S. (2020, December 10). F.D.A. advisory panel gives green light to Pfizer vaccine. The New York Times. https://www.nytimes.com/2020/12/10/health/covid-vaccine-pfizer-fda.html
[vii] Field, R.I. (2009). Mandatory vaccination of health care workers: Whose rights should come first? Pharmacy and Therapeutics, 34(11). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810172/
[viii] Bruce, G. (2020, October 13). Who do Americans trust to vouch for a COVID-19 vaccine? YouGov. https://today.yougov.com/topics/politics/articles-reports/2020/10/13/who-do-americans-trust-vouch-covid-19-vaccine