“We have a big problem,” said Martinez, 43. “The majority of the people around me are relying on what they hear from others, see on social media or their religious beliefs without knowing what it is to have the virus.”
Since the first indications that vaccine trials were successful, hope has grown that 2021 will bring an easing of the pandemic that has raged through 2020.
The three leading vaccines, developed using cutting-edge technology and being fast-tracked through the approval process, hold the promise of keeping the virus at bay in ways that counting on personal adherence to mask-wearing and social distancing have not. For many, making plans for family get-togethers and overseas travel no longer seems futile or outright dangerous.
But vaccines will not mean the immediate end of the pandemic. Emergency approval of the first vaccine, expected this week by officials at the Food and Drug Administration and the Centers for Disease Control and Prevention, will be only the first step in a rollout that presents staggering logistical challenges. Masks and social distancing will continue to be necessary. Because vaccine supplies will be limited at the outset, priority will be given to those most at risk of infection. That means it will probably be months before the average American is eligible for a shot.
And for all the enthusiasm about the vaccine — and a determination Tuesday by the FDA that it is safe and effective — there are swaths of people who, like Martinez’s neighbors, are apprehensive. For many, the speed with which the vaccines have been developed and evaluated by the Trump administration is reason to be cautious.
Iowa truck driver Candace Marley frets about bringing the coronavirus home from the road. Her boyfriend’s sister has an immune system compromised by cancer. Nevertheless, Marley is in no hurry to be vaccinated.
“They really rushed,” said Marley, 52. “Even if they make us a priority, I’ll probably wait a couple months after they start to see how everyone else is handling it.”
The resistance to vaccination is expected to be deepest in Black and Latino communities — groups that have been disproportionately affected by the virus but also subjected to racist and unethical medical practices and experiments in the past. A recent survey found that fewer than half of Black Americans and only 66 percent of Latinos would definitely or probably get vaccinated.
The study also found that only 14 percent of Black people think a vaccine will be safe and 18 percent think it will effective. The numbers for Latinos were 34 percent and 40 percent.
Liz Martin, 53, has endured a grueling nine months, moving from Georgia to South Florida for a teaching job that never materialized. She has cut herself off from almost everyone to limit her potential exposure to the virus.
Yet despite the toll the pandemic has taken on her, misinformation from the federal government about the virus has also affected her confidence in the vaccine.
“I don’t want to be anyone’s guinea pig,” said Martin, a single mother who has two children at home with her. “I have a lot to lose.”
Martin, who is Black, said she is aware of the troubled historical legacy of medical research and African Americans. But she also mentioned concern about recent reports of immigrant women in detention camps being subjected to unwanted and unnecessary medical procedures, including hysterectomies. Female detainees at a rural Georgia immigration facility have alleged “overly aggressive” gynecological procedures at a local physician’s office.
“Maybe by summer I’ll feel comfortable because I’ll see people around me who have had success with the vaccine,” she said.
Hope at a nursing home
The Trump administration initially pledged that its Operation Warp Speed would deliver about 300 million doses of vaccine by year’s end. The reality has fallen far short — to about 10 percent of that amount.
The CDC expects 35 million to 40 million doses to be available by the end of the year, enough to reach some 18 million people, because both the vaccines require two doses spread several weeks apart. Based on recommendations from a CDC advisory panel, 21 million health-care workers and 3 million nursing-home residents will be first in line. States will make the final determination on how to allocate the supply of vaccine they receive.
Residents at the Ohio Eastern Star Home in Mount Vernon, about 40 miles northeast of Columbus, have largely been spared by the coronavirus, chief executive Michele Engelbach said, knocking on wood. But she said she has watched lives fade amid the loneliness of the lockdown designed to keep the virus away.
“It’s not like they can say, ‘Well, next Christmas we can get together,’ because who knows?” Engelbach said, describing a “no win” choice between protecting residents from the virus and watching them waste away amid the feelings of isolation.
The 200 staffers and some of the 120 residents at the Eastern Star Home should be among the first people in the country to get the vaccine, solving her dilemma.
“I sure as hell hope so,” she said.
Engelbach said that some of her staffers have expressed concerns about the vaccine and that she will not mandate everyone get it, hoping instead that they can be persuaded. Residents will not be forced to get vaccinated, either, but Engelbach said they have not expressed any hesitancy.
“At that point in my mind, all the residents will be vaccinated, the majority of the staff will be vaccinated, so the only people who will be at risk are the people who choose not to get vaccinated,” she said.
Yet even as the vaccine approval nears, Engelbach said practical things, such as how it will get from the manufacturer to her facility and how it is to be administered, remain unclear, as do the implications for reopening the home to visitors.
“I know [the vaccine is] out there,” she said. “I know it’s coming. That’s about it.”
Who's next in line?
Significant questions also remain about how the vaccines will preform in the real world. The CDC says it is not clear yet how long the immunity conferred by the vaccines will last or when precautions such as mask-wearing and social distancing can safely be abandoned. There is also a chance that people who are vaccinated could still spread the virus if they subsequently become infected.
Data from the trials shows the vaccines to be generally safe, but federal officials said there will be what are known as “adverse events” as the vaccines are rolled out, and they are planning to monitor their safety.
While others ponder the risks, Bill Moore, an emergency department nurse in Boone, N.C., said he is ready to take the vaccine today, figuring it could safe his life. Though Moore, 65, should be close to the head of the line, he said he has heard nothing about when he might actually receive his first dose.
“If I knew that the vaccine was going to be here next week, I’d feel a lot better about it,” he said. “I’m working this coming weekend, and I dread it, to tell the truth.”
In the new year, the number of doses being manufactured is expected to grow, allowing additional groups of people to be vaccinated.
Whom those groups might include has not been determined, but they are likely to include older people who do not live in nursing homes and people in essential professions such as teaching and food production. Industries and unions have begun campaigning to get their workers good spots on the list.
Major fire service organizations are pushing states to prioritize firefighters, paramedics and emergency medical technicians, because many of these first responders treat coronavirus patients before they are transported to the hospital. Still, some rank-and-file firefighters are reluctant to be first in line. In a union survey of New York firefighters, more than half said they would refuse the vaccine.
Covid-19, the disease caused by the coronavirus, is the leading cause of death this year for law enforcement and corrections officers in the United States. Houston police officer Doug Griffith volunteered for one of the early vaccine trials. Hundreds of the department’s officers have tested positive for the virus. Officer Ernest Leal died of covid-19 late last month.
Griffith said he does not know whether he received the vaccine or a placebo, but he viewed participating in the trial as a way to keep his family safe.
“I’m healthy, and I think its incumbent to help out in any way I can,” said Griffith, 51. “I interact with the public every day and live close to my family. The last thing I want to do is get someone sick.”
Griffith said it makes sense for health-care workers and nursing home residents to be among the first to get the vaccine, but he would like first responders to be a close second or third.
He regularly fields questions from fellow officers about the vaccine: “Why would you do that to yourself? Did you ever feel funny? Are you afraid of it?” Griffith said he’s not trying to persuade anyone to get the vaccine, saying it’s a personal choice — but he is happy to be a “guinea pig” to help ease any doubts or concerns his colleagues might have.
'A lot of mistrust'
Federal officials say they recognize that the hesitancy among many Americans is an important obstacle to overcome and are developing strategies to work with community organizations to build confidence in the vaccine.
Baltimore pediatrician Sarah Polk said she was stunned by the depth of the concern and mistrust in the vaccine in the largely Latino community she serves. At a meeting of a community advisory board, Polk, who is White, saw how deeply damaged the medical establishment’s reputation is among immigrants.
One of Polk’s patients works in a job that will probably require her to get vaccinated, but the girl said she would rather lose the job than get the vaccine.
Polk has no concerns about the vaccine and intends to get it — and for her family to get it when it becomes available. She intends to be open with her patients about her plans but said the message might not mean much coming from someone who looks like her.
“You need many different messengers,” she said.
Dallas construction worker Oscar Torres has taken on the job of messenger. He’s heard all the baseless conspiracy theories and falsehoods: The virus is a government-engineered plot for population control. Only old people die of it. If President Trump survived, how bad could it be?
Torres was not sure what to think until he caught the virus. He and his brother were violently ill for 10 days in early May.
“I thought it was an invention to scare people,” he said. “But in reality, when I got it, it was terrible.”
Texas construction workers, a large number of whom are estimated to be undocumented or foreign born, are five times as likely to be hospitalized with covid-19 as other workers, according to a recent study by the University of Texas at Austin.
Torres wants his colleagues to be vaccinated to lower his chances of getting covid-19 a second time. But like Polk, he said the government needs different messaging to ensure everyone realizes the importance of being vaccinated. Officials should be transparent without being alarmist, he said.
“I get it. A vaccine is the most important thing we can do to fight this pandemic,” Torres said. “But . . . there is a lot of mistrust.”
And then there are those like Julie Turner, who at 82 is tired of being stuck at home alone and ready to get back to living. She needs no convincing.
Turner said she has been extremely careful since the pandemic began. When her daughter came to visit in August, she realized she had not touched another person in months.
She splits her time between Waretown, N.J., and a home on the state’s Long Beach Island. She said her health is good, but when it comes to her age, “82 is 82.”
During the summer, going to the grocery store was a high point, but as news about the vaccine became increasingly encouraging, bigger plans took shape for 2021. She has lined up trips to Nepal, Oman and the Caucasus region and plans to be snorkeling in Indonesia’s Raja Ampat region come next December.
Spending Christmas alone is going to tough, Turner said, along with the rest of the winter. But, she said, at least there is now a light at the end of the tunnel.
“I think a lot of people just need to think that there is one,” she said.