Today, thanks to vaccines, many of the deadliest infectious diseases are preventable. The availability of effective vaccines has also led to dramatic increases in life expectancy. At the same time, paradoxically, as the threat of infectious disease has become much less apparent, there is a rise in citizen concerns about the purpose and safety of vaccines. To understand the value and importance of vaccinations, people need to understand both the risks of being unvaccinated and the safety and efficacy of vaccinations. The fewer deadly infectious diseases that circulate, the harder it can become to communicate the value of vaccinations.
Key factors in vaccine demand generation — such as how people receive information, how they make sense of the world, and who they trust — have also been affected by dramatic changes driven by both technological and cultural transformations. This has made it harder for people to assess the risks of being unvaccinated or the safety and efficacy of vaccines.
For some Americans, vaccination is also closely connected to individual, collective and intergenerational memory: Black and Brown Americans’ experiences with healthcare and other social goods are different from those of white Americans. Instead of being offered life-saving vaccines or treatments, Black Americans have been coerced into serving as test subjects in medical experiments. To this day, we see stark disparities in the quality of health services offered and delivered by race, as chapter 3.c will explain in more detail. Institutions and individuals in medicine and public health have urgent work to do better and earn the trust of these communities.
Addressing these and other barriers to vaccine demand is essential to America’s ability to move past the current vaccination crisis; it is equally essential in efforts to vaccinate the world.