Potential COVID-19 vaccine has re-energized anti-vaccination groups, health experts warn

As Canadians yearn for an end to the COVID-19 pandemic and a time they can once again hug their elderly loved ones or gather in large groups without fear of infection, many are pinning their hopes on unprecedented global efforts to develop a vaccine against the virus.

But even though most infectious disease experts say the earliest possible timeframe would be at least a year or two away, anti-vaccination groups are already well into online and social media campaigns stoking doubtsabout the safety and even questioningthenecessity of a coronavirus vaccine.

"I just am astonished at how early the anti-vaccine narrative has started," Dr. Natasha Crowcroft, a vaccine expert at the University of Toronto's Dalla Lana School of Public Health, said in an interview with CBC's The Dose health podcast.

"We are really facing a major, major challenge," Crowcroft told podcast host Dr. Brian Goldman.

"And unless our public health leaders can generate a lot of trust, it's going to be very, very difficult."

That's because anti-vaccination groups have become extremely savvy communicators and "seem to be much better" than public health experts at reaching out to a variety of people with different ideologies from those who distrust pharmaceutical companies to those protesting public health lockdowns aimed at curbing the spread of coronavirus, Crowcroft said.

Anti-vaccination groups in both Canada and the U.S. are positioning themselves as advocates for what they call"personal freedoms" and "medical choice" in the midst of the coronavirus pandemic posting content online and on social media that not only targets vaccination, but also protests the closure of businesses,physical distancing requirements and the wearing of masks.

Vaccine Choice Canada one of the most high-profile anti-vaccination organizations in this country, announced in a letter posted to its website on May 13 that it was"launching legal action against the Government of Canada and others for violating our rights and freedoms during the COVID-19 outbreak."

In a June 18episode of Digi-Debates posted on YouTube, thepresident of Vaccine Choice Canada, Ted Kuntz,claimedthat COVID-19 was no more deadly than influenza and argued that a vaccine was unnecessary.

But infectious disease and public health experts widely agree that COVID-19 is far more lethal than the flu. According to the Public Health Agency of Canada,more than 8,500 deaths in Canada have been related toCOVID-19.Based on Canadian health data, the estimated number of annual deaths from influenza is much lower.

Based on data from past flu seasons, the Public Health Agency of Canada estimates that influenza causes an average of 3,500 deaths annually, a spokesperson told CBC in an email on Monday.

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Epidemiologist Dr. Christopher Labos says the vast majority of a population needs to be vaccinated in order to develop herd immunity.

In an email to CBC on Monday, Kuntz cited data fromInfection Prevention and Control Canada, which states that when pneumonia is factored in as a complication of influenza, the combined death toll is "more than 8,000 people a year."

However, pneumonia is also one of the potentially fatal complications of COVID-19. In addition, the number of COVID-19 deaths counted in Canada are only those that have been laboratory-confirmed.

Part of thestrategy used by anti-vaccination groups has been totake legitimate cautions by some well-recognized physicians in the U.S. that the quest to find a coronavirus vaccine must not be rushed and that it must gothrough all of the necessary steps to ensure it is safe and effective and then misrepresentthose comments as arguments against a vaccine, said Jonathan Jarry, a science communicator in the Office for Science and Society at McGill University in Montreal, which has a mandate to debunk misinformation for the public.

"We have the beginnings of a perfect storm on our hands [to fuel vaccine misinformation]," Jarry said.

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As we continue to grapple with the COVID-19 pandemic, most of us are anxious to return to normal life, when we can hug our elderly parents or grandparents and once again gather in large groups. Many experts say that can't happen safely until a coronavirus vaccine is developed. In this unprecedented time, researchers around the world are working toward that goal, but it has to be done safely and follow a careful scientific process. Dr. Natasha Crowcroft, a vaccine expert at the the Dalla Lana School of Public Health at the University of Toronto, joins host Dr. Brian Goldman to help explain how close we are to an effective vaccine against COVID-19, the barriers we must overcome to get there, and what we need to do in the meantime.

In the midst of a worldwide pandemic and an unprecedented effort to develop a vaccine as quickly as possible, many people have questions andanxiety about the process, he said.

At the same time, Jarry said,the anti-vaccination movement is "seemingly re-energized and ... pushing a lot of misinformation and disinformation and lies and fuelling that anxiety."

To combat that, both Crowcroft and Jarry agree, it's essential that public health officials, physicians and community leaders talk openly and transparently with Canadians about the vaccine development processand directly answer their questions and concerns and they need to start now.

"There's a small sliver of the population that is ferociously anti-vaccination. And it's very difficult to reason with these people," Jarry said.

"But there's a larger segment of the population that is vaccine-hesitant.And that is where our efforts need to be invested."

'The current situation is so different'

One of the key concerns that needs to be directly addressed is howa coronavirusvaccine canbe developed more quickly than any vaccine before it and still be safe, Jarrysaid.

The answer, Crowcroft said, is that "the current situation is so different that it is possible to get through the development steps faster without cutting any corners that might compromise safety."

It normally takes "years and years and years" to develop a vaccine, she said. "I mean 10 years would not be unusual."

A big part of the reason for that, Crowcroftsaid, is that scientists often come up with a vaccine candidatebut have a difficult time getting funding to move it to the next phase of clinical trials, because every trial stage is expensive and pharmaceutical companies are hesitant to risk spending enormous amounts of money on a product that could fail at the next stage. Plus, there's often no guarantee there will be a market for the vaccineeven if it does work.

But in the midst of a pandemic, the pharmaceutical industry is confident that the demand for a vaccine exists, she said. In addition, governments around the world are providing funding for vaccine development, which removes the potential for a huge financial loss if a company invests in a vaccine candidate that doesn't succeed in the end.

"Governments are helping to speed things up by funding the trials so they can go on in parallel and/or the gaps between each step are shorter, without the long delays for decision-making about whether the company wants to take the [financial]risk of moving forward," said Crowcroft, who was recently appointeda senior technical adviser forthe World Health Organization's measles, mumps and rubella program.

Because of that, there are more than 100 different vaccine candidates in various phases of research at the same time around the world,increasing the odds that at least one, possibly more, will prove to be safe and effective, she said.

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Because of advances in genetic sequencing,scientists' ability to learn about a new virus is also more advanced than it has ever been in the past, giving researchers a head start in figuring out what part of it to target with a vaccine.

"Nothing in the history of humankind has ever been seen like this before," Crowcroft said.

Finally, shesaid, amid all the hype as companies put out news releases boasting about their progress in vaccine development,it's "important to remember that the press release does not determine whether a vaccine will eventually be used."

It's up to each country's regulatory agency, such as Health Canada,to determine whether a vaccine can be usedand be independent of any industry influence.

"Safety cannot be compromised," Crowcroft said. "Health Canada will see to that. Itis their statutory responsibility."

In an emailed statement to CBC, Dr. Theresa Tam, Canada's chief public health officer, said that before any vaccine is approved for use in this country, "Health Canada conducts rigorous scientific reviews and testing of the vaccine to assess the quality, safetyand effectiveness."

"Once a vaccine is in use, health authorities continue to monitor the vaccine to ensure ongoing highest standards of safety."

'Empathy' and 'building trust'

But if these kinds of questions about safety, as well asother concerns,aren't dealt with directly by public health officials or if the public doesn't trust them anti-vaccination voices will fill that void with misinformation, Jarry warns.

The most effective way to talk to people who are vaccine-hesitant, he said, "all boils down to empathy and to listening and to building trust."

It's important not to criticize people for expressing concerns, even if they are based on misinformation that has long ago been debunked, he said.

"If we ignore them because we don't have time or if we ignore them because we think they're silly, the anti-vaccination movement will end up polarizing the vaccine-hesitant segment of the population against vaccination," Jarry said. "And then vaccine uptake is going to keep going down."

We've already seen the toll that vaccine refusal can take with the re-emergenceof measles, he said.

Crowcroft estimates that for a coronavirus vaccine to beeffective at protecting the population, between 60 and70 per cent of people need to be immunized.

"I'm not sure we're doing everything we can yet to prepare," she said. "We really do need to start, you know, having those discussions with communities and building relationships so that they do trust in their [public health] leaders."

In herstatement to CBC,Tam said she recognized that"vaccine hesitancy is still very much an ongoing issue within Canada and worldwide."

"In collaboration with my provincial and territorial colleagues and other stakeholders, foundational work has already begun to prepare for the possible release of a safe and effective COVID-19 vaccine in Canada, if and when it becomes available," Tam said.

That work, she said, would include "developing strategies and resources to inform and educate to build vaccine confidence as well as combat stigma, misinformation and fear around the release of a new vaccine."

The Public Health Agency of Canada, which Tam heads, said in a separate statement to CBC that "effortsto inform and educate to build vaccine confidence are part of the agency's regular business" and that it would use similar information and social media campaigns "when a new COVID-19 vaccine is released to ensure that Canadians have the proper information to inform their choice to receive the vaccine when available."