BY RYAN BOSE-ROY
With 317,800 Covid-19 deaths in the United States and 1.7 million deaths worldwide, the recent emergence of suitable Covid-19 vaccine candidates is a refreshing sight. However, vaccine availability is just a stepping-stone to the end goal; public opinion of the pandemic response and trust in the vaccine are crucial for adequate coverage and for reducing viral spread [1]. Since more than one million travelers per day are passing through American airport security checkpoints for Christmas and New Year’s, understanding how perceptions of Covid-19 and its vaccines differ across countries and regions, as well as what motivates these perceptions, is paramount in making safe decisions [2].

At this time of writing (December 21, 2020), roughly six million doses of Moderna’s newly authorized mRNA-1273 vaccine are being shipped to more than 3,700 locations across the country, adding to the three million doses of the Pfizer/BioNTech vaccine dispatched mostly to american health care workers the week prior [2]. On December 21st, this vaccine became the first one authorized in the European Union, with the European Commission concluding “that it is safe and effective against Covid-19.” [3]. Roughly 500,000 people have been vaccinated in the United Kingdom, and adding the vaccinations authorized by China and Russia—administered in July and August before being fully tested—over two million people in the U.S., UK, Russia, Israel, China, and Canada have been treated [4].
Several caveats exist alongside these promising numbers. Firstly, reports of Russia’s “Sputnik V” vaccine, despite claiming a 92 percent success rate, covered just 20 total Covid-19 cases in vaccinated and placebo groups and faces skepticism from analysts inside and outside the country. A study conducted by the Russian Levada Center in October showed that even if it was offered for free, 59 percent of Russians were unwilling to get the vaccine [5].
Secondly, newly emerged viral mutants in Britain and South Africa, predicted by modeling to be 70 percent more transmissible than the current strain, will likely alter vaccine distribution due to lockdown-induced fears. Hong Kong, Canada, India, Iran, Argentina, Colombia, Peru, Chile, and Russia have all imposed travel restrictions on Britain; Israel has closed its skies to foreign nationals and Saudi Arabia has instituted a one week ban on all international travel [6] [7]. Although the new variant likely does not cause any more serious illness than the existing strain, growing alarm over the virus and the shock of financial markets may likely delay efforts to administer vaccines in order to meet the pressing demands of maintaining order and ensuring international trade continues.
Thirdly, although roughly two million people have been treated across six countries, success seems ambiguous for hard-hit nations where distribution hasn’t started. According to CNN, Indian Prime Minister Narendra Modi’s plan to administer the first doses to 300 million people by August is highly ambitious given India’s “poor rural infrastructure and inadequate public health system that is already buckling under tremendous pressure from the coronavirus.” [8]. Nevertheless, it is worth noting that India is the lead producer of vaccines worldwide— in addition to the Pfizer/BioNTech vaccine, India is manufacturing its own vaccines, Covishield and Covaxin, locally through its already-established mass vaccine production lines. However, nations without existing infrastructure have to rely on international sales; here, competition and politics dominate distribution. The 27 member states of the European Union, together with five other wealthy countries, have already pre-ordered half of the existing vaccine candidates [9]. These countries amount to just 13 percent of the global population [9], leaving dwindling supplies for low- and middle-income nations. And even if vaccines were made accessible to countries, misleading federal efforts and inappropriate interventions may prevent treatment until it is too late [10].
Faced with a bevy of complications, from vaccine skepticism to national and international politics, how do people across the world view the coronavirus? How do they view efforts to curtail the spread of the coronavirus? Do views of their own government’s efforts differ from their views of the international community? Do people in different countries have different views?
As reports of Covid-19 vaccine effectiveness become more promising, American public confidence in the vaccine appears to increase; nevertheless, concerns about rushing vaccination are still widespread. In September, nearly 50 percent of American adults said that they were willing to take a vaccine [11]; as of December 14, that number rose to more than 80 percent [12]. While 40 percent said that they would take it as soon as possible, 44 percent said that they would wait before getting it [12]. This caution seems not to be due to concerns about vaccines in general, but instead primarily due to concerns about the politicization of the vaccine and the potential for being overly optimistic. A poll released in October by the Kaiser Family Foundation suggested that Americans were more skeptical about a rushed vaccine than an effective one: 62 percent of adults stated concerns over the Trump administration pressuring the Food and Drug Administration to approve a coronavirus vaccine before the election [13]. Those who stated that they were not planning to get a vaccine believed that they needed it, but were concerned because they wanted to know more about its efficacy and side effects. Thus, while the majority of Americans are willing to take a coronavirus vaccine, it appears as though to many, treatment feels rushed.
Many Americans’ cautious optimism towards the vaccine contrasts with their distrust towards federal response to the pandemic. According to a survey conducted by the Pew Research Center in August, over half of Americans believe that poor government response, including a lack of timely testing, is majorly responsible for the continuation of the outbreak [14]. It is important to note, however, that views towards the coronavirus spread are widely divided across partisan lines: 62 percent of Republicans held the increase in confirmed coronavirus cases as simply a result of greater testing in previous months, while 80 percent of Democrats held that the increase was due to an increase in infections. Since the United States has the highest rate of daily new confirmed Covid-19 cases per million people in the world, it is perhaps understandable that many people are frustrated, cautious, and slightly optimistic. Dr. Susan Bailey, president of the American Medical Association, suggests that it’s only natural for people to be suspicious of what they don’t know. Former acting director of the Centers for Disease Control and Prevention, Dr. Richard Besser, continues that “politics has interfered with science and public health too many times during this pandemic,” and has as a result led to a deep erosion of trust [15].
Citizens of other countries also give the United States a poor grade for its handling of Covid-19. A poll conducted by Pew Research Center, released in September, found that across 13 countries (Canda, Denmark, Belgium, Netherlands, France, UK, Sweden, Spain, Italy, South Korea, Australia, and Japan), only 15 percent of adults view the U.S. response favorably [14]. In South Korea, Denmark, Germany, and Belgium, nearly nine-in-ten adults say the U.S. response to Covid-19 has been bad. The caveat here is that people’s conception of performance—and thus their conception of Covid-19 risk—does not exist independently of people’s minds and culture. A large body of research over the last decades suggests that risk perception is constructed by cognitive, emotional, social, individual, and cultural variation between people and between countries [16]. By observing trends in people’s perceptions towards their own governments and contrasting them with perceptions towards other governments, perhaps it is possible to identify potential confounding factors that might clarify overall global perceptions towards Covid-19.
Interestingly, people across the world seem to believe that their own nation’s response to the virus was inefficient. This belief is not limited to their nation’s government, but to their citizens as well. An ongoing survey conducted at 11 universities across the world, including at MIT, Princeton, Oxford, and Harvard, currently holds that on average in 58 countries, people hold pessimistic views about their fellow citizens’ response to the pandemic. 93 percent of respondents believe that social gatherings should be cancelled, yet they estimate that only 67 percent of their fellow citizens think the same thing [17]. These views suggest that people hold strong beliefs about the importance of avoidance, but do not show confidence in the nation’s ability to uphold them.
Perceptions of federal response to the pandemic differ across individual countries. Countries such as Italy, Canada, Sweden, Australia, Netherlands, Germany, Denmark, and South Korea in general hold that they have done a good job dealing with the coronavirus outbreak. However, most of the public in these nations appear pessimistic towards their fellow citizens; a much lower percentage of people believe that their country is more united because of the pandemic. Overall, 48 percent of people feel that divisions have grown. Nonetheless, different groups of people indeed perceive the pandemic differently. For instance, a cross-sectional descriptive study of 500 nurses in Saudi Arabia found that more than half of the nurses had positive attitudes towards caring for Covid-19 patients, and over 90 percent had “excellent knowledge of Covid-19.” [18].
Ultimately, it appears as though people’s perceptions towards Covid-19 and their willingness to take the vaccine are not merely defined by their perception of the national response. Instead, their views towards Covid-19 also appear to be motivated by their views towards their fellow citizens and uncertainty towards the promising vaccine results. Perhaps a greater degree of clarity and transparency, both at the federal and healthcare industry level, would help raise overall confidence towards a solution.
Ryan Bose-Roy is a First-Year at Trumbull, aspiring in Biomedical Engineering. Outside of the Yale Global Health Review he loves reading, learning, eating sushi, and listening to Brahms’s Wiegenliend: Guten Aben, gute Nacht.
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References:
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