The incoming Biden administration will face an immediate challenge persuading a skeptical American public to take a COVID-19 vaccine when one becomes widely available.
Health officials, including the nation’s top infectious diseases expert, Anthony FauciAnthony FauciKamala Harris, Stacey Abrams among nominees for Time magazine's 2020 Person of the Year Overnight Health Care: Biden team to begin getting COVID briefings | Fauci says he would 'absolutely' serve on Biden's COVID task force | Major glove factories close after thousands test positive for COVID-19 Fauci says he would 'absolutely' serve on a Biden coronavirus task force MORE, say at least 70 percent of the U.S. population will need to take the vaccine to control the virus in such a way that future outbreaks will be easily managed and life can get back to normal.
But public opinion polling shows only a slim majority of Americans are willing to trust a first-generation vaccine. Those numbers are significantly lower among Black and Latino respondents — two of the hardest hit demographics.
In new polling from Ipsos released Tuesday, 51 percent of respondents said they will take a vaccine immediately when one becomes available.
The reasons for skepticism vary. Some people have cited what they called the Trump administration's politicization of a vaccine, despite denials from officials that politics played a role in the speedy development.
"The president and I have been clear that politics would play no role in the development, the manufacture or the distribution or approval of a vaccine," Health and Human Services Secretary Alex Azar told reporters Tuesday.
But he acknowledged that personal politics could play a role in determining whether some people trust the safety of a COVID-19 vaccine.
"And of course, as with the passing of the election, we have seen in public polling increases in vaccine acceptance among people," Azar said.
Some Americans have questioned the speed of the development process, with many raising concerns that the administration's "warp speed" approach to scientific review and vaccine regulation might compromise safety.
Peter Hotez, co-director of the Center for Vaccine Development at Texas Children's Hospital, said that in order to combat that hesitancy, President-elect Joe BidenJoe BidenHarris says she has 'not yet' spoken to Pence Kamala Harris, Stacey Abrams among nominees for Time magazine's 2020 Person of the Year Obama: Republican Party members believe 'white males are victims' MORE's team will need to launch a concerted communications campaign with trusted scientists.
Letting drug company CEOs take the lead isn't very effective, Hotez said.
"There's going to be a lot of questions about these brand new [vaccine] technologies. We don't know about the durability of protection. We don't know about herd immunity, we don't know if people are still going to need to practice some degree of social distancing and wearing masks, even after vaccination," Hotez said.
"All of that has to be communicated on a frequent and regular basis," he added.
Vin Gupta, a professor at the University of Washington’s Institute for Health Metrics and Evaluation who served as an adviser to the Biden transition team, said there's going to be resistance and skepticism to a coronavirus vaccine, but it will likely be more limited than widespread.
Gupta, whose name has been floated to be surgeon general in the Biden administration, said the messengers are going to be just as important as the message.
"I think a big problem here is a lack of trust. Trust is built on credibility and authenticity, especially in medicine, and trust is not built by putting in people who are not perceived to be experts, either through lived experience, or because they have years in public health, and they know what they're talking about," Gupta said.
He suggested giving a role to long-sidelined career officials like Nancy Messonnier, the public health official who first warned of the major disruptions from COVID-19 back in February.
"You can't just put somebody that's lived their pandemic in a suit or on a Zoom conference, and put them in front of the American people and say, 'Get a vaccine.' Trust is earned, and it's earned through actual experience," Gupta said.
While no COVID-19 vaccine has been authorized for use yet, a candidate from Pfizer and BioNTech could be cleared in as little as two to three weeks. The drug was found to be 95 percent effective at preventing both mild and severe forms of COVID-19.
A similar vaccine from Moderna is expected to follow soon after, and between the two, Trump administration health officials expect to distribute about 40 million doses to states by the end of the year, enough to vaccinate 20 million people.
Fauci, a member of the White House coronavirus task force, has long said public confidence in the COVID-19 vaccine approval process is key to beating the pandemic.
"We've got to keep hammering that home, because for the group of people who are concerned about the process, the process is sound," Fauci said during a recent event hosted by Stat News.
Still, the Trump administration has largely focused its efforts on developing a vaccine, rather than trying to contain the virus. As a result, there are some lingering concerns over the politicization of the process.
President TrumpDonald John TrumpUSAID administrator tests positive for COVID-19 Kamala Harris, Stacey Abrams among nominees for Time magazine's 2020 Person of the Year DOJ appeals ruling preventing it from replacing Trump in E. Jean Carroll defamation lawsuit MORE repeatedly promised a vaccine would be widely available before the elections and publicly complained when Pfizer announced positive results a week after voters cast their ballots.
Several states — mostly with Democratic governors — and the District of Columbia have announced the formation of committees that would further vet any vaccine reviewed by the Food and Drug Administration.
“We don’t take anyone’s word for it. We will do our own, independently reviewed process with our world class experts," California Gov. Gavin NewsomGavin NewsomMayor of Denver apologizes for holiday travel after advising residents to stay put California, Texas shatter single-day nationwide record for new coronavirus cases Denver mayor flies to Mississippi for Thanksgiving after advising against travel MORE (D) said last month when announcing the state's panel.
New York Gov. Andrew CuomoAndrew CuomoMayor of Denver apologizes for holiday travel after advising residents to stay put Kamala Harris, Stacey Abrams among nominees for Time magazine's 2020 Person of the Year Denver mayor flies to Mississippi for Thanksgiving after advising against travel MORE (D), who has frequently clashed with Trump, had a similar message.
"Frankly, I’m not going to trust the federal government’s opinion,” Cuomo said when he announced his state’s panel in September.
In an interview with The Washington Post this week, Fauci said he understood why the governors might be suspicious, but he urged them to trust the process.
“I can understand, but I don’t agree with their doing that. ... They have heard mixed messages from Washington," Fauci said.
"So I don’t fault them from wondering what is going on,” he added. “But I can tell them, if they are listening, and I hope they are, that the process really is a sound process.”