Vaccine hesitancy has been concerning experts for a while now. The reason? People who may be at high risk from severe outcomes if they do catch Covid-19 are avoiding the vaccine, putting their lives in danger.
If not enough people have the vaccine, any attempt at reaching herd immunity will be scuppered – some estimate we need two thirds of the population to be vaccinated to achieve it.
A survey by University of Glasgow of more than 12,000 people in the UK suggests that, overall, intention to be vaccinated is high – 82% of survey respondents said they were “likely” or “very likely” to have the jab. But it also revealed vaccine hesitancy is high in specific communities.
For example, it was higher in women (21.0% vs 14.7% of men), younger age groups (26.5% in 16-24 year olds vs 4.5% in those aged 75+) and those without any qualifications (18.6% no qualifications vs 13.2% degree qualified).
Vaccine hesitancy was also high in Black (71.8%), Pakistani/Bangladeshi (42.3%), Mixed (32.4%) and non-UK/Irish White (26.4%) ethnic groups.
Why are people hesitant?
The main reason for hesitancy was fears over unknown future effects – 42.7% cited this as their main reason. This was also one of the main reasons given by Black/Black British participants for not taking the vaccine (30% said this) as well as lack of trust in vaccines (29%). Pakistani/Bangladeshi participants cited concerns about side effects (36%) and unknown future effects (35%) as their main reasons for hesitancy.
A recent report by HuffPost UK found structural inequalities and historical medical racism have also led to “hesitancy” about the jab in Black, Asian and minority ethnic communities.
Dr Zubaida Haque, a member of the Independent SAGE group of scientists, said the government has “not done enough” to make specific efforts to reassure Black, Asian and ethic minority communities about the safety of the vaccine. “There are so many myths surrounding the vaccination that it’s irresponsible of the government not to set up a dedicated website with frequently asked questions,” she said.
Young women are also hesitant to have the vaccine, with many citing worries about fertility. A survey of 55,000 Brits by Find Out Now in December found 18- to 34-year-old women were most likely to refuse the jab, i News reported.
In light of the hesitations, here are some facts about the Pfizer and AstraZeneca vaccines, both of which are now being issued in the UK, that you might want to know about if you have concerns.
1. If you’re worried about what’s in the vaccines
People want to know the ingredients of something that’s being injected into their bodies – it’s a question that’s been submitted to HuffPost UK on our Covid health questions form.
The below might not mean much to you, but others might recognise some of the ingredients if they have allergies. If you’re allergic to any of the below, you should let your GP, pharmacist or nurse know before having the vaccine.
Here’s what you can expect to find in the Pfizer/BioNTech vaccine.
- The active substance is BNT162b2 RNA,
- ALC-0315 = (4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate),
- ALC-0159 = 2[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide,
- potassium chloride,
- potassium dihydrogen phosphate,
- sodium chloride,
- disodium hydrogen phosphate dihydrate,
And here’s what’s in the Oxford/AstraZeneca vaccine:
- The main ingredient is Covid-19 vaccine (ChAdOx1-S recombinant) viral particles. This is basically a chimpanzee adenovirus vector encoding the SARS-CoV-2 Spike glycoprotein, which cannot replicate in our cells.
- L-histidine hydrochloride monohydrate,
- magnesium chloride hexahydrate,
- polysorbate 80,
- sodium chloride,
- disodium edetate dihydrate,
- water for injections.
2. If you’re worried about the RNA aspect of the vaccine
The Pfizer/BioNTech Covid-19 vaccine is a new type of vaccine that uses something called RNA in the body.
Historically, vaccines have put a weakened or inactivated virus into our bodies. But with vaccines that contain RNA (known as mRNA vaccines – the ‘m’ stands for messenger), they teach the body’s cells how to make a protein, or even just a little piece of a protein, that triggers an immune response in the body.
If you later come into contact with the virus, your body knows to launch an attack – it’s like having a well-trained guard dog waiting in the wings.
Such vaccines do not use the live virus that causes Covid-19, so they can’t give you Covid just by having them. There have also been concerns that they might alter DNA in some way but this is not true nor possible, say scientists.
mRNA doesn’t enter the nucleus of the cell, which is where our DNA (genetic material) is kept, explains the Centers for Disease Control and Prevention (CDC) in the United States. The cell breaks down and gets rid of the mRNA soon after it is finished using the instructions to build the bit of protein.
3. If you’re worried about who the vaccine has and hasn’t been tested on
If you’re in a particular age group or have a specific vulnerability to the virus, you might be concerned about whether the vaccines have been tested in other people like you.
The Pfizer vaccine has been tested on 43,000 participants worldwide and “well tolerated across all populations”. Efficacy was consistent across age, gender, race and ethnicity demographics – with observed efficacy in adults over 65 years of age being 94% after two doses. For everyone else, the overall efficacy rate is 95%.
Approximately 42% of global participants were from racially and ethnically diverse backgrounds – specifically, 5% of participants were Asian, 10% were Black, 26% were Hispanic/Latinx and 1.1% were Native American. Around 41% of global participants were 56-85 years of age.
HuffPost has asked AstraZeneca vaccine for a breakdown of demographics involved in phase 3 trials and will update the article when we hear back.
Neither vaccines have been tested in many pregnant women, so this group are advised not to have the jab unless they’re deemed high risk – either because of an underlying health condition or their job.
The vaccines do not contain organisms that can multiply in the body, so they cannot infect an unborn baby. But because of a lack of safety evidence in this group, experts are holding off recommending it to all pregnant women for now
The Pfizer vaccine has been tested in some young people – the global trial saw 1,090 people aged 12-15 injected as well as 738 16-17 year-olds.
Meanwhile the AstraZeneca jab is set to be trialled in children aged 5-12 years old. However until larger numbers of young people are tested the vaccines are only being offered to adults aged 18 and over.
People who have previously had a severe allergic reaction to any of the vaccine ingredients, or experienced anaphylaxis after the first dose, should also not have it.
4. If you’re worried about how quickly it was made
In the past, vaccines have taken decades to create and finalise, however when the Covid-19 pandemic struck, the world needed to create an effective vaccine. Such a huge need, as well as some of the world’s best minds working on the problem, have resulted in not one, but multiple viable vaccines that have been shown to be effective.
There have been no shortcuts, nor lowered safety standards – in fact, if anything, there is more pressure to adhere to safety standards as the whole world watches and waits.
The speed of vaccine development has been mainly due to the huge amounts of money and effort thrown at the problem – the UK government alone has spent £6bn in total to develop and procure them.
Medicine cell biologist Dr Jennifer Rohn, from University College London (UCL), previously told HuffPost UK there has also been “an enormous amount of groundwork” on these vaccine prototypes prior to the pandemic which meant we were “quick off the mark from a research point of view”.
5. If you’re worried about fertility implications
There have been claims that the vaccines might cause infertility because of a shared amino acid sequence in the SARS-CoV-2 spike protein and a placental protein. Some people believe this means the immune system becomes trained to attack the placental protein as well as the Covid-19 protein – but this is not the case.
Virology professor Ian Jones at the University of Reading told Full Fact the spike protein and placental protein aren’t similar enough for the immune system to attack them. He said the placental protein (called syncytin-1) is “completely unrelated to the SARS [spike] protein” and the risk of infertility is “therefore essentially fictitious.”
Dr Edward Morris, president at the Royal College of Obstetricians and Gynaecologists, also said: “We want to reassure women that there is no evidence to suggest that Covid-19 vaccines will affect fertility. Claims of any effect of Covid-19 vaccination on fertility are speculative and not supported by any data.
“There is no biologically plausible mechanism by which current vaccines would cause any impact on women’s fertility. Evidence has not been presented that women who have been vaccinated have gone on to have fertility problems.”
Forbes reports that during the Pfizer-BioNTech trial, 23 participants became pregnant. Sadly there was one pregnancy loss, but this was in a participant who received the placebo rather than the Covid-19 vaccine.
6. If you’re worried about side effects
The prospect of getting a side effect from a new vaccine can be pretty scary – but the side effects reported in both the Pfizer and AstraZeneca vaccines are very similar to other vaccines – for instance, the flu jab.
With the Pfizer vaccine, most side effects are mild or moderate and go away within a few days. The following are quite common, impacting around one in 10 people: pain at injection site, tiredness, headache, muscle pain, chills, joint pain, fever, injection site swelling, redness at injection site and nausea.
Some more uncommon side effects, which are thought to affect up to one in 100 people, include enlarged lymph nodes and generally feeling unwell. Rare side effects (impacting one in 1,000 people) include temporary one sided facial drooping and in very rare instances, there have been severe allergic reactions.
The AstraZeneca vaccine has similar common side effects, which are: tenderness, pain, warmth, redness, itching, swelling or bruising where the injection is given, generally feeling unwell, feeling tired (fatigue), chills or feeling feverish, headache, feeling sick (nausea), joint pain or muscle ache.
In clinical studies, most side effects were mild to moderate in nature and resolved within a few days. Some were still present a week after vaccination
7. If you’re worried about the jab itself
Needles aren’t nice, but they’re a lot nicer than coming down with Covid-19 – though most will get mild symptoms after testing positive, there are many who end up with symptoms for months after contracting the virus (dubbed long Covid), as well as those who end up hospitalised due to severe disease.
Thousands of people died from the virus, too. Figures from the University of Oxford’s research platform Our World in Data revealed just this week that the UK now has the highest death rate from Covid-19 of any country in the world.
The vaccine is injected into the upper arm muscle. The process is over in a matter of seconds and people are observed for 15 minutes afterwards to ensure there are no reactions. You should be given a card confirming you’ve had the vaccine and should also be told when your next appointment is.
Since having the vaccine, some people have taken to social media to discuss what it felt like, with some, like Dr Ranj Singh, saying they couldn’t even feel it.