Transcript: Vaccine Hesitancy in a Pandemic | Jan 07, 2021

Steve sits in the studio. He's slim, clean-shaven, in his fifties, with short curly brown hair. He's wearing a blue suit and shirt, and a spotted blue tie.

A caption on screen reads "Dealing with COVID-19 vaccine hesitancy. @spaikin, @theagenda."

Steve says NOW THAT IT'S NOT A MATTER OF IF BUT OF WHEN YOUR TURN WILL COME FOR THE COVID-19 VACCINE, WILL YOU TAKE IT? THE ANSWERS THAT PEOPLE GIVE TO THAT QUESTION COULD MAKE OR BREAK THIS CRISIS. MANY CAN'T ROLL UP THEIR SLEEVES FAST ENOUGH. OTHERS ARE STILL UNSURE. WHY AND WHAT DO THOSE WHO ARE HESITANT NEED TO KNOW? AND LET'S FIND OUT FROM SOME OF THE EXPERTS. WE WELCOME, FROM THE NATION'S CAPITAL: DR. SUPRIYA SHARMA, SHE IS CHIEF MEDICAL ADVISOR, HEALTH CANADA...

Supriya is in her thirties, with long straight black hair. She's wearing a burgundy sweater.

Steve continues AND IN THE PROVINCIAL CAPITAL: DR. SAMANTHA HILL, PRESIDENT OF THE ONTARIO MEDICAL ASSOCIATION...

Samantha Hill is in her thirties, with long wavy blond hair. She's wearing glasses, a black blazer and a burgundy shirt.

Steve continues MAYA GOLDENBERG, ASSOCIATE PROFESSOR OF PHILOSOPHY AT THE UNIVERSITY OF GUELPH AND AUTHOR OF THE FORTHCOMING BOOK, "VACCINE HESITANCY: PUBLIC TRUST, EXPERTISE AND THE WAR ON SCIENCE."

Naya is in her early forties, with long wavy brown hair. She's wearing a purple sweater.
A picture of her book appears briefly on screen. The cover features a picture of a needle approaching a vaccine vial.

Steve continues AND SAMANTHA YAMMINE, WHO IS A NEUROSCIENTIST AND SCIENCE COMMUNICATOR, ALSO KNOWN AS "SCIENCE SAM."

Samantha Yammine is in her thirties, with long straight dark hair. She's wearing a light gray blouse and a silver pendant necklace.

Steve continues IT'S GREAT TO WELCOME YOU FOUR TO TVO TONIGHT. I JUST WANT TO START OUR DISCUSSION BY PUTTING SOME FACTS ON THE TABLE HERE. PROFESSORS PETER LOEWEN, TAYLOR OWEN AND DEREK RUTHS CO-LEAD SOMETHING CALLED THE MEDIA ECOSYSTEM OBSERVATORY AND THEY JUST PUBLISHED A REPORT ABOUT VACCINE HESITANCY IN CANADA, SURVEYING ALMOST 40,000 PEOPLE, SO THIS IS A PRETTY DEEP DIVE ON THIS.

A quote appears on screen, under the title "Understanding vaccine hesitancy in Canada." The quote reads "Only two thirds [65 percent] of Canadians are currently willing to take a vaccine. Opinions are stable, and there appears little that can be done to convince the 15 percent who are unwilling. The 20 percent who are unsure need to be convinced of the efficacy and safety of a vaccine, which could be difficult given high levels of distrust and an increasingly loud and chaotic information ecosystem. Figuring out how to reach these Canadians is as important as procuring another million doses of a vaccine."
Quoted from Peter Loewen, Taylor Owen and Derek Ruths, The Globe and Mail. January 5, 2021.

Steve says THAT LAST LINE IS HUGE. SO I GUESS... I GUESS WE SHOULD SAY THAT MUCH OF THE ADVICE WE'RE GOING TO HEAR FROM YOU FOUR TONIGHT WILL FOCUS ON THAT 20 percent THAT IS PERSUADABLE BUT STILL HESITANT. DR. SHARMA, LET'S START WITH THIS: IF THE NUMBERS AS I'VE JUST OUTLINED THEM PERSIST, HOW WOULD THAT AFFECT THIS COUNTRY'S ABILITY TO ACHIEVE HERD IMMUNITY?

The caption changes to "Supriya Sharma. Health Canada."
Then, it changes again to "Understanding the uncertainty."

Supriya says YOU KNOW, I THINK WITH ANY VACCINE, EVEN THE BEST VACCINES, THE ONES WITH THE HIGHEST EFFICACY, IT ONLY WORKS IF SOMEBODY GETS IT. SOMEONE HAS TO AGREE TO GET IT AND THEN HAVE IT ADMINISTERED TO THEM. WE ALREADY KNOW FOR THE VACCINES WE HAVE THAT THERE ARE SOME POPULATIONS THAT WE WILL NOT BE VACCINATING THEM YET, SO FOR CHILDREN, FOR SOME OTHER GROUPS, FOR EXAMPLE, BECAUSE THEY HAVEN'T BEEN TESTED. SO THAT'S WHY IT'S REALLY IMPORTANT FOR THE ADULTS WHO ARE ELIGIBLE TO GET THE VACCINE TO BE VACCINATED. SO, YOU KNOW, WE SEE THAT... WE DON'T KNOW EXACTLY WHAT THE HERD IMMUNITY LEVEL SHOULD BE AT THIS POINT IN TIME FOR COVID, BUT WE'RE ESTIMATING THAT IT SHOULD BE AROUND 60 TO 70 PERCENT. SO, YOU KNOW, WE DO NEED LARGE NUMBERS OF PEOPLE TO COME FORWARD AND TO AGREE TO BE VACCINATED, OF COURSE IN CANADA.

Steve says DR. SAMANTHA HILL, WHEN YOU LOOK AT THOSE NUMBERS, WHAT GOES THROUGH YOUR MIND?

The caption changes to "Samantha Hill. Ontario Medical Association."

Samantha Hill says I THINK WE AS A COMMUNITY HAVEN'T GONE A GOOD JOB OF EXPLAINING IT IF THERE ARE STILL 20 percent OF PEOPLE WHO ARE UNCERTAIN. I DON'T LIKE THE WORD CONVINCING. I DON'T THINK I HAVE TO CONVINCE ANYONE. OUR JOB IS TO PROVIDE THE EVIDENCE, PROVIDE THE UNDERSTANDING, CLEAR UP THE MISINFORMATION THAT ABOUNDS ON THE INTERNET, AND LET PEOPLE MAKE THE RIGHT DECISION FOR THEM. FOR MOST PEOPLE THAT WILL BE TO GET THE VACCINE BUT WE HAVE TO TRUST IN PEOPLE TO MAKE THE RIGHT DECISION WITH THE RIGHT SUPPORT.

Steve says THAT HAVING BEEN SAID, DR. GOLDBERG, DO YOU HAVE ANY ISSUE WITH THE NUMBERS THAT HAVE BEEN PRESENTED?

The caption changes to "Maya Goldenberg. Author, 'Vaccine hesitancy.'"

Maya says THOSE NUMBERS ARE CONSISTENT WITH WHAT WE'VE HEARD IN OTHER CONTEXT. PEDIATRIC VACCINES USUALLY POLLS AT ABOUT TWO-THIRDS OF CANADIAN PARENTS WITH YOUNG CHILDREN ARE... PLAN TO VACCINATE THEIR CHILDREN. SO KNOWING THAT PEOPLE CAME INTO THIS LANDSCAPE OF DISCUSSION AROUND COVID VACCINES WITH PRIOR FEELINGS ABOUT VACCINES, IT'S NOT TOO SURPRISING, AND ACTUALLY NOT TOO CONCERNING THAT THE NUMBERS MATCH EACH OTHER. THIS IS A NEW VACCINE. THE CONTEXT IS VERY DIFFERENT FROM THE KIND OF DECISION-MAKING THAT PEOPLE HAVE HAD TO MAKE... HAVE HAD TO MAKE AROUND PEDIATRIC VACCINES, SO IT DOESN'T SURPRISE ME TOO MUCH THAT WE'RE SEEING SIMILAR NUMBERS AND I THINK WE CAN USE THE KIND OF STRATEGIES THAT HAVE WORKED AROUND PEDIATRIC VACCINES AND CHANNEL THAT TOWARDS COVID VACCINATION TOO.

Steve says OKAY. SAMANTHA YAMMINE LET ME FOLLOW UP ON THOSE NUMBERS AND THAT ANGLE AGAIN. DO YOU HAVE ANY REASON TO BE SUSPICIOUS ABOUT THE ACCURACY OF THOSE NUMBERS?

The caption changes to "Samantha Yammine. Science Communicator."

Samantha Yammine says I THINK WHEN IT COMES TO HUMAN DATA AND DATA WHERE PEOPLE ARE SELF-REPORTING, WE HAVE TO BE MINDFUL THAT ARE CAVEATS AND LIMITATIONS TO THE STUDIES. IN THAT CASE I WONDER HOW HELPFUL THEY ARE WHEN WE, YOU KNOW, BROADLY DISCUSS THEM. IT'S IMPORTANT FOR POLICYMAKERS AND PUBLIC HEALTH OFFICIALS TO THINK ABOUT VACCINE HESITANCY IN THESE RATES, BUT WHEN WE THINK ABOUT THEM MORE BROADLY, VACCINE HE IS TENANCY ITSELF IS CONTAGIOUS. AND THE MORE WE SAY PEOPLE ARE HESITANT, THE MORE PEOPLE WILL START TO QUESTION WHERE THEY MAY NOT HAVE BEFORE. WE HAVE TO KEEP IN MIND WHEN WE TALK ABOUT THESE DATA, THAT THERE ARE BIASES TO THESE TYPES OF SELF-REPORTING STUDIES. THERE'S SOMETHING CALLED THE SOCIAL DESIRABILITY BIAS. PEOPLE WANT TO GIVE AN ANSWER THAT THEY THINK OTHER PEOPLE WILL APPROVE OF AND THAT MIGHT CHANGE THE ANSWER THAT THEY GUY. THERE'S ALSO PRIMING. YOU DON'T KNOW WHAT SOMEONE HAD SEEN JUST BEFORE THEY ANSWERED THIS TYPE OF SURVEY. SO WE ALWAYS HAVE TO TAKE THESE TYPES OF STUDIES WITH A GRAIN OF SALT AND KNOW THAT SOMEONE'S INTENTION TO VACCINATE MAY NOT TRANSLATE TO WHAT THEY ACTUALLY DO. WHEN YOU SEE THESE NUMBERS, YOU THINK MAYBE I WON'T LET THAT AFFECT ME BECAUSE WE DON'T KNOW WHEN THE STUDY WAS DONE, ALL THESE THINGS, AND TRY TO REMEMBER THAT YOUR DECISION SHOULD BE ABOUT YOUR PERSONAL HEALTH AND WHAT YOU NEED TO DO TO PROTECT YOURSELF, YOUR COMMUNITY, AND YOUR FAMILY.

Steve says MAYA GOLDENBERG, LET ME FOLLOW UP WITH YOU ON THAT. I KNOW IN POLITICS, HOW YOU ASK THE QUESTION MATTERS HUGELY, AND I GUESS IN THIS CASE IF YOU WERE TO SAY, YOU KNOW, ARE YOU UP FOR TAKING THE COVID-19 VACCINE, THAT MIGHT GET YOU ONE SET OF ANSWERS, BUT IF YOU WERE TO SAY, WOULD YOU BE OPEN TO TAKING A VACCINE WHICH WOULD PREVENT YOU FROM BEING ONE OF THE THOUSAND PEOPLE THAT DIE EVERY SINGLE DAY FROM A HORRIBLE ILLNESS THAT WILL MAKE YOUR LAST DAYS ON EARTH MISERABLE, YOU MIGHT GET A VERY DIFFERENT ANSWER. FAIR TO SAY?

Maya says OH, THAT'S VERY FAIR TO SAY. SOCIAL SCIENTISTS KNOW THAT, HOW YOU ANSWER A QUESTION IS VERY IMPORTANT. I AGREE WITH THE PREVIOUS STATEMENT THAT INTENTION AND ACTION DON'T ALWAYS LINE UP. WHEN I SEE THESE... AGAIN, WHEN I SEE THESE KINDS OF STUDIES, I'M LOOKING AT HOW MANY PEOPLE ARE SAYING THAT THEY DO PLAN TO GET THE COVID VACCINE, AND THAT'S BECAUSE WE HAPPEN TO KNOW FROM PREVIOUS VACCINATION EFFORTS THAT THE BEST WAY TO GET PEOPLE TO VACCINATE IS TO MAKE IT THE NORMAL THING TO DO. SO YOU DO THINGS LIKE YOU FOCUS ON THE NUMBERS WHO DO WANT TO DO IT. RIGHT NOW, YOU KNOW, PHYSICIANS ARE TAKING SELFIES SHOWING THEMSELVES BEING VACCINATED SO THEY'RE SENDING AN IMAGE THAT THIS IS A NORMAL THING TO DO, NOT AN EXCEPTIONAL THING TO DO. AND PEOPLE SEE THAT AND THAT'S GOING TO HAVE MUCH MORE INFLUENCE THAN FOCUSING ON THE PEOPLE THAT DON'T WANT TO GET VACCINATED.

The caption changes to "Watch us anytime: tvo.org, Twitter: @theagenda, Facebook Live, YouTube."

Steve says WELL, I DO WONDER ABOUT THAT. I MEAN, WHAT YOU'VE SAID MAKES PERFECT SENSE, BUT DR. HILL, I NOTE JUST BEFORE THE HOLIDAYS, QUEBEC LONG-TERM CARE HOMEMADE NEWS FOR THE FACT THAT... IMAGINE THIS... IN LONG-TERM CARE HOMES, WHICH IS REALLY THE FRONT LINES AGAINST COVID-19, ONLY 35 TO 40 PERCENT OF STAFF PLAN TO GET THE VACCINE, AND THIS WEEK THE HEAD OF THE ONTARIO PERSONAL SUPPORT WORKERS ASSOCIATION... THAT'S OUR PROVINCE... SAID THAT MORE THAN HALF OF ITS MEMBERS DON'T WANT TO GET VACCINATED. WHAT DO WE DO ABOUT THAT?

The caption changes to "Samantha Hill, @SamHillMD."

Samantha Hill says WELL, I THINK WE START FROM WHERE THE OTHER SAMANTHA SAID, WHICH IS WE DON'T KNOW WHAT THOSE NUMBERS EXACTLY MEAN BUT THEY CERTAINLY ARE HEADLINE WORTHY AND THEY CERTAINLY ARE MEDIA-CATCHING. WHERE WE GO WITH IT, THOUGH, IS TO ACKNOWLEDGE THAT THERE IS SOME PROPORTION THAT IS NOT NEGLIGIBLE OF EVEN HEALTH CARE WORKERS THAT ARE VOICING CONCERN. THAT'S A PROBLEM FOR TWO REASONS: THEY THEMSELVES MAY NOT GET VACCINATED WHICH PUTS THEM AT RISK AND THE POPULATION THEY'RE ATTENDING TO AT RISK. THE OTHER PART IT SENDS A SIGNAL TO MEDIA AND THEIR FAMILY THAT IF HEALTH CARE WORKERS HAVE A CONCERN, PERHAPS IT ISN'T AS WELL-ESTABLISHED AS THE AUTHORITIES WOULD HAVE YOU BELIEVE. AND SO I THINK THAT'S PART OF THE DISCUSSION WE NEED TO HAVE. WHEN WE TALK ABOUT VACCINE HESITANCY, IT'S REALLY ABOUT WHERE MISINFORMATION AND MISTRUST COLLIDE. SO THOSE ARE THE THINGS THAT WE NEED TO KEEP COMING BACK TO. SOME ARE SOCIAL DETERMINANTS AND SOME ARE GOING TO TAKE YEARS TO WORK AROUND, PARTICULARLY WHEN YOU THINK ABOUT THE DIFFERENT CULTURES PEOPLE COME FROM AND THE DIFFERENT EXPERIENCES THEY MAY HAVE HAD HISTORICALLY, BUT SOME OF IT IS JUST A QUESTION OF MISINFORMATION. SO WHEN PEOPLE TELL ME THAT THEY'RE WORRIED THAT THE VACCINE WILL INCORPORATE WITH THEIR DNA, FOR EXAMPLE, AND CHANGE THEIR GENETIC COMPOSITION, I POINT OUT THAT WE DON'T HAVE THE CAPACITY TO DO THAT IN THE HUMAN BODY, MUCH THE SAME WAY, AND I LOVE THIS LINE SO I'M GOING TO USE IT, IS WHEN YOU EAT A STEAK, YOU DON'T TURN INTO A COW. WE GO FROM DNA TO RNA TO PROTEIN. IT HAS NO POSSIBILITY OF CHANGING YOUR OWN GENETIC CODE. WHEN PEOPLE HEAR THAT AND WHEN THEY HEAR A REAL LIFE EXAMPLE THAT'S SO OBVIOUS LIKE THE STEAK AND THE COW, IT RESONATES AND THEY'RE REASSURED. WHEN PEOPLE ARE REASSURED, THEY'RE IN A BETTER PLACE TO MAKE GOOD DECISIONS.

Steve says FOLLOWING UP ON THAT WITH DR. SHARMA, THOUGH. IF THE PEOPLE WHO ARE MOST AT RISK OF DYING AT COVID-19 AND THAT IS IN SOME RESPECTS THE PEOPLE WHO TAKE CARE OF THE PEOPLE, 70 percent OF WHOM... I'M NOT SAYING THIS WELL... 70 percent OF THE DEATHS IN THE PROVINCE OF ONTARIO ARE PEOPLE WHO LIVE IN LONG-TERM CARE HOMES. THE PEOPLE WHO TAKE CARE OF THOSE PEOPLE ARE THEREFORE ON THE FRONT LINES OF CARE. THEY SEEM TO BE AMONG THE MOST VULNERABLE AS WELL TO DIE FROM THIS THING, AND IF FEWER THAN HALF OF THEM WANT TO TAKE THIS POTENTIAL LIFE-SAVING OPTION, WHAT SIGNAL DOES THAT SEND, DR. SHARMA?

Supriya says JUST ECHOING SOME OF THE OTHER COMMENTS. IT'S WHAT IS THAT DATA, RIGHT? SO WHEN WE'RE LOOKING AT AND I THINK WHAT WE FOUND WITH HEALTH CARE PROFESSIONALS IS THAT, YOU KNOW, A LOT OF THEM ARE SAYING THAT THEY DON'T WANT TO GET IT RIGHT NOW. SO, FOR EXAMPLE, THEY WOULD SAY, I WOULDN'T BE IN THE FIRST ROUND, BUT AS OTHER PEOPLE GET IT, THEN I MIGHT GET IT. WE ALSO KNOW THAT, WHETHER IT'S HEALTH CARE PROFESSIONALS IN LONG-TERM CARE OR OTHER FACILITIES, IF YOU BRING THE VACCINE TO THEM... SO IF YOU MAKE IT VERY EASY AND MAKE IT EASILY ACCESSIBLE... THEY ARE MORE LIKELY TO GET IT AS WELL. SO I THINK... YOU KNOW, WHAT THE KEY IS THAT WE NEED TO MAKE SURE THAT PEOPLE GET INFORMATION, WE MEET THEM WHERE THEY ARE. SO WE'RE NOT ONE BIG MONOLITHIC BLOB, WE ALL HAVE DIFFERENT RISK PERCEPTIONS. THERE ARE SOME PEOPLE THAT GO SKYDIVING OR BUNGEE JUMPING AND OTHER PEOPLE THAT DON'T. WE NEED TO HAVE THAT INFORMATION. WHAT WE SAID AT THE FEDERAL LEVEL WITH RESPECT TO HEALTH CANADA AND THE VACCINES, AND WE'RE GOING TO BE OPEN AND TRANSPARENT WITH YOU. WE'RE GOING TO TELL YOU WHAT WE KNOW AND DON'T KNOW AND WHAT WE HAVE IN TERMS OF PLANS OF KNOWING MORE ABOUT THE VACCINE AND PUTTING THAT INFORMATION OUT THERE, WORKING WITH THE PROVINCES AND TERRITORIES. WE KNOW THAT PEOPLE IN GENERAL ACROSS THE BOARD RESPOND TO INFORMATION FROM PEERS OR PEOPLE THAT THEY KNOW IN DIFFERENT WAYS COMPARED TO, YOU KNOW, LARGE ORGANIZATIONS THAT ARE VERY DISTANT FROM THEM. SO I THINK WE NEED TO TAKE THIS INFORMATION... IT'S REALLY IMPORTANT... BUT REALLY FOCUS ON WHAT DO PEOPLE NEED TO GET THEM TO A YES, RIGHT? AGAIN, IT'S NOT CONVINCING THEM. IT'S HAVING THAT INFORMATION AVAILABLE SO THEY CAN ACCESS IT WHENEVER THEY NEED IT AND BE ABLE TO MAKE WHAT WE THINK IS THE MOST APPROPRIATE DECISION.

Steve says FAIR ENOUGH. BUT INFORMATION CAN ONLY COMBAT SO MUCH. AND I THINK, SAMANTHA YAMMINE, LET ME ASK YOU THIS AND I DON'T SAY THIS FACETIOUSLY. SOUGHT PEOPLE ARE TERRIFIED OF NEEDLES AND WE HAVE SEEN THE NEEDLES OF THIS COVID-19 VACCINE AND IF YOU'RE AFRAID OF NEEDLES, THESE THINGS LOOK PRETTY SCARY. WHAT DO WE DO ABOUT THAT?

The caption changes to "Samantha Yammine, @heysciencesam."

Samantha Yammine says I WANT TO START OFF BY SAYING I AM ONE OF THOSE PEOPLE. I AM VERY TERRIFIED OF THEM. I TRY TO AVOID IT AS I CAN. I AM IN THIS CASE, DESPITE THAT FEAR, REALLY EXCITED TO GET THIS VACCINE JUST BECAUSE OF THE YEAR WE'VE HAD. I JUST WANT TO SAY HAVING A FEAR OF NEEDLES IS SOMEWHAT COMMON, AND I UNDERSTAND THAT ANXIETY SO DEEPLY, BUT I THINK THAT'S A TIME WHERE WE NEED TO REACH OUT TO OUR HEALTH CARE PROFESSIONALS, ASK FOR THE SUPPORT THAT WE NEED, AND ADDRESS THAT FEAR OF THE NEEDLE AND NOT CONFLATE IT WITH THE FEAR OF WHAT'S INSIDE THE NEEDLE. AND THAT'S WHY I'VE BEEN ACTUALLY REALLY HAPPY TO SEE SO MANY PEOPLE SHARING THEIR VACCINATION PICTURES BECAUSE IT'S HELPED TO... IT'S BEEN A BIT OF EXPOSURE THERAPY, INFORMAL EXPOSURE THERAPY, JUST TO SEE ALL OF THESE MASKS, BUT YOU CAN SEE THE CRINKLY SMILING EYES RECEIVING THE NEEDLE AND REMINDING ME IT DOESN'T NEED TO BE A SCARY EXPERIENCE AND IN FACT THIS IS EXCITING WHEN WE THINK SCIENTIFICALLY WHAT'S BEEN ACHIEVED HERE. I THINK IF YOU HAVE THOSE FEARS, I UNDERSTAND. THERE IS HELP YOU CAN GET AND SUPPORT THAT YOU DESERVE FOR THAT. BUT REMEMBER THAT IT'S TWO SEPARATE THINGS. THERE'S A NEEDLE AND THERE'S WHAT'S INSIDE OF IT AND WHAT'S INSIDE OF IT IS SOMETHING WE REALLY NEED TO HELP GET US OUT OF THIS HUGE CRISIS.

Steve says WELL, MAYA GOLDENBERG, LET ME GET YOU TO FOLLOW UP ON THAT IN AS MUCH AS, I KNOW WHEN ANTHONY FAUCI GOT HIS SHOT WE WERE PROBABLY ALL WATCHING THAT PHOTO OP TO SEE IF HE WOULD FLINCH AND HE DID NOT. HE TOOK IT LIKE A CHAMP. SO DID THAT 91-YEAR-OLD WOMAN IN GREAT BRITAIN WHO WAS THE FIRST THERE TO GET VACCINATED. SHE TOOK IT LIKE A CHAMP AS WELL. I HAVE SEEN PICTURES ON TV OF PEOPLE GETTING THE NEEDLE AND SAYING "OUCH!" HOW INFLUENTIAL ARE THOSE KINDS OF PICTURES WHEN YOU'RE TRYING TO GET THE MESSAGE OUT THAT IT'S NOT JUST THE NEEDLE, IT'S WHAT'S INSIDE THE BOTTLE AS WELL THAT COUNTS?

The caption changes to "Maya Goldenberg, @goldenbergmaya1."

Maya says LOOK, EVERYTHING WILL PLAY INTO IT, BUT IT DOESN'T MEAN THAT ONE "OUCH!" PICTURE IS GOING TO CHANGE THE SITUATION. IT'S NICE THAT IT'S OUT THERE. IT'S NICE THAT IT'S HONEST. I LIKE THE ATTENTION TO THINGS LIKE NEEDLE FEAR THAT WE DON'T MARGINALIZE IT. WE SAY, THIS IS AN IMPORTANT... THIS IS AN IMPORTANT FEATURE OF THE HEALTH CARE DECISIONS THAT WE'RE MAKING. I DON'T SEE IT AS PARTICULARLY PROBLEMATIC TO KNOW THAT SOME PEOPLE SAY OUCH! I THINK IT'S GREAT TO BE EXPLICIT ABOUT IT. PEOPLE ARE ALSO SHARING THEIR EXPERIENCES OF MUSCLE PAIN OR WHAT KIND OF EFFECTS THEY HAD IN THE DAYS AFTER. PEOPLE WOULD RATHER KNOW THAN NOT KNOW. BECAUSE WHEN THEY DON'T KNOW, THEY FILL IN ALL KINDS OF GAPS.

Steve says OKAY. DR. SHARMA, LET ME COME BACK TO YOU WITH THIS NEXT ONE. I HAVE HEARD PEOPLE SAY: THIS VACCINE GOT DEVELOPED IN RECORD TIME AND I AM DUBIOUS AS TO WHETHER OR NOT IT GOT ADEQUATELY TESTED, AND BEFORE I PUT ANYTHING INTO MY BODY, I'D SURE LIKE TO KNOW THAT IT WAS APPROPRIATELY TESTED. WHAT COULD YOU SAY TO THAT GROUP OF PEOPLE TO ALLAY THOSE CONCERNS?

The caption changes to "Subscribe to The Agenda Podcast: tvo.org/theagenda."

Supriya says WELL, FIRST OF ALL, I WOULD SAY, IT'S GOOD THAT PEOPLE ARE ASKING THE QUESTIONS. I THINK IT'S IMPORTANT FOR PEOPLE, BEFORE THEY TAKE SOMETHING, TO BE AWARE OF WHAT THEY'RE TAKING AND WHY. WE ARE IN THIS INCREDIBLE TIME WHERE THE FACT THAT WE HAVE VACCINES LESS THAN A YEAR FROM WHEN WE KNEW THE GENETIC CODE OF THIS VIRUS IS AN AMAZING SCIENTIFIC MARVEL. AND I CAN UNDERSTAND WHEN PEOPLE HEAR THE CONCEPT OF, NORMALLY WHEN WE HAVE VACCINES, IT TAKES YEARS TO DEVELOP. THIS HAS BEEN LESS THAN A YEAR, AND WE'VE REVIEWED IT VERY QUICKLY. BUT THE THING THAT'S THE MOST IMPORTANT TO HIGHLIGHT IS THAT NO STEPS WERE SKIPPED. SO THERE WAS NO CORNERS CUT. IT'S STILL... YOU KNOW, THE DEVELOPMENT OF THESE VACCINES ARE GOING THROUGH EVERY PHASE THAT A VACCINE WOULD GO THROUGH, NOT IN PANDEMIC TIMES, AND ALTHOUGH FROM THE HEALTH CANADA PERSPECTIVE, WE DID REVIEW IT IN A SHORTER PERIOD OF TIME, WE STILL WENT THROUGH ALL THE STEPS. WE JUST HAD A DEDICATED TEAM THAT WAS WORKING ON IT. IT STILL TAKES ON AVERAGE 2,000 HOURS OF REVIEW TIME OF A GROUP OF SCIENTIFIC REVIEWERS THAT ARE ABOUT SEVEN TO TEN PEOPLE THAT ARE GOING THROUGH TENS OF THOUSANDS, HUNDREDS OF THOUSANDS OF PAGES, AND ANALYSING THAT BEFORE IT'S AUTHORIZED. AND I THINK THE IMPORTANT PART OF THIS IS THAT THERE'S DIFFERENT PHASES FOR VACCINE DEVELOPMENT FOR A REASON. YOU KNOW, YOU GET EARLY CANDIDATES. SOME OF IT MAKE IT THROUGH. SOME OF THEM DON'T. BUT YOU ACTUALLY HAVE TO HAVE THEM GO THROUGH AND MAKE IT THROUGH EVERY STAGE TO GET TO THE POINT WHERE THEY'RE EVEN IN CLINICAL TRIALS. YOU KNOW, I THINK PEOPLE ALSO SHOULD KNOW WHEN WE'RE LOOKING AT, FOR EXAMPLE, THE PFIZER AND THE MODERNA VACCINES, THE STUDIES WERE TENS OF THOUSANDS OF PEOPLE. SO WE DO KNOW A LOT ABOUT THESE VACCINES AND THEY'RE REALLY BEING HELD TO THE SAME STANDARDS THAT ANY VACCINE WOULD. IT'S JUST THAT WE'RE DOING ALL OF THIS IN A COMPRESSED TIME.

Steve says OKAY. EVEN AMIDST THOSE THOUSANDS AND THOUSANDS OF PEOPLE... DR. HILL, LET ME GET YOU ON THIS ONE... NOT KIDS AND NOT PREGNANT WOMEN. SO WHAT DOES ONE SAY TO THEM?

Samantha Hill says THEY'RE ACTUALLY A VERY DIFFERENT POPULATION. THE THREE POPULATIONS THAT COME TO MIND MOST CLOSELY ARE CHILDREN, IMMUNOCOMPROMISED AND PREGNANT WOMEN. WE DON'T HAVE ENOUGH DATA ON TO SAY THINGS ARE ABSOLUTELY SAFE. THAT'S A KEY SENTENCE. IT'S NOT THAT WE'VE EVER SAID, AND WE IS THE MEDICAL COMMUNITY, TO SAY THAT IT IS UNSAFE. THAT IS ROUTINE. YOU ALWAYS TRY THINGS OUT ON YOUR BEST STUDIED POPULATION FIRST, WHICH IS YOUR TYPICAL ADULT, BEFORE YOU STUDY THE SUB POPULATIONS BECAUSE OF THE RISKS THAT ARE ASSOCIATED. CHILDREN ARE NOT MINIATURE ADULTS, THEY HAVE A DIFFERENT IMMUNE SYSTEM, AND THINGS SOMETIMES WORK DIFFERENTLY FOR THEM. WE KNOW THEY REQUIRE MULTIPLE DOSES AND MULTIPLE BOOSTERS TO ACHIEVE A DECENT IMMUNITY. SO THAT NEEDS TO BE TAKEN INTO ACCOUNT. WITH RESPECT TO BREASTFEEDING WOMEN, WHAT I THINK WE ALL HAVE TO BE VERY CAREFUL ABOUT SAYING IS THAT THEY CAN'T RECEIVE IT. WHAT THE ACTUAL STATEMENT IS THAT IT NEEDS TO BE RISK BALANCED. AND SO THAT MEANS THAT THERE'S AN INDIVIDUAL DISCUSSION THAT HAS TO HAPPEN WITH THE PREGNANT WOMAN AND THEIR PHYSICIAN OR PRIMARY CARE PROVIDER AROUND WHAT THEIR PERSONAL RISKS ARE OF ACQUIRING COVID, THE RISKS THAT THEY MAINTAIN AS A PREGNANT INDIVIDUAL IF THEY GET COVID, WHICH IS MUCH HIGHER THAN THE AVERAGE, AND THE RISK OF GETTING THE VACCINE. AND THEN THEY HAVE TO MAKE A DECISION FOR THEMSELVES. THAT ALSO INCLUDES THE SAME POPULATION OF LACTATING WOMEN. WE CAN'T AS A GROUP SAY THAT WE WILL DENY ACCESS TO THAT POPULATION BECAUSE, FIRST OF ALL, IT'S A QUESTION OF WHEN. EVENTUALLY I EXPECT THE STUDIES WILL BE THERE AND WE'LL BE ABLE TO OPEN IT UP. BUT ALSO BECAUSE THAT WOULD BE A SYSTEMIC DISENFRANCHISEMENT FROM WOMEN OF THEIR OWN HEALTH CARE. HEALTH CARE WOMEN, NURSES, PSWS, PHYSICIANS ARE IN A VERY DIFFERENT RISK CATEGORY THAN THE GENERAL POPULATION. WE CANNOT KEEP OURSELVES AWAY FROM THE COVID VIRUS. AND SO THAT DISCUSSION HAS TO PLAY OUT VERY DIFFERENTLY THAN THE DISCUSSION WITH THE GENERAL POPULATION.

Steve says IN WHICH CASE, LET'S TALK COMMUNICATION, AND I'LL GO TO SAMANTHA YAMMINE ON THIS ONE. YOU'VE GOT THE WOMAN REPRESENTING ALL OF ONTARIO'S DOCTORS, SAMANTHA HILL IS THE HEAD OF THE OMA. IN WHICH CASE WHAT WOULD YOU LIKE TO HEAR DOCTORS COMMUNICATE ABOUT THE ADVISABILITY OF TAKING THIS VACCINE THAT YOU MAYBE HAVEN'T HEARD SO FAR?

Samantha Yammine says I THINK... THAT'S A GOOD QUESTION. I THINK IT'S REALLY IMPORTANT THAT WE ADDRESS PEOPLE'S QUESTIONS. I THINK INSTEAD OF JUST MAKING SWEEPING STATEMENTS LIKE, "YES, TAKE IT." WE NEED TO ASK PEOPLE WHAT THEY ARE REALLY CONCERNED ABOUT. VACCINE-HESITANT PEOPLE ARE NOT A MONOLITH. THERE ARE MANY REASONS PEOPLE ARE HESITANT. AND THAT HESITANCY MAY JUST MEAN THEY HAVE QUESTIONS. SOME MAY HAVE HISTORICAL REASONS WHY THEY MISTRUST GOVERNMENTS AND LARGE ORGANIZATIONS. THOSE ARE VERY VALID. I'M NOT HERE TO SAY THAT THAT ISN'T. IT MAY MEAN WE NEED TO BE MORE TRANSPARENCY ABOUT THE PROCESS AND THE PEOPLE INVOLVED. THERE ARE GOOD PEOPLE. THERE'S REPRESENTATION IN THE SCIENTIFIC PROCESS. THERE ARE PEOPLE WHO CARE ABOUT THE SAME CHALLENGES THAT YOU MAY BE THINKING AND THE SAME CONCERNS YOU MAY HAVE. THERE ARE PEOPLE WITHIN THE PROCESS THAT HAVE THOSE SAME CONCERNS. THERE ARE INDEPENDENT SCIENTISTS OUTSIDE THE PROCESS, LIKE MYSELF, WHO ARE REVIEWING THINGS AS WELL AND HAVE YOUR BEST INTERESTS AT HEART. AND I THINK THAT KIND OF GRANULARITY, THE VALIDATION THAT THE QUESTIONS, YOU KNOW, ARE IMPORTANT AND ADDRESSING THEM HEAD ON IS REALLY KEY, AND WHEN IT COMES TO THE LONG-TERM SAFETY, JUST REMINDING PEOPLE THAT MOST ADVERSE EVENTS HAPPEN WITHIN THREE MONTHS. THE FIRST INJECTION FROM THE PHASE ONE TRIAL WAS MARCH 16TH OF 2020. SO WE'VE HAD A LONG ENOUGH WINDOW TO OBSERVE ANY POTENTIAL ADVERSE EVENTS. AND FORTUNATELY THERE REALLY HAVEN'T BEEN MANY MORE THAN YOU WOULD EXPECT FROM THE GENERAL POPULATION. AND ESPECIALLY WHEN YOU COMPARE IT TO THE ADVERSE EVENTS FROM COVID. THAT'S WHAT WE HAVE TO KEEP IN MIND: IS THIS VACCINE BETTER THAN THE CURRENT STANDARD OF CARE, WHICH FOR COVID IS VERY LIMITED, AND SO FAR, YES, IT REALLY, REALLY IS.

Steve says IN OTHER WORDS, IF IT WAS A PROBLEM, WE'D KNOW BY NOW.

Samantha Yammine says YES.

Steve says GOT IT. OKAY. LET'S TALK TRUST FOR A SECOND HERE, SHALL WE? MAYA GOLDENBERG, I'M GOING TO BRING YOU IN ON THIS BECAUSE YOU HAVE A BOOK OUT ON THIS, WHICH ISN'T OUT FOR A FEW MONTHS, BUT WE GOT A SNEAK PREVIEW, AND I'M GOING TO READ A SNIPPET OF IT HERE. SHELDON, THE GRAPHIC IF YOU WOULD?

A quote appears on screen, under the title "Earning public trust." The quote reads "Public-health and vaccine advocates are aware of poor public trust in vaccines but see this as a problem with the publics rather than signalling one in scientific governance. Vaccine pundits often contribute to public shaming and disparaging of vaccine hesitators and refusers rather than trying to build bridges. This lack of priority must be rethought, given that public health is so dependent on public trust for achieving its community health goals.
The lesson here is that public trust is hard won. Biomedical and scientific institutions cannot take it as a given that they should be trusted; instead, trust must be earned and maintained."
Quoted from Maya Goldenberg, "Vaccine hesitancy." 2021.

Steve says OKAY. BOY, SO MANY QUESTIONS COMING OUT OF THAT, STARTING WITH: HOW?

Maya says WELL, LET ME GO BACK A LITTLE BIT ON THE IMPORTANCE OF TRUST HERE. IF I COULD GIVE A MESSAGE TO ALL ONTARIO DOCTORS, BECAUSE WE HAVE DR. HILL HERE, IT WOULD BE THAT ALL CONVERSATIONS WITH THE GENERAL PUBLIC SHOULD BE APPROACHED WITH THE UNDERSTANDING THAT IT IS REASONABLE PEOPLE... IT IS REASONABLE FOR PEOPLE TO BE SKEPTICAL ABOUT A NEW VACCINE (1) BECAUSE IT'S NEW, BUT ALSO BECAUSE PEOPLE HAVE QUESTIONS AND IT'S OKAY TO HAVE QUESTIONS. I'VE SAID THIS ABOUT PEDIATRIC VACCINES, WHICH HAVE A FAR LONGER RECORD THAN THE COVID VACCINE, SO A MUCH STRONGER TRACK RECORD. THERE IS THE TENDENCY AMONG SCIENTISTS AND HEALTH PROFESSIONALS TO REGARD VACCINE HESITANCY AS A PROBLEM OF MISINFORMATION OR SCIENTIFIC ILLITERACY... SORRY, SCIENTIFIC ILLITERACY AS BEING THE PRIMARY PROBLEM, AND THEREFORE THE SOLUTION TO THAT WOULD BE TO EDUCATE THE PUBLIC AND TO PROVIDE THE FACTS THAT THEY NEED. OF COURSE, INFORMATION IS IMPORTANT BUT A LOT OF THE FEAR AND DISCOMFORT AROUND VACCINES COMES FROM PROBLEMS OF MISTRUST, AND THAT'S GOT MUCH MORE TO DO WITH THE SOCIAL CIRCUMSTANCES THAT PEOPLE FIND THEMSELVES IN. SO ME, I'M NOT SURPRISED AT ALL THAT LONG-TERM CARE WORKERS ARE HESITATING AROUND THE VACCINE. EVEN THOUGH THE RISK/BENEFIT SEEMS TO STAND UP, THESE ARE LARGELY RACIALIZED AND IMMIGRANT WOMEN WHO HAVE REALLY BORNE THE BRUNT OF THE DISPARITIES NOTICED THROUGH COVID. SO THE FACT THAT THE SYSTEM DID NOT PROTECT LONG-TERM CARE WORKERS DURING THIS PANDEMIC, OR DID NOT PROTECT THEM WELL, IT SHOULDN'T BE TOO SURPRISING THAT THEY DON'T TURN TOWARDS THE SYSTEM FOR THE SOLUTION, WHICH RIGHT NOW IS A COVID VACCINE. SO THE KINDS OF TRUST-BUILDING THAT WE NEED IS MUCH MORE THAN PROVISION OF GOOD INFORMATION. OF COURSE WE NEED THAT. BUT WE REALLY NEED TO BE BUILDING BRIDGES AND ADDRESSING HISTORIC AND CURRENT INJUSTICES ALL AROUND US.

Steve says NO, I APPRECIATE THAT ANSWER, AND I SEE DR. HILL APPLAUDING THAT AND I GUESS I'D REMIND EVERYBODY THAT THE FIRST THING DR. HILL SAID IN OUR DISCUSSION WAS, SHE'S NOT HERE TO CONVINCE ANYBODY TO TAKE IT. SHE WANTS TO PUT INFORMATION OUT THERE AND JUST MAKE THIS AS CLEAR AS POSSIBLE. LET ME PICK UP, MAYA GOLDENBERG, ON ONE THING YOU SAID THERE. YOU WERE TALKING ABOUT ETHNIC COMMUNITIES AND WHY SOME, RACIALIZED COMMUNITIES, FOR EXAMPLE, MIGHT BE EVEN MORE HESITANT THAN OTHERS TO TAKE THIS. WHAT WOULD BE THE HISTORICAL UNDERPINNINGS OF THAT?

The caption changes to "Maya Goldenberg. University of Guelph."
Then, it changes again to "Crisis of trust."

Maya says THE HISTORICAL UNDERPINNINGS ARE MEDICAL RACISM, MEDICAL MISCONDUCT ON MARGINALIZED COMMUNITIES. WE HAVE A LONG HISTORY OF THAT. AND WE CAN'T JUST ERASE THAT AND PRETEND THAT IT'S AN ARTEFACT. WE STILL DEAL WITH DISPARITIES OF HEALTH BASED ON RACE, BASED ON ETHNICITY AND SOCIOECONOMIC STATUS TODAY. SO THE PEOPLE THAT ARE HESITATING AROUND VACCINES LIVE THAT AND DON'T SEE THE TECHNOLOGICAL SOLUTION AS THE BIG ANSWER. IN FACT, IF ANYTHING, COVID HAS EXPOSED MORE OVERTLY THE KIND OF DISPARITIES THAT PEOPLE DEAL WITH EVERY DAY. SO THE KIND OF TRANSFORMATION THAT WE NEED WHICH WILL RESULT, LIKELY RESULT, IN MORE UPTAKE OF VACCINES, IS MUCH BROADER THAN HEALTH INFORMATION. YOU HAVE TO CREATE SYSTEMS THAT PEOPLE TRUST AND THAT THEY SEE AS ACTING IN THEIR OWN AND THEIR OWN COMMUNITY'S INTERESTS, AND NOT EVERYONE FEELS THAT WAY ABOUT PUBLIC HEALTH AND CANADIAN HEALTH CARE.

The caption changes to "Watch us anytime: tvo.org, Twitter: @theagenda, Facebook Live, YouTube."

Steve says UNDERSTOOD. IN OUR LAST FEW MINUTES HERE, LET'S TALK ABOUT HOW WE BUILD THOSE BRIDGES. DR. HILL, LET ME GET YOU IN HERE. HOW SHOULD PEOPLE TALK TO THEIR LOVED ONES WHO ARE... WHO HAVE DOUBTS ABOUT TAKING THIS VACCINE?

The caption changes to "Building bridges."

Samantha Hill says IT'S SUCH A GREAT QUESTION AND IT'S NOT JUST YOUR LOVED ONES. I'M GOING TO SPEAK TO EVERY SINGLE HEALTH CARE PROVIDER OUT THERE WHEN YOU'RE TALKING TO COMMUNITIES. I WANT TO QUOTE SOMEONE ELSE SAID ON THIS SET AND THAT IS THAT HESITATION IS OKAY, QUESTIONS ARE OKAY, UNCERTAINTY IS OKAY, AND WE HAVE TO START FROM A PLACE WHERE WE DON'T EXPECT PEOPLE TO KOWTOW OR TO IMMEDIATELY OBEY. FREE WILL IS IMPORTANT. AND FREE CHOICE IS IMPORTANT. AND POSSIBLY EVEN MORE IMPORTANT THAN SURVIVAL FROM COVID IS YOUR FREE WILL AND YOUR FREE CHOICE. AND YOU NEED TO START EVERY CONVERSATION FROM THAT PLACE. YOU ALSO NEED TO START EVERY SINGLE CONVERSATION FROM A PLACE OF RESPECT, AND THAT MEANS UNDERSTANDING THE WHY. AND THAT'S WHAT WE'VE DANCED AROUND FOR A LOT OF THIS SESSION IS WE'VE TALKED ABOUT THE NUMBERS OF PEOPLE WHO ARE HESITANT, BUT WE'RE NOT TALKING ABOUT THE WHY. AND SOMETIMES THE WHYS ARE PERSONAL AND THEY CAN BE ADDRESSED WITH INFORMATION WHICH ISN'T JUST ABOUT PROVIDING INFORMATION BUT HOW YOU PROVIDE IT AND MAKING SURE IT'S HEARD AND IT'S ACCESSIBLE. IT'S ALSO ABOUT THE CULTURAL PHENOMENONS. WE KNOW THE STORIES THAT HAVE PREDATED AND LED US TO A PLACE WHERE FRANKLY MANY OF OUR BLACK POPULATION DON'T TRUST HEALTH CARE. AND FOR THEM AND TO THEM I WOULD SAY, WE NEED TO REMEMBER THAT THERE ARE DETAILS THAT ARE IMPORTANT, LIKE THE FACT THAT THE MODERNA VACCINE HAD 37 percent REPRESENTATION IN THE BIPOC COMMUNITY. SO IT HAS BEEN STUDIED. WE ALSO NEED TO REMEMBER WHO LED THAT VACCINE. IT WASN'T SOMEONE WHO LOOKS LIKE ME, IT WAS SOMEONE WHO LOOKS A LOT MORE LIKE THEM, IT WAS A BLACK SCIENTIST WHO WAS THE HEAD SCIENTIST ON THAT STUDY. WE NEED TO PUT THOSE FIGURES IN FRONT AND MAKE THEM VISIBLE. SO PEOPLE CAN SEE PEOPLE WHO LOOK LIKE THEM, HEAR PEOPLE WHO TALK LIKE THEM, AND UNDERSTAND THAT THOSE PEOPLE COME FROM THE SAME COMMUNITIES THAT THEY DO. THAT MAKES THAT TRUST A LITTLE MORE ACCESSIBLE BUT THAT TRUST IS GOING TO TAKE A LONG TIME. WHEN SPEAKING WITH YOUR LOVED ONES IS DON'T BURN BRIDGES OVER THIS. LEAVE THE SPACE OPEN TO COME BACK TO A CONVERSATION AND HAVE IT AGAIN LATER. THE TRUTH OF THE MATTER IS, RIGHT NOW IN ONTARIO WE HAVE 150,000 VACCINES, 40 percent HAVE BEEN GIVEN. WE HAVE TIME TO HAVE THOSE CONVERSATIONS. I'D LOVE TO SAY WE GET 14 MILLION VACCINES COMING IN TOMORROW AND WE HAVE TO FIGURE THIS ALL OUT RIGHT NOW. BUT WE DON'T. WE HAVE TIME. THE PRESSURE IS THERE, BUT WE CAN TAKE TIME AND GIVE PEOPLE TIME TO HAVE SPACE TO COME TO THE RIGHT DECISION IN THEIR OWN... ONE MORE TIME... TIME.

Steve says SAMANTHA YAMMINE, I'VE GOT 30 SECONDS LEFT. DO YOU WANT TO GIVE US THE LAST WORD ON THAT ANGLE?

Samantha Yammine says ABSOLUTELY. I THINK IT'S REALLY EASY TO FEEL REALLY INTENSE AND ANGRY AND IT GETS VERY EMOTIONAL, BUT SOMETIMES IT'S GOOD TO JUST TAKE A BREAK, TAKE A STEP BACK, AND REALLY ADDRESS THE ROOT CAUSE OF SOMEONE'S MISTRUST AND JUST REMIND THAT PERSON YOU'RE TALKING TO THAT, HEY, I CARE ABOUT YOU. LET'S JUST FIGURE THIS OUT SO WE CAN BE HAPPY, BE SAFE, AND HANG OUT AGAIN.

The caption changes to "Producer: Patricia Kozicka, @TrishKozicka."

Steve says HANGING OUT AGAIN WOULD BE VERY NICE, ACTUALLY. I WANT TO THANK THE FOUR OF YOU FOR COMING ONTO TVO TONIGHT AND HELPING US OUT WITH THIS, DR. SUPRIYA SHARMA IN OTTAWA, DR. SAMANTHA HILL, WHO LOOKS LIKE SHE'S IN THE MIDDLE OF A FOREST BUT I'M ADVISED SHE'S SOMEWHERE IN DOWNTOWN TORONTO. MAYA GOLDENBERG, AND SAMANTHA YAMMINE. GREAT TO HAVE ALL OF YOU ABOARD TONIGHT, THANK YOU SO MUCH.

The guests say THANK YOU.

Watch: Vaccine Hesitancy in a Pandemic