Round Rock family physician Dr. Tina Philip keeps having the same conversation with patients these days. She encourages them to get vaccinated for COVID and flu. They say no.
“I've even had patients that, you know, previously would get the flu vaccine every year, and then now they're like, ‘Nah, I'm just not going to do any of that anymore,’” Philip said.
At the end of 2021, 77% of Travis County residents aged 5 and up had gotten at least one dose of the COVID vaccine — many of them after eagerly waiting in line for a shot that could bring a bit of normalcy back to their lives. But as of this month, only 23% of adults had received the latest shot, according to the Centers for Disease Control and Prevention. Likewise, the CDC reports, flu vaccination rates have tracked steadily downward since 2019.
More kindergartners are opting out of school vaccine requirements, and state lawmakers are trying to make it even easier to do so.
Dr. Claire Bocchini, an infectious disease specialist with Texas Children’s Hospital, said vaccine hesitancy was rising even before COVID-19 emerged – but the pandemic exacerbated the trend.
“With the COVID vaccine generating so much media attention and misinformation online via social media, I think that we did see a rise of vaccine hesitancy in general,” Bocchini said.
What’s driving hesitancy?
KUT News received more than 200 responses to a survey this month about attitudes toward vaccines. Many respondents said their education about the COVID-19 vaccine had reinforced the importance of immunizations to protect themselves and the community.
But others, like Austin resident Alicia Giangiacomo, said they had become more skeptical following the rollout of the COVID-19 vaccine.
Giangiacomo said she never got the vaccine, partly because she was never required to, and partly because she was nervous about how quickly it was developed.
“I would like to believe that our health organizations and pharmaceutical companies would put in the due diligence to make a vaccine that is safe,” she said. “However, I don't think that they are putting in that kind of effort.”
In fact, although the first vaccines from Pfizer and Moderna were fast-tracked under the Trump administration’s “Project Warp Speed,” they were developed from a decade of existing research and were tested in large clinical trials before they were approved for emergency use in the U.S.
Giangiacomo also said she was disappointed the vaccine did not prevent transmission of the virus. She said health leaders were misleading about that.
Ahead of the vaccine’s first release, however, experts said they weren’t sure if the vaccine would prevent transmission. But they were clear it would prevent severe cases of the disease and keep folks out of the hospital — and that was true.
“From my standpoint as an infectious disease specialist, this vaccine really did make an impact in being able to have people get COVID and still do well, without being in the hospital, without dying from the infection,” Bocchini said. “It made a huge difference in my job.”
But most people aren’t infectious disease specialists, and don’t get to see what Bocchini sees every day.
Dr. Mark Escott served as Austin’s top public health official through the height of COVID. Now, he’s chief medical officer for the City of Austin. Looking back, he said, health leaders could have done a better job of communicating to the public how vaccines work – of letting them know, for instance, that some types of vaccines wane in effectiveness over time and require regular boosters – like flu shots, and now, like COVID vaccines.
“I think one of the lessons learned is that we have to ensure that the public understands it like we do,” he said. “We don't want to oversell something to try to reach a public health goal.”
The role of misinformation
As Bocchini pointed out, there was also significant misinformation about vaccines that circulated during the pandemic. There continues to be – and not just with COVID. Bocchini said parents who come to her practice often incorrectly believe there’s a risk their child will develop autism if they get the vaccine for measles, mumps and rubella. That theory has been repeatedly debunked.
“Vaccines don't cause autism," she said. "Vaccines can have some very minor side effects, but they're very safe."
“Vaccines don't cause autism. Vaccines can have some very minor side effects, but they're very safe." Dr. Claire Bocchini, infectious disease specialist with Texas Children’s Hospital
When fewer people are vaccinated for contagious diseases like measles, the stakes are high. Dropping vaccination rates have led to resurgences of the once-eliminated disease. One child and one adult have died amid an outbreak in West Texas and New Mexico; dozens have been hospitalized.
Meanwhile, America’s highest-ranking health official, Robert F. Kennedy Jr., has downplayed the severity of measles and repeated misinformation about vaccines.
Escott said he hopes outbreaks like the one in Texas will remind people how dangerous measles can be; it commonly leads to complications like pneumonia, and occasionally causes swelling of the brain and other life-threatening or disabling conditions.
“That may be enough to push people over the line to say, ‘You know what, there wasn't a threat before, but there is now. So maybe now is the right time to get my child vaccinated,’” he said.
Giangiacomo said she is paying attention to the latest measles outbreak and that it reminds her vaccines have importance. In the past, she made sure her daughter received standard childhood vaccines, and she is now considering whether she would vaccinate any future kids she may have.
“We've been vaccinating [for diseases like measles] for decades. They obviously work at eradicating these diseases within our community," she said. "That's a pretty big deal, and I do stand behind that."
Breaking through the noise
With the rise of social media, Escott said the public has to field a lot more information these days — which makes how scientists communicate even more important.
“Public health is used to communicating science and charts and graphs,” he said. “We have to understand how people think and how they process information.”
For some people, public health messaging has broken through the noise – even during the continuous years of the pandemic.
Take Cecilia Mireles. The 46-year-old Austin jewelry maker grew up in a family that was skeptical of Western medicine. Before the pandemic, she didn’t see a general practitioner, refused vaccines and avoided medications.
“When COVID happened, and it seemed like vaccines might be the only way out of it, I tried to have an open mind about possibly taking a vaccine,” she said.
After tuning into reporting on the vaccine’s development and researching vaccine risks, Mireles said she discovered that some of her beliefs about vaccines were unfounded, like the myth that vaccines can cause autism. She decided to get the COVID shot — and then some other shots, too.
“I have gotten every vaccine out there,” she said, laughing. “I did such a 180.”
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