Yale scientist co-chairs Lancet Commission, publishes report on vaccine hesitancy

A new report co-edited by Yale in The Lancet examines the current state of COVID-19 vaccine rejection and acceptance, as well as strategies to address vaccine reluctance in the United States.


Contributing journalist


Sarah eisenberg

The Lancet Commission on Vaccine Rejection, Acceptance and Demand in the United States, which is co-chaired by the director of the Yale Institute for Global Health, Saad Omer, released a report outlining its findings on the current status of the country’s COVID-19 vaccinations and suggested strategies to promote vaccination across the United States.

Founded in response to a growing anti-vaccine movement and increased rejection of the measles vaccine in 2019, the Lancet Commission aims to investigate current and future trends in vaccine reluctance, to identify grounded interventions. on evidence to fight disinformation and promote vaccination against different diseases, including COVID -19. Chaired by Omer and Peter Hotez ’80, president of the Baylor National College of Tropical Medicine, the commission is made up of 20 medical and scientific professionals from across the country. According to Omer, the diversity of the commission “allows[s] us to have solid discussions that [lead] to consensus.

The November 15 report, published in The Lancet, addressed the causes of vaccine reluctance and the consequences of insufficient vaccine coverage against COVID-19. The report assessed the potential effectiveness of a variety of proposed interventions, ranging from warrants to centralized immunization reminder systems, in scaling up immunization. The authors concluded that interventions that “keep immunization on people’s minds” are most effective. The report proposed solutions to tackle social media misinformation and socio-demographic inequalities in access to vaccines.

The Lancet report also discussed the role of political rhetoric in creating the current landscape of COVID-19 vaccine reluctance, placing responsibility for the sentiment of the COVID-19 vaccine in the United States on the shoulders of politicians. far-right and anti-vaccine NGOs.

Omer said politicians should, at the very least, “stop making statements that undermine confidence in vaccines.”

Josh Sharfstein, commissioner and professor at the Johns Hopkins Bloomberg School of Public Health, agreed with Omer and added that political leaders of “Republican men in particular,” a group with one of the vaccination rates the lower ones, “could do a lot to help. He believes that even at this point, pro-vaccine rhetoric from political leaders can make a difference and “will help those leaders’ supporters stay alive.”

According to the report, Omer and Sharfstein conceded that messages from public health authorities on boosters could be improved.

“Everyone agrees that in high risk groups like the elderly, reminders are extremely important and I think a clearer message on this would be helpful,” Omer said.

According to Sharfstein, public health officials can better explain the evidence they review before making decisions, rather than after. He said official messages regarding the boosters were “a bit muddled” over the summer, where “the evidence was not clear” and “the data was not being shared.” Sharfstein added that people react negatively when evidence is presented after an official decision has been made, not before.

Sharfstein also noted the effect the new variants might have on vaccination rates. He said if Omicron “turns out to be really bad, dangerous” it could push more people to get the vaccine.

“We saw during the Delta Wave that as the number of infections in a particular area increased, more and more people were lining up to get vaccinated,” Sharfstein said. “I think if this becomes a tangible threat to people and the vaccine provides some value, some people will take steps to protect themselves. In the abstract, before it becomes a tangible threat, people will be saying all kinds of things if they are trying to justify not getting the vaccine.

Sharfstein and Omer largely agreed that more data is needed before deciding whether a recall warrant is justified and necessary. Sharfstein said that before the Omicron threat, there was still no rationale for requiring booster shots, given the past effectiveness of vaccines against previous variants. Both stressed that at the moment the most attention should be paid not to those who are resistant to boosters, but rather to those who are not vaccinated at all, as they are most at risk.

While Omer believes the report will shift the conversation about COVID-19 vaccine reluctance “toward evidence-based interventions,” the Lancet Commission work is far from over. Members of the commission plan to apply their knowledge of COVID-19 to other diseases, breaking into sub-groups to write briefing notes on emerging vaccine-related issues that have been highlighted by the pandemic.

Currently, 90 percent of people hospitalized at Yale New Haven Hospital are unvaccinated.

Amanda J. Marsh