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The anti-vaccination movement is hardly new. However, the coronavirus pandemic and the rollout of vaccines this winter have led to a surge in unfounded vaccine fears, including messenger RNA vaccines’ ability to change DNA, infertility stemming from the COVID-19 vaccine, microchipped doses, and more.

Stephanie Wasserman, Executive Director of the nonprofit Immunize Colorado, has been looking at vaccine hesitancy since long before the pandemic. She says the pre-existing anti-vaccine movement has fueled much of the hesitancy around COVID-19 vaccines and it stems from the same sources.

“There’s a lot of misinformation about the safety and importance of vaccines that are shared on social media that are driven by a pretty well-organized and well-funded anti-vaccine movement,” she explains. “Some of those people have been removed from social media, which is great, but there’s still a lot of disinformation that’s shared on social media and in the media in general.”

Pediatrician Josh Williams, M.D., has been running vaccine listening circles among religious groups to tackle hesitancy in those communities. Williams feels that one of the best ways to mitigate vaccine hesitancy is to give people open, safe spaces to ask questions.

“There’s maybe one percent or two percent or three percent of individuals who adamantly refuse [vaccines],” he says. “The majority of people who might fall under the term [vaccine hesitant] have genuine questions about vaccines, but they’d like to get them answered by a professional with expertise and knowledge about vaccines. I’ve tried to do that in these settings, and public health workers around our state and around the country are trying to find novel ways to do that in other settings.”

One of the more vulnerable communities when it comes to COVID-19 and misinformation exposure is those aged 70 and older, who have been a high priority for COVID-19 vaccination. At least 30-40 percent of the attendees at Williams’ listening circles have been seniors or middle-aged.

“People want information about medicines that they take and vaccines that are recommended,” he explains. “When it comes to elderly individuals or caregivers for the elderly, it’s just as important to want vaccines that are safe and effective as it is for parents of young children.”

Those seniors also often come with stories of the time during the 1950s and before, of working in polio wards and operating iron lungs. “There are a lot of health care workers or retired health care workers,” he says. “The memory from the elderly community of vaccine-preventable diseases is very different than it is in the younger generation, and that could be one of the reasons why there’s less hesitancy in the elderly, at least in the work that I’ve done.”

Williams feels seniors may also be more inclined to accept offers to get the vaccine due to the higher risks of COVID-19 for their demographic.

“Most [elderly individuals] who are offered the vaccine end up accepting the vaccine,” he says. “Interestingly, even though we know that there’s a disparity in vaccination by race and ethnicity, it seems older members of racial and ethnic minority groups are more likely to accept vaccines, and the COVID vaccine specifically, than younger members of those groups.”

Since the start of the pandemic, Immunize Colorado has aimed to better understand and address vaccine hesitancy in communities hit hardest by COVID-19, launching the Colorado Vaccine Equity Task Force made up of a variety of “diverse stakeholders” who can connect with their communities on vaccines.

“Communities of color, low-income communities, and communities that experience language and access barriers are where we are finding some hesitancy,” Wasserman says. “With communities of color, layered on top of that disinformation is historic distrust of the medical establishment due to systemic racism and mistreatment.”

Much of the public, including seniors, felt a lot of concern about COVID-19 vaccine safety due to the widespread politicization of the vaccine and the pandemic. Wasserman found misconceptions around vaccine ingredients and technology and concerns about mandates to be key causes for hesitancy.

“No one is ever required to get a vaccine, even those that are school-required, and if you are a parent and don’t want to get the vaccines in Colorado, you can exempt your child from that.” Colorado is one of only 15 states that allows vaccine exemptions, usually requiring a healthcare provider signature or an online education module.

“With the COVID vaccine, there will likely be employer mandates, although there are not any AVV is aware of — yet. For example, healthcare workers will likely be required to get a COVID vaccine in the same way that, in Colorado, healthcare workers are required to get a flu vaccine,” Wasserman continues. “That’s a way for healthcare workers to protect themselves and their patients from transmitting infectious diseases.”

One of the biggest obstacles to vaccination, however, isn’t hesitancy, but accessibility.

“In some cases, seniors can’t leave their homes,” Wasserman says. “They have disability challenges or they might not have a car. We need to be able to provide vaccines to them, to be able to go door-to-door and provide vaccines in their homes. Their caregivers and their family members are critically important in helping navigate those challenges.”

Caregivers for seniors, including children, can also play a big role in ensuring seniors’ access to and understanding of the vaccine. “They can play a critical role in not just addressing questions but helping navigate the wayfinding that needs to happen for getting the COVID vaccine,” Wasserman says. “For seniors who may not have access to the internet or may not know how to sign up for something on the internet or may not have a computer,… it’s very important that the people around them provide that support.”

Denise Micciche, Director of the Upper Arkansas Area on Aging echoed Wasserman’s concerns on a local level.

“Having to use the internet to sign up, as many seniors either don’t have internet access or aren’t familiar enough with how to use it [is one hurdle],” she says. “The other hurdle is transportation to the vaccine locations.”

Andrea Carlstrom, Director of Chaffee County Public Health, says that it may still be hard to determine how prominent vaccine hesitancy is in the community. “Demand from the allowable groups has started to subside. That could be because we have effectively gotten through the majority of the groups or because there is hesitancy among those groups.”

Chaffee County has been fairly successful in getting high-risk groups vaccinated. “I am attempting to work with CDPHE to give us some forgiveness so that we can officially start vaccinating the groups in the next phase,” Carlstrom says. “While in the past, rural local public health agencies have expressed concern over being allocated limited resources for programming, one bright light through this pandemic is that we have proven we can vaccinate mass quantities of approved groups efficiently and effectively with our population size.”

Overall, Williams feels public health and frontline workers have done well in vaccinating priority groups, including seniors. “There’s always more work to be done. Everyone is very busy, but people are trying to increase access to vaccines for those who are at greatest risk.”

“It’s important to remember,” he said in closing, “that our individual decision to vaccinate or not vaccinate is part of our collective larger decision in our community about our herd immunity and protecting those who can’t get vaccines or too young to do so, who might be otherwise vulnerable.”

“I really hope our community sees that this is our ticket out of the pandemic and that those who may have been hesitant in the past see their friends, family, and co-workers being able to travel and participate in activities without so many restrictions or fear and will opt-in,” Carlstrom says of the vaccine. “However, all perspectives should be respected. We will continue to provide our community with science-based information and resources to make educated and thoughtful decisions that are best for them and their households.”