Offering advice to those who are vaccine hesitant, in my personal and professional life



As an autism researcher, I often am asked whether vaccines cause autism. As I’ve shared in a previous blog post, they do not. However, in studying vaccine hesitancy among parents of children with autism compared to other parent groups, I have come to appreciate that concerns about vaccines are multi-faceted and we, as scientists and health care providers, need to do a better job of explaining things. This is particularly critical now as COVID-19 vaccines are becoming increasingly available. But their availability is only half the battle. It’s vaccination—actually getting vaccines into people’s arms—that will help us combat COVID-19.

Much of what we hear from media outlets is that the demand for COVID-19 outweighs current supply. However, there are emerging reports about people feeling hesitant to accept the vaccine. My cousin is one of those people. During a recent email exchange, she revealed three key issues that were leading her to “hold off” on accepting the vaccine when it becomes available to her. I was actually surprised to learn of her concerns—she is not hesitant about other vaccines and her children’s shot records are up-to-date. But, I thanked her for sharing her concerns and providing me with an opportunity to address them. I told her that her apprehensions were common and valid and that I loved her.

I decided that, in responding to my cousin’s concerns about COVID-19 vaccines, it might be helpful for others who have similar worries to hear what I shared with her. Her points and my responses are below.

Risk-benefit ratio of contracting COVID-19 versus the currently unknown, long-term effects of a new vaccine. My cousin does not feel that her family is at risk for significant effects of COVID-19. Although she is aware of the serious medical hardships that so many have suffered, everyone who she personally knows who contracted COVID-19 “beat it effortlessly.”

The reality is that we can’t predict who is going to develop severe COVID-19 symptoms or die from this disease. We have identified risk factors that increase COVID-19 morbidity and mortality, but the fact remains that healthy individuals at low-risk for COVID-19 complications have died—including children. We must counterbalance that risk with comparable risks of the vaccine. To date, there have been no reported deaths associated with the COVID-19 vaccine in clinical trials. While it’s true that other potential long-term effects cannot be known at this time, there is nothing about how the COVID-19 vaccine works or in the current clinical data to suggest long-term side effects. To note, data are routinely collected to evaluate potential long-term side effects of the COVID-19 vaccine. Alternately, there are known long-term health consequences of COVID-19 infection, which include cardiovascular, respiratory, neurological and psychiatric complications. These can happen even in mild cases.

It seems better to wait it out. Given the variety of COVID-19 vaccines available now and in development, there are questions about which versions afford better protection against new strains of the virus, or which can eliminate a second dose. My cousin questions why she would “rush in to get the early model” when a better version may be around the corner. Her perspective is similarly reflected in new data collected by the Simons Foundation on a sample of more than 3,000 parents participating in the national SPARK study. Among those who were reportedly hesitant to accept a COVID-19 vaccine, the only thing that would make them feel more comfortable about receiving it was time. Unfortunately, COVID-19 does not afford us the luxury of time, especially with the evolution of more contagious strains. The safest and fastest way to return to pre-COVID-19 normalcy is to stop the spread of COVID-19 through vaccination that leads to community immunity. This is especially important for infants and children who are currently too young to receive the vaccine: when we are vaccinated, we protect those who cannot be vaccinated. The longer people wait to accept the vaccine, the more people will suffer from COVID-19 and the longer it will take us to get to the level of community immunity that affords sufficient protection for things to get back to normal.

What actually goes into the vaccine? Each ingredient in a vaccine serves an important role to ensure its safety and efficacy. Many of these ingredients are found in other common sources, like foods, medications and other health care products—things that people use or consume every day. A full list of ingredients for any vaccine should be available from the manufacturer. For example, the ingredients for the Pfizer COVID-19 vaccine are available on the manufacturer’s fact sheet. A unique feature of some of the initial COVID-19 vaccines is messenger RNA (mRNA). mRNA instructs the cells in our bodies to produce a protein. That protein tells our bodies to create a defense (antibodies) to protect us from the virus. Antibodies are what help prevent infection. Although some people have expressed concerns about the rapid development of these vaccines, mRNA techniques actually have been researched for years. This is what allowed scientists to move quickly in evaluating their efficacy in combating COVID-19.

Unfortunately, there are myths about ingredients in COVID-19 and other vaccines that undermine confidence in their safety; some raise ethical concerns. It is important to consider the source of any vaccine information, as many alarming reports are concocted by antivaxxers who actively campaign against vaccines, particularly through social media. If anyone has questions or concerns about COVID-19 or other vaccines, it is best to raise these with a trusted health care provider who can direct them to credible sources of information. I am glad that my cousin trusted in me to openly voice her concerns. Hopefully the information I’ve shared will assuage her hesitancy about the COVID-19 vaccine, but if her concerns remain or new worries arise, it’s more important that she knows I’m still here and the lines of communication are always open.   

For additional resources, including frequently asked questions and videos featuring some of my colleagues, visit texaschildrens.org/covidvaccine.