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Kai Wright: I'm Kai Wright, host of The United States of Anxiety, a podcast from WNYC. I'm in for Tanzina Vega, who'll be back on Friday. Vaccine hesitancy is where we start on The Takeaway today.

Joe Biden: When I came into office, you may recall, I set a goal that many you said was way over the top. I said I intended to get 100 million shots in peoples' arms in my first 100 days in office. Tonight, I can say we're not only going to meet that goal, we're going to beat that goal.

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Kai Wright: As the Biden administration ramps up its vaccination campaign, more and more Republicans are expressing skepticism about getting their COVID-19 shot. According to a CBS News poll, a third of Republicans have said they won't get vaccinated, with another 20% saying they're unsure. That's compared with just 10% of Democrats hesitant about getting vaccinated. At the same time, recent polling suggests that Black and Latinx Americans have become as willing, if not more willing, to get vaccinated than their white counterparts.

There were some concerns early on about the possible hesitancy of these populations to get vaccinated, given the many ways that people of color encounter racism and prejudice inside the medical system. While vaccine enthusiasm overall is on the rise, the Biden administration is kicking off a sweeping campaign to reduce vaccine hesitancy and combat misinformation in the weeks ahead so that every eligible adult in the US can and will get their shot.

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With me now is Dr. Latesha Elopre, an assistant professor of infectious disease at the University of Alabama at Birmingham. Dr. Elopre, glad to have you with us.

Dr. Elopre: Hi, happy to be here.

Kai Wright: Also with us is Dan Diamond, a national reporter investigating health politics and policy for The Washington Post. Dan, welcome back to the show.

Dan: Kai, how are you?

Kai Wright: I am well. Thanks for asking. Dan, let's start with a seemingly straightforward question. Why are so many Republicans hesitant to get vaccinated?

Dan: I think it depends, Kai, which Republicans you talk to. As someone who's reported on this for The Post for several weeks, I think the biggest concerns come down to concerns I've been hearing for months across a lot of demographic groups. They're worried about how fast the vaccine was developed. Some think that the risk of coronavirus is overblown. I think the reason Republicans have cottoned on so much to this is because many believe that coronavirus, the response, and more recently, the vaccine, has been used as a political weapon, first, against President Trump last year leading up to the election, and more recently, that President Biden and his team are using politics to shape the response as well.

That dates back to some of the resentments that President Trump stoked during the virus outbreak last year, and the ways that he attacked public health and blamed his election loss in part on what he claimed was an effort to submarine him using the outbreak. I think that's where public health efforts really have their work cut out, trying to convince these Republicans to take politics out of public health.

Kai Wright: Excuse me, the former president, Donald Trump, said on Fox last night that he encouraged his supporters to get vaccinated. Do you think that would matter to them, Dan?

Dan: I think it's definitely a good thing, but how much of a good thing is unclear. I had reported about a week ago that pollsters like Frank Luntz, longtime Republican pollster who's now working on vaccine hesitancy, they believed that if President Trump just came out and told Republicans, "Go get this shot," that that would be powerfully motivating. Then I watched a focus group that Luntz convened of about 20 Trump voters.

He asked them, "How important is it if President Trump tells you to go get a shot?" To a person, they all said that they'd rather hear from their doctor, they'd trust their spouse more, which makes sense. I think it also shows that President Trump might not be the single answer here. Their hesitation was, they've heard from politicians for months about coronavirus; they don't trust politicians at all, even the one that they voted for.

Kai Wright: Dr. Elopre, can you help pull this apart a little bit from a public health perspective? First of, in public health circles, does this come as a surprise; this concern and this reluctance amongst this particular group of people?

Dr. Elopre: I don't really think anyone's surprised by this. I think that even in the beginning when we were seeing early polling, trying to understand which communities would have hesitancy towards vaccines, a lot of emphasis and publicity was placed on Black and brown communities. It was noted that there was also hesitancy amongst this group as well. I think that what we've seen that's been different is that there has been grassroots' efforts with Black community members, especially leaders and trusted figures within Black communities, going out and having multiple town halls as well as Latinx communities, to try to change opinions and really spread knowledge in a way that hasn't been done across all communities.

Kai Wright: Just to focus a second on that success story amongst Black and Latinx communities, you said part of it is that there's been this effort. What are the some of the details of that effort that succeed, that might then translate to other hesitant groups?

Dr. Elopre: We've seen this with other pandemics before and other countries as well. When you have opinion leaders go out and have multiple town halls and change the opinions of people within their social circles so that people can go out to their friends and families and say, "I heard from this trusted person within our community about the vaccine and I'm going to get it," you fully see this diffusion of innovation, where opinions change across the community.

It often takes more than one time. I think we have to get that same leadership on the other side across the aisle going out and having these multiple town halls, these multiple personable discussions so that you have this change across social circles.

Kai Wright: Dan, how do we understand all the contours of the hesitancy amongst Republicans? Is it just about COVID vaccines, or is there a larger vaccine skepticism at play?

Dan: Kai, I was asking you about that because I think in the popular imagination, anyone who doesn't want to get a COVID vaccine after this horrible year that we've been through, what must they be thinking? I know that I am so eager to get my shot. Republicans that I've spoken to, both in the story recently about the focus group and certainly before, they're insistent. They are not against all vaccines. They're nervous about this one because of how fast it was developed and how much they think politics has played a role in coronavirus.

They said in this focus group, they've gotten shots for other, say, childhood diseases. They've had their kids go get shots. It's just the coronavirus vaccine that they're balking out for now.

Kai Wright: Which on some level is hopeful. That means that, in fact, some of the things that Dr. Elopre is talking about might work. That this is a persuadable question as opposed to something that is based on ideology.

Dan: I think it's totally hopeful. The focus group that I watched, Kai, I've done some interesting reporting over the past year. It was certainly on the shortlist of most fascinating experiences reporting during the pandemic. There were 20 Trump voters who came in. One dropped off pretty quickly. Of the 19 left, nearly all of them were more likely, if not, very interested in getting the vaccine at the end of this 2.5-hour focus group, which suggests that there are ways to reach holdouts and skeptics. It just may take persistence and the right messenger.

Kai Wright: We're talking about Republicans in the polling there, but, Dan, are there other notable trends in who is and is not willing to get vaccinated that we should be aware of?

Dan: I think the doctor is correct, that there has been broad concern about communities of color and some of the hesitancy that showed up in earlier polls. That is trending in the right direction. In speaking to public health messaging experts, a lot of the concerns are not so different. People have questions about why the coronavirus vaccine came along so quickly. I think there are good answers, including that the work that led into the coronavirus vaccine was not so different than other vaccines. It's just red tape was cut to get rid of what usually would be empty spaces, months of waiting, perhaps, between approvals and trial results.

The other issue that I think cuts across groups is simply access and where one might go to get the vaccine. At this point in the process, average doctors are not administering shots. You might have to go to a big vaccination site. That would very much change, not just the messaging, but how folks are making the decision to get the shot. If it's with someone that they've been getting medical care for years, that would seem to augur a lot better.

Kai Wright: Dr. Elopre, some European countries just announced they'd be suspending the use of the AstraZeneca-Oxford vaccine. How does news like that land in this context? Do you worry that that will further vaccine hesitancy in the population in general?

Dr. Elopre: I do. I actually just did a town hall where that was brought up in the question, as to why it hasn't been in the news that people are dying after they get the vaccine. I tried in that town hall to really, again, spread information and knowledge that we, unfortunately, have adverse events with vaccines across the board, it's just not publicized. Because COVID is so much in the news right now and the pandemic is at the forefront of everyone's minds, we're hearing about all of these bad outcomes, but when actuality, you look outcomes across vaccines, it's actually less than what we've seen with COVID compared to flu vaccine.

Kai Wright: What about the details, just so people get it, of the AstraZeneca-Oxford vaccine? What exactly do we need to know about the risks or not?

Dr. Elopre: I think that whenever anybody chooses to get a vaccine, it's interesting. It's become so normal to say, "Okay, I'm going to get my childhood vaccines. I'm going to get my flu vaccine," and we don't always think about the risk that's associated with getting a vaccine. With COVID, we are in a state where we're always thinking about the risk. I would really encourage people to think and pay attention to what the death toll has been when it comes to the pandemic. Overall, that individual risk, yes, take it into account, but think about your loved ones that you've lost or your friends that have died in isolation. I think from a greater picture, from a greater goal, we have to take that into consideration from public health standpoint.

Kai Wright: Then the Biden administration is launching this huge push now to combat vaccine hesitancy. What do you expect to hear and what do you think will work?

Dan: The Biden team has been working on this push for some weeks. My understanding is it's still a little bit away, but there have been multiple messaging campaigns from folks like the Ad Council, this private-sector consortium, that is running ads across media. The messages, Kai, I think are pretty consistent, that vaccines overall are safe. This one is as safe and tested as others have been and went through trials with tens of thousands of people last year. That health professionals, doctors, they're overwhelmingly getting the shot when they are given the opportunity. That seems to reassure Americans. Then, as the doctor just said, this is about recapturing moments that were lost and getting back to being with family that you might not have seen in months. Getting a shot is a path back to normalcy.

Kai Wright: We will all need them in order to get back to that normalcy. Let's hope we can get there. Dan Diamond is a national reporter investigating health politics and policy for The Washington Post, and Dr. Latesha Elopre is an assistant professor of infectious disease at the University of Alabama at Birmingham. Thanks to both of you for coming on the show.

Dan: Thank you.

Dr. Elopre: Thanks for having me.

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