A critical aspect of the vaccination campaign

In a high note for medical history, Margaret Keenan in the United Kingdom became the first person in the world (outside of a clinical trial) to receive the COVID-19 vaccine made by Pfizer-BioNTech on Dec. 8. For many health professionals, however, she was just as important for another reason – her mental attitude.

“There’s nothing to be afraid of,” she told the BBC. “I’m over 90 years old, and I had no doubt.”

Ever since the devastating 2014-16 Ebola outbreak in West Africa, global health experts have put a new focus on ways to alleviate public fear and mistrust of both vaccines and the health care establishment. Much of the work against Ebola had been hindered by high levels of distrust among local communities, even feelings of being victimized by health services. In response, the World Health Organization set up an independent body, the Global Preparedness Monitoring Board, to look at “the human dimensions of health security,” or what’s also called “design thinking.”

In its latest report since the coronavirus pandemic began, the board concluded this: “In many countries, communities are an afterthought, rather than at the center of preparedness, and governments and public health authorities have defaulted to one-way, directive communications rather than developing collaborative approaches that involve communities, leading to a disconnect between national messages and local contexts.”

And to add a finer point, it made a prediction: “How the world emerges from this crisis will depend on whether and how countries, actors and communities overcome their unwillingness to work together.”

That report was echoed in the United States by a study out of Johns Hopkins University in July. Titled “The Public’s Role in COVID-19 Vaccination,” the study made this stark assessment: “Much is still unknown about what the diverse U.S. public knows, believes, feels, cares about, hopes, and fears in relation to SARS-CoV-2 vaccines.”

It suggested the health community shift its attitude in how to administer the coronavirus vaccine: “What does the person on the receiving end think, expect, experience, and sense about the valued good intended for him or her?” Greater listening to individuals will help reduce what the health industry fears – “vaccine hesitancy.” The public’s sense of safety, the report stated, extends beyond health matters.

This attention to the mental climate of a health crisis is not new. Florence Nightingale, the famed 19th-century nurse pioneer, advised nurses to attend to a patient’s thinking as much as to the body. “How very little can be done under the spirit of fear,” she said.

An effective vaccination campaign relies on more than a vaccine. Health officials must first understand their communities and the values of each individual. Such tender care is good medicine, lifting people’s thought to be active participants in any health emergency.