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How Privilege Plays A Role In America's Vaccine Hesitancy


For a moment there, some Americans were desperate enough to get the coronavirus vaccine that they were cutting the line. Now, some states are offering up everything from free beer to a million bucks to convince people to get vaccinated. And that's in large part because many who haven't yet are still hesitant about the vaccine. But with a new variant on the rise in many countries - Brazil, India still devastated by the virus - this pandemic is far from over. Dr. Junaid Nabi thinks that is a reality some vaccine-hesitant Americans just don't grasp. He's a physician and health systems researcher who wrote an op-ed for NPR about the kind of privilege of vaccine hesitancy.

Dr. Nabi joins me now.

JUNAID NABI: Thank you so much for having me.

CORNISH: So the thing you wrote about was about the privilege of vaccine hesitancy...

NABI: Right.

CORNISH: ...A sign of what you call extreme privilege. In what way?

NABI: Vaccine hesitancy, in the U.S. especially, is a very complicated issue. I don't think it's black and white. I know of the history that underserved and minority populations in this country have faced. But at the same time, I live in the U.S. right now, but I have a lot of family in India and a lot of countries in Africa, and what I see is that there is this large disparity in the attitudes. And what I noticed in the U.S. was this casual recklessness towards vaccinations. And it's been a little disturbing because in the U.S., there are health care facilities and, in general, there's a lot of support for getting vaccinations. To refuse getting vaccinations, that to me is a big privilege because this is not something that's available to people in other parts of the world. They are struggling to get vaccinations.

CORNISH: So the idea of hesitancy, that's sort of on the micro level. I want to talk about something - another trend you write about, which is vaccine nationalism. What's going on there? And how is that actually playing out?

NABI: So we noticed early on that when the conversation around development of vaccines and how they needed to be distributed, that was mostly concentrated in certain countries of the world. And what started happening is that rich countries, mostly in the West, they started hoarding vaccines, and they're not helping other countries in terms of raw materials or technology transfer. And what's instead happening is that there is this donation approach where, OK, we're going to distribute 500 million doses. But these will not be enough. We need almost 10 billion doses at the global level.

CORNISH: But can I stop here? - because, you know, President Biden announced that the U.S. will purchase, just like you said, and donate half a billion Pfizer doses and donate them to 92 countries. I mean, aren't those numbers showing that there's a little more effort? Or are you saying that donating is not as good as creating a scenario where countries can do this on their own?

NABI: So there's definitely effort, and I do think these actions are in the right direction. I just don't think they're enough because we need to understand that there's a lot of variants in circulation right now.

CORNISH: Right, like the Delta variant.

NABI: Yes. And that's causing a lot of devastation. So we don't know all the dynamics around viral transmission, and that means that other countries need to have the capacity to build their own systems and build their own manufacturing units. And by just donating them once in a while, it's not an approach that is sustainable or fair.

CORNISH: In the end, what do you think that this chapter is revealing about global health and how particularly people in the U.S. see the issue of global health?

NABI: We know already if we look at Ebola response or what's happening in terms of tuberculosis or malaria in so many other countries. There has always been an attitude of this is not our problem. But even after more than a year of being in a pandemic, I see that the attitudes haven't changed that much. And a lot of people in developed countries think that these are problems in these other places. There is this notion of otherness, not an attitude of this is our problem. So that, to me, reveals what has been happening and why we haven't been able to control diseases such as malaria, tuberculosis or others, why there hasn't been enough investment - because a lot of them never reach Western, rich nations.

CORNISH: You say Americans can do something to alleviate the dire situation in a country like India, where most of your family is. And the number of vaccinated Indians is still under 5%. So fundamentally, are you implying that this is something that Americans can somehow help on an individual level?

NABI: Yes. At the individual level, I feel that if Americans were to participate fully in the vaccination programs and play a role not just for their own country, but this would also enable the U.S. government, for example, to worry a little less about the national response and start helping other countries more broadly. Because at some level, there is a concern - how are we going to control the spread if variants get spread too much or a certain vaccine doesn't work? So a lot of governments are worried about that. The more people participate in these programs, the more they alleviate that concern that we have a certain level of protection, where we can start thinking about other countries.

CORNISH: That was Dr. Junaid Nabi. He's a physician and health systems researcher at Harvard and the Aspen Institute.

Thank you for sharing with us.

NABI: Thank you so much for having me.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Audie Cornish
Over two decades of journalism, Audie Cornish has become a recognized and trusted voice on the airwaves as co-host of NPR's flagship news program, All Things Considered.
Jonaki Mehta is a producer for All Things Considered. Before ATC, she worked at Neon Hum Media where she produced a documentary series and talk show. Prior to that, Mehta was a producer at Member station KPCC and director/associate producer at Marketplace Morning Report, where she helped shape the morning's business news.
Sarah Handel
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