“The United States currently has the safest vaccine supply in its history. The nation’s long-standing vaccine safety system ensures that vaccines are as safe as possible. Vaccine safety is a vital part of the nation’s response to the COVID-19 pandemic. As vaccines are developed and become available, the public’s knowledge of their safety, both initially and during extended use, is an important part of a successful national vaccination effort.”

The United States is a polarized country, divided along ideological lines, and the question about whether to routinely vaccinate, particularly for children, has been hotly debated. America’s belief in the fundamental rights of personal freedom is steeped in 250 years of national identity, and many people cling to the idea of self-determination in “life, liberty, and the pursuit of happiness.” Further complicating the issue today is the ease at which erroneous information about public health can be shared on social media.

Much of the federal and state efforts to immunize the population is geared now to public education campaigns on the safety and efficacy of vaccination—which, coincidentally, can also be easily shared on social media. As in all healthcare issues, oncology nurses must take a prominent stand in getting the message out, especially as members of the most trusted profession for two decades, by providing accurate information to healthcare consumers.

Why Vaccinate?

“Public health is not only about science. It is also about guiding a population in the face of danger,” the Washington Post editorial board wrote. Because of vaccinations, once-deadly diseases from viruses and bacteria like polio, diphtheria, and smallpox no longer threaten society.  

COVID-19 is not the first pandemic to wreak havoc on the world. The closest comparison is the 1918 influenza pandemic, which resulted in an estimated 500 million infections and 50 million deaths (almost 700,000 in the United States) when it ravaged the globe. Other examples of epidemics, which affect fewer people in more limited geographic areas than pandemics, include SARS, Ebola, and Zika, all of which were successfully contained because of concerted public health efforts—which included developing a vaccine in the 2014–2016 Ebola outbreak in West Africa.

But because COVID-19 is a pandemic, the entire world is working together to find solutions. The temporary protocols for social distancing, mask wearing, and cleaning that most countries have been following are stop-gap measures, not long-term strategies. “The challenge for modern vaccinology is to provide a nonvirulent, harmless agent capable of generating a strong immune response tailored against specific viral attack,” researchers wrote. “An efficient vaccine is the best option for controlling and preventing the COVID-19 pandemic.” Now that several options of such a vaccine are available, the focus turns to dissemination.

What Is the Federal Government’s Role?

Ensure safety: Some of the skepticism and misinformation claims that the vaccines were not fully tested, their creation had limited oversight, and or that they cause the recipient to develop COVID-19. However, the U.S. Food and Drug Administration (FDA), through the Center for Biologics Evaluation and Research, has regulatory authority over vaccines to “ensure the safety, efficacy, purity, and potency of these products.” 

Distribute: Aspects of the American Rescue Plan Act are expediting the vaccine’s rollout throughout the country. “We’re going to be in a position where, because of what you all did in the past, we had the money to go out and literally purchase hundreds of millions of vaccines, and then go out and make sure we had enough vaccinators,” President Biden said. “Vaccine is one thing. To get the vaccine in a vial, out of that vial and into a needle, and a needle into someone’s arm—it took tens of thousands of people.”

The legislation also provides funding for:

• Vaccine-related activities through the Federal Emergency Management Agency Disaster Relief Fund, Centers for Disease Control and Prevention, and Indian Health Service
• Increasing the number of people to administer the vaccine, including training National Guard members
• Testing and contact tracing, variant sequencing, and manufacturing personal protective equipment

Educate: The Centers for Medicare and Medicaid Services (CMS) developed a toolkit for individuals, institutions, and organizations with resources to help them educate the communities they serve. And to address racial, ethnic, and geographic disparities in underserved communities, the Biden administration is funding $250 million in health literacy grants for community-based education programs.

“Information is power, especially the ability to understand and use information to support better health, keeping families and communities safe,” Acting Assistant Secretary for Health RADM Felicia Collins, MD, said. "Nowhere is this more important than in communities hit hardest by the pandemic, especially racial and ethnic minority communities and other vulnerable populations.”  

Who Is Supporting Vaccinations?

Organizations offering support are focusing on promoting trust in the science of vaccination. “It is even more troubling to think that a significant portion of the population might reject vaccines once they become available because of distrust, misinformation, or some other factor,” American Medical Association President Susan R. Baily, MD, said. “Government and public health officials at every level, from the incoming administration on down, face the difficult task of restoring a level of trust in science that prevailed in our recent past.”

The American Nurses Association (ANA) released a statement and guidelines and the COVID Vaccine Facts for Nurses educational hub to help nurses educate themselves, their patients, and their communities. “Being protected is important because even though many people with COVID-19 have only mild symptoms, others get severely ill, may experience long-term health effects, and/or expire. There is no way to know how COVID-19 might affect you,” ANA said to fellow nurses on its hub.

Several public service announcements are also providing Americans with accurate information about the vaccines.

• The COVID-19 Vaccine Education and Equity Project reduces disparities caused by misinformation by communicating “transparent, scientifically accurate information about vaccines. Building confidence in the process and the science is key for vaccines to be a contributor to addressing health inequities.”
• Ad Council COVID Collaborative’s It’s Up to You: COVID-19 Vaccination outlines frequent asked questions.
• Ad Council COVID Collaborative’s This Is Our Shot corrects misinformation about vaccines, endorses the evidence behind their efficacy and safety, and provides facts about potential side effects.
• Former Presidents Jimmy Carter, Bill Clinton, George W. Bush, and Barak Obama speak directly about the importance of vaccinations in the nation’s efforts to eventually get back to normal in an Ad Council video.

“I would recommend it, and I would recommend it to a lot of people that don’t want to get it, and a lot of those people voted for me, frankly,” former President Donald Trump said in an interview with Fox News. “But again, we have our freedoms, and we have to live by that, and I agree with that also. But it’s a great vaccine, and it is a safe vaccine, and it is something that works.”

Despite those efforts, Americans still need more education—even healthcare provider colleagues. In early March 2021, the Kaiser Family Foundation conducted a survey of frontline healthcare workers, including physicians, nurses, institutionalists, managers, and administrative clerks. Although the providers were prioritized to receive vaccinations, the responses showed that “as of early March, just over half (52%) say they have received at least one dose of a COVID-19 vaccine, including 42% who have received both doses. This leaves 48% of frontline healthcare workers who have not yet received a COVID-19 vaccine.”

What’s ONS’s Perspective on Vaccination?

“Patients with cancer who are infected with COVID-19 have an overall 21.2% increased mortality rate, compared to 8.7% for those without cancer—and for those with a smoking history, mortality increases to 31.1%,” ONS reported in previous ONS Voice articles. However, a few factors that may affect a limited number of patients (e.g., current CAR T-cell therapy) may indicate a need to delay. Patients with cancer should discuss vaccination with their cancer care team to determine whether it’s appropriate for them, make the decision together, and if electing to get vaccinated, obtain it as soon as it’s available to them. 

ONS has long advocated for nurse education for safety around hazardous drugs, and the same principles apply to hazardous diseases. Learn as much as you can about COVID-19 and vaccination so you can confidently educate and protect your patients, providing them with factual information and quality care that improves outcomes. Oncology nurses are experts in applying evidence to practice. Get the facts about vaccination and put advocacy into action—for yourselves, your patients, and your colleagues.