What if we find COVID vaccine … and people refuse to be vaccinated?

Hospital CEOs applaud Murphy’s efforts, but worry residents may be fearful of getting vaccine — or confused about its effectiveness

Gov. Phil Murphy was very deliberate with his words and actions Monday regarding the rollout of a potential COVID-19 vaccine in the state.

The distribution will be equitable for all communities, he said. The plan was not thrown together — it is a product of months of collaboration, he said. The hope, Murphy said, is that the state will be able to successfully vaccinate two-thirds of its adult population.

There’s just one issue: What happens if New Jersey residents refuse to be vaccinated?

Bob Garrett. (File photo)

That is the biggest concern of Bob Garrett, the CEO of Hackensack Meridian Health, one of the state’s two large hospital systems. Garrett likes the push for a vaccine. He’s just not sure everyone shares his view.

“One thing that keeps me up at night is public acceptance of the vaccine,” Garrett told ROI-NJ. “I do believe that we’re going to have a vaccine. I do have faith that the vaccines are going to be effective, they’re going to be safe and they’re going to be available as we get further into next year.

“But, will the public be accepting?”

HMH, which has 17 hospitals and 11 long-term care facilities, was the hardest-hit system in the state this spring — and certainly one of the hardest hit systems in the country.

Garrett understands the impact a vaccine would make — but he sees that others are not seeing it that way.

“When I look at some of the polls out there, Pew Research, Gallup, there isn’t a high rate of acceptance of it now,” he said. “Hopefully, that will change. Having a vaccine available could be a game-changer.”

Shereef Elnahal. (File photo)

Shereef Elnahal, the CEO of University Hospital in Newark and the former commissioner of health for the state, knows the impact a vaccine can have — and he knows the reluctance his hospital is going to have when it comes to administering one.

“We’re only going to be able to move at the speed of trust in any vaccine, even after FDA authorization,” he told ROI-NJ. “That requires transparent discussions with community now — especially to Black and brown residents.

“Survey results show that a substantial majority of Black residents would avoid receiving any FDA-approved vaccine. I think hospitals, and the public health infrastructure more generally, owe it to vulnerable communities to begin these discussions now, to inform and involve.”

Elnahal already has experienced the backlash.

When University Hospital announced in August that it would take part in a trial for a COVID-19 vaccine by Moderna, Enahal himself signed up to be a participant. And even though he said participation is voluntary — and stressed that volunteering could help people of color — there was considerable backlash.

Newark Mayor Ras Baraka expressly told residents they have a right to be skeptical — due to how people have been used in vaccine trials previously — and that they have a right to choose not to participate.

“Citizens have the right to be skeptical and cautious about vaccines and clinical trials due to unethical practices that have transpired around the world, in both developed and developing countries,” he said.

And, although he praised Elnahal for taking part, he stressed others should not feel obligated to follow.

“The city of Newark cannot and did not authorize for any residents to partake in the research,” he said. ‘If you do not want to be involved or have any uncertainty, please do not participate.

“The trial is 100% voluntary, and you have the right to say no.”

Elnahal said the city and the state need to face these facts head on.

“We’ve done extensive sessions with community leaders in Newark surrounding our COVID-19 trial, and what the clinical trial process entails, more generally,” he said. “People want to understand and trust the science behind any vaccine, but, just as importantly, they also need to trust the people asking them to take it. And that only comes with humble engagement.”


Mike Maron. (Holy Name)

Holy Name Medical Center in Teaneck was the epicenter of the first outbreak in the state. Its CEO, Mike Maron, said he and the hospital always have been pro-vaccine.

Maron, however, said vaccines are not a simple proposition.

“There is confusion and misinformation related to the overall effectiveness of vaccines,” he said. “Vaccines have an important role in facilitating population immunity, often called herd immunity. It is a piece, an important piece, of a very complex and comprehensive puzzle.”

Maron can cite himself as an example.

“Most people know I had the virus back in March,” he said. “I have the antibodies and continue to test positive for antibodies, although diminished. Basically, the same end state someone would achieve by a vaccine if they had not contracted the virus.

“Am I immune? We don’t know.”

Maron said a potential vaccine should only be seen as a first step of care.

“It is unrealistic to think a vaccine will eradicate this virus,” he said. “A vaccine will most certainly help us all improve our risks associated with this virus and, as such, we believe firmly the vaccine should be made easily available to those segments of the population with the highest risk of contamination before all others.

“But there is still so much we do not know about this virus. So, all the other precautions and guidance are still warranted, even if a vaccine is made available.”

Moving forward, Garrett said it will be about health and government officials working together.

“HMH and other health care systems need to partner with the state and with the federal government to be sure that there’s good public awareness about the safety, about the efficacy of the vaccines, once they come out,” he said. “I think that’s going to be a really critical, critical piece.”

Messaging, Garrett said, will be crucial.

“We need to sure that minority and underserved communities get that message, because, sometimes, the messaging doesn’t always get there,” he said. “We need to double down on our efforts to make sure that the message is heard.

“It gives me some pause, but I think we can work through it. It’s going to take a tremendous effort — and I think it has to be cooperative effort. It’s another good example of the need of a public-private partnership to really educate the general population.”