COVID-19 vaccine acceptance has been a critical concern over the past few months. To address hesitancy and to encourage uptake, FDA-approved vaccines have repeatedly been described to be safe and effective. Some understand “safety” in this context as a guarantee that no vaccine shot would cause death in a recipient while others have set greater expectations that often pertain to the avoidance of certain adverse effects. Despite variances in the desired outcomes, the communicated standard for safety from the authorities is clear: you will not die from vaccination alone. However, such a standard for effectiveness has not been clearly established.
In management, “effectiveness” is defined as the degree to which something succeeds in producing a desired result. This is in stark contrast with perceiving effectiveness merely as the presence of causal effects. From a managerial standpoint, defining the desired results is a necessary step in evaluating the effectiveness of a product or endeavor. When it comes to vaccines, the desired results may vary greatly from person to person. Given the vast amounts of knowledge on the various vaccines that have been generated so far, we have several bases for defining our desired outcomes and for guiding our vaccination-related decisions. For instance, some would prioritize avoiding specific adverse effects that occur frequently for some vaccines. Others would consider their medical histories and other vulnerabilities including but not limited to past allergic reactions, immunodeficiencies, and mental health considerations. Some would consider non-medical factors such as potential work and travel implications, while others would just want to get the vaccination over with by using any vaccine brand that is already available. With such a wide variety of factors to consider and with clear differences in the actual effects of the different options, it is easy to appreciate that effectiveness should not simply be dictated to us by the authorities. Rather, we ourselves need to assess effectiveness based on our own desired results.
No matter which factors we choose to value for our own assessments of effectiveness, authorities should have communicated a minimum standard clearly and consistently from the start: that an approved vaccine will not by itself kill you and will decrease your chances of infection, transmission, hospitalization, and death. Sadly, one of the many factors that have affected vaccine acceptance is the inability of authorities to stay consistent with their communication. Instead of presenting a consistent set of reasonable expectations, they took a reactive approach and dealt with each unfavorable event as it happened.
Many people started with the expectation that vaccines would allow us to go back to the way things used to be. When persons who got one shot either tested positive or died, authorities emphasized that a second shot was needed. When persons who got two shots still tested positive, authorities emphasized that full protection only comes two to three weeks after the second shot, and that although infection can still occur, hospitalization and death could be avoided. Recently, several fully vaccinated persons died of COVID-19. All these outcomes should have been expected, and we should realistically expect more of such outcomes because no vaccine is 100% effective in preventing infection, transmission, hospitalization, and death. Instead, a series of broken expectations resulted in the incremental degradation of the perceived value of some vaccines. Such degradation could have been avoided through clear, consistent, and honest communication, which authorities should work towards moving forward.
Today, my 91-year-old grandmother will get her second vaccine shot. Tomorrow, I will get mine. In a few weeks, we will be among less than 3 million fully vaccinated people in the Philippines, which is sadly less than 4% of the 70 million target population for herd immunity. My desired vaccination result of minimizing our risks of infection, transmission, hospitalization, and death, and the path leading towards it has always been clear to me no matter how little control I have over it.
Can I still get infected by COVID-19, transmit it, and get hospitalized or die due to it after getting fully vaccinated? The answer is still “yes.” However, the chances of each of those undesirable events occurring should be significantly reduced after my second shot, enabling me to protect myself and the people around me. Due to decisions made based on my desired results, vaccine effectiveness will have been achieved.
Rafael Gerardo S. Tensuan, an engineer, is a lecturer at the Management and Organization Department of the Ramon V. Del Rosario College of Business of De La Salle University.