To vax or not to vax? For many, the answer comes easily, while others hem and haw about their decision.

Most people I know tried to make an appointment for the vaccine on the day they became eligible. I’m needle phobic, but I was happy to step right up, roll up my sleeve and get jabbed on two occasions.

Some folks remain on the fence about getting vaccinated. “Vaccine hesitant” is the term used to describe them, and they represent about 10–15% of the population, according to Dr. Matt Willis, Marin County’s public health officer.

Others don’t believe in vaccinations in general or in the Covid vaccination specifically. They make up the anti-vaccine movement and represent about 2–3% of the population, Willis says.

I spoke with two Marin anti-vaxxers. Neither woman will get the Covid-19 vaccination, although they’re both aware the decision is controversial. One agreed to be interviewed under a pseudonym, as she doesn’t want to face backlash. The other agreed to provide a written statement, and was still concerned her words would be taken out of context.

I couldn’t verify many of their claims. Their opinions are wholly their own. One thing is certain, they are just as sure they shouldn’t be vaccinated as Anthony Fauci is sure they should be.

Joan Andrews—not her real name—74, has had a lifelong interest in health. However, the Mill Valley resident says none of the information about the Covid-19 vaccine in the mainstream media rang true.

“Mass hysteria was being created by the papers,” Andrews says. “I started investigating. First of all, it’s not a vaccine. It’s actually experimental gene therapy. The reason they’re calling it a vaccine is so that they bear no liability should anyone have an adverse reaction. Who knows what could happen a month down the road, two months down the road? The whole nation needs to be a lot healthier, so we don’t resort to a vaccine. Our body will take care of things.”

Andrews’ perspective is revealing, because the vaccine-hesitant are likely looking at the same type of information. Over 31 million people follow anti-vaccine groups and pages on Facebook, most of which are run from the United States, according to a 2020 report by the Center for Countering Digital Hate.

To reach community immunity, Marin needs most of the vaccine-hesitant to end up in favor of vaccination. Otherwise, we will remain vulnerable, Willis says.

“If we can get 85% of everyone age 12 and above vaccinated, I think we’re going to be much better protected as a community,” Willis says. “As the variant infections march their way across the country and into California, I think we will be well-protected if we get to those levels of the vaccination.”

As of now, only those 16 and older are eligible for the vaccine; however, vaccinating 12- to 15-year-olds is fast approaching. Pfizer asked the Food and Drug Administration (FDA) earlier this month to expand emergency approval of its Covid-19 vaccine. The company hopes to begin administering the vaccine to this age group before the start of the next school year in the fall.

Currently, more than 75% of people age 16 and older have received at least one dose of the Covid-19 vaccine, and more than 51% have completed the vaccine series in Marin. While those numbers are high, and Marin is far above the state vaccination rate, the last percentage points needed for herd immunity may be difficult to achieve.

Marin recently surveyed approximately 6,000 residents about their vaccine beliefs. Many of those in the vaccine-hesitant camp think the process to develop the Covid-19 vaccine happened too quickly. Willis hopes people will become comfortable after more time passes and they learn about the safety of the vaccine.

The political setting in which this vaccine was developed also contributed to vaccine hesitancy, according to Willis. A lack of trust in government, which seems to have reached a height in recent years, made some people tentative about getting vaccinated. However, that dynamic is changing. On a national basis, fewer people are hesitant now than when the vaccine was first released.

Some people may rely on the assumption that the rest of the population will achieve herd immunity on their behalf. That’s not a safe strategy. The vaccine-hesitant often spend time with like-minded people and share the same social groups within a community, Willis says. This results in clusters of people who are not vaccinated, rather than a random distribution. When a group has a low vaccination rate and the virus is introduced to them, it spreads quickly.

“The more of us who are vaccinated, the better protected we all are,” Willis says. “Hesitancy will affect any community. People who are unvaccinated are reservoirs for the virus to remain active in the community and that puts everyone at risk.”

An important incentive in choosing to get vaccinated is the freedom it allows. The state of California announced earlier this month that people who are fully vaccinated do not need to stay six feet apart at live events. A venue requiring proof of vaccination is rewarded with increased capacity. There is also talk of vaccine passports for travel. Schools already require vaccinations for a variety of diseases, and it’s not a stretch to imagine the Covid vaccination will be added to the list.

Anti-vaxxers are calling foul on the restrictions. Maureen Block, of San Rafael, an attorney who is cofounder of the Children’s Health Defense – California Chapter, says the role of government is to protect the people, not industry.

“Vaccine passports are dangerous for our democracy,” Block wrote in an email. “First, the ACLU is against them and they will hurt minorities. Second, it goes against civil rights, in general, and HIPPA. Third, it creates a new minority class that will be discriminated against based on their genetics that makes vaccines dangerous for them. Fourth, we are dealing with Emergency Use Authorization products [vaccines]. These are not FDA approved products.”

Willis believes we’ll see more settings where a person’s vaccine status determines how they participate, because it doesn’t make sense to hold everybody back from community activities. He suggests anyone with concerns about the Covid-19 vaccine talk to their personal physician. They are well-equipped to discuss the pros and cons of vaccination.

“The best way for us to put this pandemic behind us, the single most important thing you can do, is get vaccinated,” Willis says. “If not for yourself, then for your family and your community.”