It's the 'vaccine hesitant', not anti-vaxxers, who are troubling public health experts

Lydia Guthrie is not very daring by nature. A psychotherapist and mother of two from Oxford, she couldn’t be persuaded into bungee jumping for all the money in the world, and even shudders at skiing. “I’m very risk averse and a bit of a coward. I can’t even watch horror films.” Yet nonetheless, earlier this year she volunteered to be injected with an experimental Covid-19 vaccine as part of a clinical trial in the city, a partnership between the university, the NHS and drug company AstraZeneca.

Like all the guinea pigs, she doesn’t yet know if she got the real thing or the meningitis vaccine used as a dummy. She had a headache afterwards and felt exhausted for a couple of days, but has never regretted taking part. She trusts the university’s ethics panel, having encountered it through her own degree research, and was also swayed by gratitude towards the city’s John Radcliffe hospital, where she had her own children. “If it hadn’t been for the NHS we might all have died. I feel I owe them.”

The clincher, however, is probably that as a former probation officer she’s used to weighing risks against potentially transformative benefits. For her, doing her bit to halt a pandemic was “a no brainer”. But what about for the rest of us?

This week’s announcement that the Moderna vaccine proved 94% effective in trials, following a similar announcement last week from Pfizer, has felt like the first good news in months. The Oxford team too should report soon, with other candidates worldwide to follow. But the next giant leap towards herd immunity will be persuading everyone to actually take whatever emerges, a task made harder by the viral spread of anti-vaxxer sentiment online. What really keeps public health experts awake at night, however, isn’t a handful of people convinced that Bill Gates wants to inject them with invisible microchips, nor the Russian bots now amplifying their loopy theories. It’s the “vaccine hesitant”; people in a sense not so very different from Lydia Guthrie. Or you. Or me.

The first group causing concern is older men, often from ethnic minority backgrounds who may be wary of going to the doctor and have proved harder for immunisers to reach in the past. Reassurance from community and religious leaders, perhaps along the lines of the Muslim Council of Britain’s campaign to promote winter flu jabs following concern about pork gelatine being used in some vaccines, may be key. But the second are the sort of university-educated, broadsheet-reading women who pride themselves on doing their research and absolutely know their Jonathan Van-Tam from their Chris Whitty.

You almost certainly know one. She’s been taking vitamin D supplements ever since she first read something about Covid patients being deficient in it, watches all the Downing Street press conferences, and hates being mansplained at by older men (sometimes including GPs). She shops ethically, eschewing chemical additives for “natural” alternatives, and was comforted by the idea of lockdown allowing the planet to heal. She’d have been appalled by Donald Trump’s ramblings about bleach and wears a mask.

But the caution that made her comply diligently with lockdown now makes her wary. When she hears minsters talk about “fast tracking” the vaccine to save lives, she’s worried that corners might be cut.

Only 7% would definitely refuse a Covid vaccine, according to a poll published last week by JL Partners. But around one in five are reluctant to some degree, with women more likely than men to believe it hasn’t been tested thoroughly enough. It’s these wobbling “vaccine hesitants” who could most easily be swayed by something their friend puts on Facebook; who’d rather wait and see what happens when others have the jab.

Helpfully, those in greatest danger from Covid are most enthusiastic about vaccination, with almost nine in 10 older people willing to take it. Those who remember classmates dying from measles know what a world without immunisation looks like. But reaching herd immunity requires bringing their children and grandchildren on board too, and that means taking questions about why everything seems to be happening so fast seriously.

Part of the answer is that Oxford was working on a novel vaccine process that could be used in a future pandemic before Covid actually happened, putting them ahead of the game when it did. But the rest involves grappling with the now rather counterintuitive idea that for once in the chequered history of Britain’s battle against coronavirus, we might have actually got something right.

The European commission last week signed a deal with Pfizer to buy its vaccine, allowing member countries to begin preparing for rollout. Kate Bingham, the biotech investor charged by government with identifying the most promising candidates, did her deal in July. The vaccine taskforce she chairs has been working through the next steps – like procuring special freezers for a vaccine that needs storing at -70C – for months, while building a manufacturing chain for other promising candidates.

The Oxford vaccine has been rolling off production lines since summer, even though we don’t yet know if it works, in the kind of gamble inconceivable outside a national emergency. If it’s a dud then all that expensive work will be wasted, but if not, lives could be saved.

A process that usually takes years when worked through sequentially – first the scientific breakthrough in the lab, then entering clinical trials, then winning approval from the independent safety regulator, then beginning production – is effectively happening all at once, as if a restaurant brought out your starter, mains, and pudding simultaneously. The cooking time for each is no shorter, but the meal isn’t half speeded up. It’s unprecedented, and like Lydia Guthrie, I’m naturally cautious. But if all goes to plan in the coming weeks, I’d take a vaccine. The question is, would you?

• Gaby Hinsliff is a Guardian columnist