Misinformation and fear of unknown long-term health effects remain potent drivers to keeping some Santa Clara County residents from receiving a COVID-19 vaccine, according to a study presented to the Board of Supervisors on Tuesday.

The county is nearing its milestone against COVID-19, with 80% of residents ages 12 and up having received at least one dose of the vaccine and 71% fully vaccinated, county testing and vaccine officer Dr. Marty Fenstersheib told the board.

But a study by EMC Research conducted for the county found that there are persistent pockets of resistance to the vaccines — largely among parents of youth and some groups of men. Conducted the week of June 7, the survey of 28 participants indicated that they are still concerned about the safety of the vaccines, the study found.

During Tuesday's board meeting, a representative of EMC Research said its qualitative study of vaccine-hesitant residents focused on a group of eight parents of unvaccinated 12- to 17-year-olds; a group of seven unvaccinated white men ages 50 to 64; an English-language group of eight Latino men ages 18 to 29; and individual phone interviews with five Latino men ages 18 to 29.

In the parents group, many said they were generally supportive of the COVID-19 vaccines and were vaccinated themselves, but they were worried about their children getting immunized. Their concerns focus on the potential long-term impacts on adolescents, including the possibility of infertility or permanent genetic harm. The parents want more time to pass and more data before deciding on whether to have their children vaccinated.

The study also found that parents said their children's autonomy and preference would weigh heavily on their decision regarding vaccination. Some said they would encourage their children to be vaccinated eventually while others said they would wait to see if it becomes a requirement. The parents said they expect vaccination would be mandated for school, sports and other after-school activities. "Exclusion" from these activities would be a motivating factor for encouraging their children to receive a vaccine.

The parents didn't feel a sense of urgency for their children to be vaccinated, since kids generally have a less severe reaction to COVID-19. Some are aware that children can spread the virus even if they are asymptomatic or don't become seriously ill, but achieving herd immunity and reducing the risk to others doesn't factor into their decision-making, the research found.

Parents said they worry about the accuracy of information their children are getting regarding the vaccines. The children are "clearly influenced" by their peers, particularly through social media. Some parents said their children want to be vaccinated because their friends have done so, the research found.

Men remain more entrenched

Most unvaccinated men in the different groups consider COVID-19 to be a real disease, but said the response to the pandemic has been overblown. They want public health restrictions to go away and don't think they are personally at risk for serious illness, the research found.

The middle-aged white participants were focused on the impact of the virus and vaccines on them personally, but they didn't have much concern about the effect on the community. Likewise, surveyed men in the Latino groups had a similar viewpoint, but they did express concern for their families. Several continue social distancing to keep their families safe, according to the study.

The male participants said they don't trust the quick rollout of the vaccines and the "new" technology behind it. They fear unknown, potential long-term effects of the vaccines more than COVID-19, they said.

The young Latino men said their minds are not entirely closed to getting a vaccine, but they want to wait. They don't feel they need it and are not in any rush, the research found. The young Latino participants were appealed by the idea of being leaders in their communities and protecting their families, however.

The white and Latino male groups said they strongly resent the idea of vaccine passports. They believed the passports are inevitable and that there will be future restrictions in the Bay Area for people who remain unvaccinated.

Returning "back to normal" is compelling to them, but coercion and incentives aren't going to sway them, they maintained. While the state and county have held giveaways such as a lottery and free tickets to concerts and sporting events, most of the men claimed they aren't enticed by incentives. Some see them as proof that the vaccines are flawed if the state must bribe people to become immunized. They believe "other" people would be enticed by the incentives, however, particularly given pandemic-related economic hardships.

The group of white men also felt that messages about protecting their families and communities are manipulative. They expressed concern about COVID-19 complications that can cause erectile dysfunction.

The white men appreciated receiving information about vaccines in a straightforward way, such as explanations of how the mRNA vaccines were developed and the age of the technology, compared to messages that were obvious attempts at persuasion. They didn't want to be pressured or shamed into being vaccinated, the study found.

The men in all groups said they generally trust their doctors, but some said they felt that doctors are under pressure to "sell" the vaccines. Some reported that they wouldn't listen to their physician if they were "told" to be vaccinated, but they would trust them as an information source.

The county still needs 85,000 residents to reach an 85% vaccination rate — the number he said would put it solidly into the herd immunity category and a point where the disease would no longer spread. If the county vaccinates 2,000 people per day, it could reach its goal by the end of July, Fenstersheib said.

The county is making a big push to make the vaccines available closer to where people live and work in more community-based settings such as schools and some businesses. They also hope the survey will help find ways to reach those who are resistant.

Fenstersheib and Dr. Sara Cody, the county's health officer, have said there's no evidence that the vaccines cause the kinds of harm the survey participants said they fear. Persistence of this kind of misinformation has been one of the largest barriers county health officials said they've previously faced. During a press conference on Monday, Cody said all evidence has shown the vaccines are safe and highly effective in preventing serious COVID-19 infection.

The drastic reduction in the number of cases and deaths is showing the vaccines' effectiveness. The seven-day average of positive COVID-19 cases is now at 27; in the last two weeks there have been 11 deaths — a 67% reduction compared to mid-May, Fenstersheib said.

The wild cards continue to be COVID-19 variants, which are mutations of the virus as it passes through populations. The highly concerning Delta variant, which emerged in India and is now prevalent in the United Kingdom, is also present in the U.S. It appears to be more contagious and is more likely to cause hospitalizations, he said.