Some Americans were primed for vaccine skepticism after decades of mistrust in Big Pharma

• Claims of mismanagement and greed in the pharmaceutical industry may have contributed to vaccine hesitancy.
• Of Americans who said they would "definitely not" get a COVID-19 vaccine, 20% say they trust drug companies, according to KFF.

Ten months after the world's first COVID-19 vaccine received an emergency green light for use, the US is still reeling from COVID cases among mostly unvaccinated Americans.

Among Americans who said in a recent survey that they will "definitely not" get a COVID-19 vaccine, only 20% said they trust pharmaceutical companies to provide reliable information, according to Ashley Kirzinger, the associate director of public opinion and survey research at the Kaiser Family Foundation.

Pharmaceutical companies large and small are responsible for advancements in medical treatments that have helped cure diseases, relieve chronic pain, and save lives. Several developed COVID-19 vaccines that are highly effective at preventing severe disease.

But publicized claims of mismanagement and greed among some of the world's largest pharmaceutical companies, collectively known as Big Pharma, have eroded public trust and, in turn, have contributed to vaccine hesitancy among some Americans, experts told Insider.

"In the '50s, after World War II, the drug industry was highly respected; they saved hundreds of thousands of lives," Gerald Posner, investigative journalist and the author of "Pharma: Greed, Lies, and the Poisoning of America," said in an interview. "They lost that over decades of greed and mismanagement."

Now, as some pharmaceutical companies lobby to keep their COVID-19 vaccine formulas out of the hands of manufacturers in low-income countries (thereby maximizing profits from the life-saving shot), some Americans may develop a renewed distrust of Big Pharma, Posner said.

"[Pharmaceutical companies] are behaving as if they have absolutely no responsibility beyond maximizing the return on investment," Tom Frieden, infectious disease expert and a former head of the Centers for Disease Control and Prevention, told The New York Times.

Skepticism of Big Pharma has been decades in the making

American trust in Big Pharma reached a peak in the early-to-mid 20th century, when the pharmaceutical industry ushered in life-saving treatments like penicillin and vaccines, as Patrick Radden Keefe reports in his book "Empire of Pain."

Public trust started to erode, however, with the invention and widespread adoption of addictive drugs, Keefe reported. Gallup, whose polling has placed pharmaceutical companies as America's least liked industry for the past two decades, attributes the public's dislike to the companies' high drug prices, tremendous lobbying budgets, and their roles in the opioid epidemic.

Over the last 50 years, lawsuits began piling up against pharmaceutical companies, including those that developed COVID-19 vaccines.

In 2013, Johnson & Johnson settled a federal investigation involving marketing fraud of several drugs, including one to treat dementia patients. Reuters reported in 2018 that small amounts of asbestos were found in the company's baby powder between the early 1970s and the early 2000s. The report claimed that the company failed to disclose that information, which Johnson & Johnson has repeatedly denied. The company is facing thousands of lawsuits alleging that the talc-based products caused cancer and mesothelioma.

Last year, 46 US states sued 26 drug makers, including Pfizer, over allegations of conspiring to drive up drug prices. (Pfizer told Reuters the company did not behave in unlawful conduct.)

In 2009, Pfizer, which produced the first FDA-approved COVID-19 vaccine, paid the second-largest healthcare fraud settlement in US history to settle accusations of misleading advertising of an anti-inflammatory drug. When asked to comment on this article, a Pfizer spokesperson told Insider the company "cannot speculate why some remain vaccine hesitant, but vaccination remains one of the best tools we have to help protect lives and work to achieve herd immunity."

The anti-vaccine movement in the US, which gained momentum in the early 2000s, has tried to use drug industry scandals to discourage parents from inoculating their children, according to Dr. Stewart Lyman, the owner of Lyman Biopharma Consulting LLC and a vaccine advocate.

In the mid-2010s, measles in children began resurfacing despite the CDC having declared measles as eliminated from the US in 2000. Some anti-vaccine believers fought for personal exemptions for vaccine mandates during local measles outbreaks.

Others within the movement said not to trust the pharmaceutical company Merck with vaccines because of a whistleblower complaint claiming that the company overstated the effectiveness of the shot. (Merck did not respond to Insider's request for comment.)

Big Pharma's business model drives mistrust among vaccine skeptics

Kirzinger told Insider anecdotal data from Kaiser suggests some Americans are hesitant about the COVID-19 vaccine due to how pharmaceutical industries profit from shots, despite the shots being rigorously tested by scientists before given to the public and built on decades of research.

Vaccine makers have made billions in revenue by selling the shots to countries, and soaring pharmaceutical stocks have minted a class of "vaccine billionaires."

"[Some vaccine hesitant Americans] are talking about distrust of Pharma because they think that they're mostly concerned about profits rather than safety," Kirzinger said.

The price of the life-saving hormone insulin, for example, has skyrocketed in the last decade, costing diabetes patients around $300 for a 10-millimeter vial, up from about $93 in 2009. Many low-income Americans have resorted to rationing insulin to make it last longer, and lawmakers are pressuring drug companies to reduce costs.

Still, pharma companies are currently lobbying President Joe Biden to prevent him from waiving intellectual property protections for COVID-19 vaccines - thereby keeping manufacturers in poor countries from making life-saving shots for vulnerable populations.

And while some vaccine makers like Johnson & Johnson have sold COVID-19 vaccines at cost, others, including Pfizer and Moderna, have sold them for a profit.