Building Community Trust for the COVID-19 Vaccine
The good news: States are expanding eligibilityfor the COVID-19 vaccine so rapidly thatmore than three million people, on average, are receiving ashot each day in the United States,
Theless goodnews:As of April 22, 2021, one in three people in the United States over the age of 18 years were fully vaccinated and more than half of U.S. adults had received at least one dose of a .Thismeans thatwe have a way to go to reach the70% to 85%needed forthe United Statesٴ achieveherd immunityand stopthe diseasefromspreading.
Whyare somanyAmericansstill unvaccinated?And why are rates of vaccination higher in white Americansthan inblack, Indigenous and people of color(BIPOC)? Among themany reasonsisa lackof trust,resultingfromAmerica’s long history of unethical treatment of BIPOC in medicine and research,saysLinnie M. Golightly, M.D., Associate Dean of Diversity and Inclusion at 鶹ý andAssociate Professor of Clinical Medicine, Microbiology & Immunology, Division of Infectious Diseases, Center for Global Health.
The most noted example ofsuch mistreatmentisthe 1932in which the U.S. Public Health Service, togetherwith the Tuskegee Institute,“sٳܻ徱”600 impoverished African-American men--399 of whom had latent syphilis--to see howthe diseaseprogressed and, despite the promise offreemedicalcare, never provided any. Ultimately, 128 study participants died, either directly from syphilis or from related complications.
There are other reasons forleeriness about the shot, including: religious prohibitions against vaccinations; concern about vaccine safety amongpregnantand breastfeedingwomen, as well asindividuals with chronic health conditions; the ‘anti-vaxxer’ movement, which opposes vaccination generally;as well asthe speedof the vaccine’sdevelopment.“There’s an overall fear of both COVID-19 and the vaccine,” Dr. Golightly says.“Here’s anewdisease that people hadnever heard ofbefore 2020,andnow almost everyone knows someone who has died from it.”People are afraid of both the disease and the cure.
Yet,widespread trust in the vaccineis critical forcreatingthe level of immunity needed to halt the spread ofCOVID-19and its variants. This calls for education, Dr. Golightly says.“If you educate people,thenthey are empowered to personally make a decisionٴ take it,and the more people who takeit,the morepeoplewill perceive it as safe.”
Here’s how you can educate yourself:
Learn about thehistory of the vaccines(PfizerBioEnTech,Moderna, Johnson & Johnson).
For example,PfizerBioEnTechandModernaproducedtheirvaccines asfastas they didbecausethemessenger RNA (mRNA)engineering used to make themwas alreadyin development.“Theywere easy to make because scientistsalready had the template.No steps were missed,”Dr. Golightly says.
Find out what “emergency use authorization”(EUA)means.
Emergency Use Authorization (EUA) is a mechanismthat theusestomakemedicaltreatments,such asvaccines,availableduring public health emergencies. Issuing anEUArequiresadequate manufacturing informationthatensuresquality and consistency,andthat thevaccine’sbenefits outweighitsrisks.
Know whatthe vaccinesare made of.
Read the packagingor go onlineto find out what’s in the vaccines.You can alsoaskyourdoctor or pharmacist. “Patients should be empowered to look at the vaccine’s ingredients,” Dr. Golightly explains. “No one should be discouraged from trying to understand what’s in the vaccine.”
Understandhowthe vaccineswork.
Because theydo not contain live virus, they cannot infect you with COVID-19.In very rare cases,peoplehaveexperienced serious allergic reactions to the vaccine, and these have generally occurred in individuals with a history of serious allergic reactions.Solong as you are not allergic to any of the vaccine’s ingredients, and any medications that you takedo not interact negatively with it, then you can safely take it.Another rare side effect--the development of blood clots--has occurred in an extraordinarily small number of patients who received either the Johnson & Johnson or Oxford-AstraZeneca vaccine. The U.S. Food and Drug Administration has not yet authorized use of the AstraZeneca-Oxford vaccine. Itrecentlyended a temporary pause in usage of the Johnson & Johnson vaccine, with the requirement that package labeling include warning about the possibility of blood clots.“Bon the knowledge we have now and the risk of disease, most people would be better off with the vaccine than risking the virus,” Dr. Golightly says.
Speak with your allergist.
If youhave a history of severe allergic reactions or anaphylaxis,then consult your primary care physician or allergist. “People who have a history of anaphylaxis shouldcarrytheirEpiPens,” Dr. Golightly says.
Consult your medical specialist.
If you have a particular medical condition, like lupus orsome other immunodeficiency, orcancer, then talk to your medical specialist about thepotentialrisks and benefits of vaccination. You might findinformation from the organization that researches your condition, such as theor the“I don’t know of any major medical organization that has said ‘Do not get the vaccine,’ĝDr. Golightly says.
Considerations for immunocompromised adults.
If you are immunocompromised,you are at increased risk for dying from severe COVID-19, which is whythe CDC urges you to get the shot. Studiesexcludedimmunocompromised patients because theybelievedthat the vaccine would not work as well in them as in otherpatients, giventheirweakened immune response, Dr. Golightly says.
Considerations for pregnant or breastfeeding adults.
If you are pregnantor breastfeeding,there is no biologic reason to suspect that the vaccine would be unsafe,saysLaura E. Riley, MD, chair of Obstetrics andGynecology at 鶹ý and Given Foundation Professor in Clinical Obstetrics and Gynecology, who help draftThe American College of Obstetricians and Gynecologists’ (ACOG)for COVID-19 vaccine use for pregnant and lactating patients. “Although data on these patients isn’t yet available, we do know that COVID-19 disease in pregnant women is associated with greater risk for severe illness leading to ICU admission and need for mechanical ventilation,” Dr. Riley says.She notes that pregnant patients should have access to vaccine trial data andspeak with their ob-gyn about vaccine efficacy, itsbenefits,risks, and potential side effects for mothers and their fetus or newborn, as well as virus risks andtransmission rate in their community.
Consult your religious community.
If you oppose taking a vaccinewhose research and development involvedfetal cells,then you can choose one thatdid notinvolvefetal cell use.“See what is being said in your religious community,”Dr. Golightly says.Most religious leaders are advising that people should receive one of the vaccines.
Review findings from reputable sources.
Visit theandwebsites.TheNMA is theoldest and largest organization representing more than 30,000 African-American physicians and health professionals,and theirpatients.“Recognizing that there would be concerns about vaccine safety and trust in the Black community, the NMA established a committee to review clinical trial data,” Dr. Golightly says, urging people to look at their findings.“So far, theNMA supports the useof theModernaand Pfizer vaccines but hasnot yet issued an opinion about the Johnson & Johnson vaccine.”
Talk to your primary care physician.
“Whensomeone you trust gives you information, thenyou can hear it, especially if you’re armed with your own information.”
Rememberthatyou are in control.The decision to get vaccinated is yours.Educate yourself. “Patients have the power to look up information and make an informed decision,” Dr. Golightly says.