What It’s Like….Addressing Vaccine Hesitancy

An important disclaimer: I am not a doctor or immunologist (at least not yet). I’m simply a now graduated college student who studies immunology and is training to become a physician-scientist, and is using the resources that are available to talk about COVID-19 and Vaccination in a way that I don’t think people are doing correctly.

In about one month, I will be on a plane as I get ready for my next adventure in San Francisco. One week ago I booked my flight and earlier that day, Los Angeles County instated a new mask mandate. A couple days later, I booked my parents flight and UCSF had reintroduced their indoor mask mandate. As i’m writing this blog post to help calm me down because I’m not sure where to take my research, the CDC is expected to update indoor and likely recommend or require a reintroduction of a mask mandate for fully vaccinated folks. Federal and State Governments and regular people like are still continuing to beg people to get vaccinated—fully vaccinated—and there are many people who still don’t want to.

It has been over a year since COVID-19 has changed our lives and demonstrated the inequity and inequality that runs our world, and that truly, we as people, not governments or elites, help and save each other. Yet, the government and these elites still have a major responsibility and through funding from these groups, since December 2020, currently 3 vaccines have received emergency authorization from the USA FDA for public usage: Johnson and Johnson, Pfizer, and Moderna.

These vaccines are the main key to help pull the US and the world from COVID-19. That is a fact. Yet in the US, barely 50% of the country is fully vaccinated and about 70% is at least Half vaccinated. If these vaccines are the key for getting back to “normal” or a “new normal” why haven’t we reached at least 80% of the country being fully vaccinated? Especially, with a country that frankly is literally hoarding the vaccines; vaccines that will help pull the world out of COVID-19. Because remember, even if all 333 million US citizens are vaccinated, it won’t matter if the rest of the world isn’t and less than 15% of the whole world, only 1 Billion people, are fully vaccinated. It’s why we’re going to keep seeing new variants like Delta, Lambda and every other Greek letter that reminds me off the names of proofs I hated learning in math class during my 1st year of college. So, while we have the resources to be vaccinated, why are people not getting vaccinated and how do we get people to be vaccinated?

Well I’ll tell you this: because we’re talking about vaccines and addressing vaccine hesitancy in the wrong way.

Everyone wants this pandemic to be over. We’re all sick of it. I’m so sick of it. I lost my last year of college due to COVID-19. I lost over a year of access to learning valuable research skills and I already know that my transition to full time research in a month will be a large catch up game for me. And as a first generation, low-income student, that catch up game is about rough. So for me, the world being vaccinated is so important so I can continue my journey to becoming a physician-scientist. But as frustrated as I am with people not wanting to be vaccinated, i’m more frustrated with the way social media, the news, physicians, scientists and the government is treating people who don’t want to be vaccinated. Frankly, these individuals are some of the main reasons people don’t want to get vaccinated in the first place.

Firstly, let’s stop with the claim that Black people and people of color are the face of the vaccine hesitancy “movement".

We’re not. When vaccine rollout was at its peak, there were images and videos of Black folks and people of color in long lines that spread around blocks to get vaccinated. Are there Black people and people of color that are hesitant to the vaccine? Yes! Of course there are! You want to know why? Because of the way medicine and science has treated us. Dr. James Marion Sims, considered the Father of Modern Gynecology, invented the vaginal speculum, a tool used for dilation and examination. He also created the surgical technique to repair vesicovaginal fistula, a common 19th-century complication of childbirth in which a tear between the uterus and bladder caused constant pain and urine leakage. However, he did this on enslaved Black women, without their consent or anesthesia THAT WAS ACCESSIBLE AT THE TIME. However, Dr. Sims, like many doctors still assume in 2021, assumed that Black people didn’t experience pain like white people do.

To this day, Black women are more likely to die from childbirth compared to white women because our symptoms are not taken seriously, and with the limited amount of Black women doctors in the US, the growing anxiety that Black women have about childbirth is absolutely valid and heartbreaking. The doctors office for Black women, is the equivalent of being stopped by a police officer for Black Men—and Black Women.

The Tuskegee experiment, an experiment that began in 1932 in a search for a cure syphilis, enrolled 600 Black men, 399 men with latent syphilis and a control group of 201 others who were free of the disease, that they were being treated for bad blood, but were only given placebos such as aspirin. 15 years into the study, in 1947, penicillin was the recommended treatment for syphilis but researchers convened physicians to not treat the patients, in order to track the diseases fully progression. It wasn’t until the story was leaked in July of 1972 that the experiment came to an end, along with the death of 28 participants from syphilis, 100 from syphilis-related complications, and 40 spouses and 19 children also getting the diseases.

These are just two examples, but I promise you there are many more. For example, In 2010, President Barack Obama apologized for a U.S.-sponsored experiment in Guatemala that between 1946 and 1948, nearly 700 men and women were intentionally infected with syphilis without their knowledge or consent to determine whether penicillin could prevent syphilis infection.

The US Government and healthcare system is complicit in the mistreatment, racism, and creating polices that have discriminated, violated, hurt and killed Black people and people of color. Black people and people of color were some of the main frontline workers for COVID-19 and though COVID-19 as a disease does not see race, the years of redlining, lack of investment of communities, food desserts and health desserts, once again, BIPOCs ended up suffering the most from COVID. And guess what, BIPOCs are still not vaccinated to the same level that non-BIPOC communities because……. years of redlining and lack of investment in BIPOC communities have created a gap in access to healthcare resources like small clinics and hospitals. So yeah, there are many people of color and Black folks that want to get vaccinated, our system is just so unjust and racist that these communities can’t even get vaccinated in the first place. We’ve told these communities for years, for generations, you don’t matter. Did you really think that now with COVID-19, these communities are going to forget about that and trust you? No. Of course not. But instead of acknowledging this generational trauma, we’ve decided to mock, insult and make Black people and people of color the face of the vaccine hesitancy.

I’ve made this mistake. I’ve fallen into this trap, this idea that being vaccinated allowed me to critique and get angry at people who didn’t want to be vaccinated, because it is really easy to look at this situation in Black and white and judge people for not wanting to get vaccinated. Because yes, not being vaccinated puts so many people and even vaccinated people at risk. But to ignore and deny years of generation trauma, trauma that I share, is wrong, and I want to the take the time to acknowledge my own mistakes and harm and apologize to those that I’ve hurt in doing so.

So if you want Black people and People of color that are vaccine hesitant, that carry this generational trauma and fear and mistrust towards science, health and the government, we must address these fears. Be honest. Tell people, yes, healthcare and science have done you wrong. We have hurt you. We are complicit in your fear. We have to do better to not just treat you and protect you from COVID-19, but to actually invest in your communities to address other underlying causes that make a COVID-19 infection more dangerous and fatal (high blood pressure, obesity, asthma and other immune-based disorders, cancer, racism). Address that. Address that fear and then the next step, act like doctors and scientists. Doctors and scientists, your jobs, my future job, is to answer questions. No question, is a stupid question. And guess what, even if it sounds stupid to you, calm your facial expressions and just provide an explanation. All questions, especially on vaccines are being asked because people are worried and want to know that they are safe. If you cannot do the one thing we spend our entire career doing, because you don’t want to or you don’t think is necessary or you think is “stupid”, you are contributing to the exact reason why Black people and persons of color don’t trust you.

However, this advice is not limited to Black people and people of color.

Like I said, we all need to stop saying that Black people and people of color are the face of the vaccine hesitancy movement. There are many white people who are just as worried and do not want to get the vaccine, for the same reasons Black people and people of color don’t want to. There are many white people that site Tuskegee, Dr. Sims, Guatemala and Henrietta Lacks for their mistrust of science and the government.

But what happens when the government is the reason for the mistrust?

Yeah, that’s difficult and it sucks. The US Government, from the President to the CDC, messed up the handling of the COVID-19 pandemic. I don’t need to write a long paragraph about all the ways Trump and the GOP are the reason why so many people are vaccine hesitant—you can look at CNNs instagram account for that, since the only thing liberal media is good at is reporting on Trump and the GOP, and being silent on Andrew Cuomo’s sexual misconduct or Lori Lightfoot’s use of COVID-19 funds on policing and disrespect of Chicago Alderman that are trying to make this city better(but that’s a discussion for another day).

But yes, Trump and the GOP’s downplaying of COVID-19 by ignoring mask mandates—even after getting COVID— and playing to racism, Anti-Chinese sentiments and xenophobia, has made the pandemic worse. They are ultimately complicit for 611,000+ deaths in the United States and the millions of cases that have happened and will continue to happen.

And they know that, because now there are GOP governors, mayors and congressmen and women that are backpedaling.

Senate Minority Leader Mitch McConnell (R-Ky.) stressed the need for unvaccinated Americans to get vaccinated before the US returns to a “situation in the fall that we don’t yearn for, that we went through last year…I want to encourage everybody to do that and to ignore all of these other voices that are giving demonstrably bad advice.” Rep. Steve Scalise of Louisiana urged others to get vaccinated after he got his first dose of the Pfizer vaccine and said that “there shouldn’t be any hesitancy over whether or not it’s safe and effective.”

This is the right move, the GOP should absolutely be doing this. But they are also doing this the wrong way. The Republican governor of Alabama, Kay Ivey, has said it is “time to start blaming the unvaccinated folks” for rising cases of Covid-19. “Folks are supposed to have common sense, but it’s time to start blaming the unvaccinated folks, not the vaccinated folks. It’s the unvaccinated folks that are letting us down.”

But that’s where you’re wrong Governor Ivey: and that’s where conservatives, liberals, leftists, scientists and doctors are wrong.

It is too easy and personally, absolutely wrong to blame the unvaccinated folks for the rise of COVID-19.

You want to know what would’ve slowed down the spread of COVID-19? If we actually had a real lockdown. If our government did monthly stimulus checks and had mailed us masks at the start of the pandemic. If our elected officials, were not wasting their time and ours, arguing about mask mandates, whether or not to send aid to the states and people they represent, playing eugenics with our disabled friends and grandmothers, and undermining the CDC, Healthcare workers, Scientists and WHO. If Trump had not used xenophobic language and downplayed the pandemic as just a flu. If Biden, actually locked down the country for real the moment he became President. If the CDC did not lift mask mandates so early. And for doctors and scientists, mocking people and their hesitancy on CNN, MSNBC or twitter, you’re not helping or making things better. All of these things, could’ve slowed down the spread of COVID-19. Because guess what? Australia sees 10 infections and shuts down, we see 100,000 in a day and were fighting about masks in congress.

Last week, Dr. Brytney Cobia viral Facebook post only demonstrated how individuals who didn’t want to get vaccinated or were hesitant to get vaccinated was the fault of a blame game that put the “unvaccinated folks” at fault. Dr. Cobia states “I’m admitting young healthy people to the hospital with very serious COVID infections. One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late. They cry. And they tell me they didn’t know. They thought it was a hoax. They thought it was political. They thought because they had a certain blood type or a certain skin color they wouldn’t get as sick. They thought it was ‘just the flu.’”

When our leaders described COVID-19 as just the flu, as a political game, this is the result. People who are losing their lives, losing loved ones and family members because they didn’t know any better. We created this hesitancy because the people we were supposed to be able to trust, our governors, mayors, congressmen/women, President, even our doctors and scientists, created mistrust and misinformation, and some were more concerned about winning twitter fights than informing people on what is right and what is wrong.

People look to leaders, from government officials to doctors, for guidance. So yeah, people who are unvaccinated are at risk of contracting and potentially dying from COVID-19. And yes, individuals who contract COVID-19 and are not vaccinated can spread COVID-19. And yes, even though we are seeing breakthrough infections with folks that are vaccinated against COVID-19, extremely severe symptoms and deaths from COVID-19 among those that are vaccinated is low. So yes, vaccination is important and people need to get vaccinated.

But if we really want the spread of COVID-19 to slow and come to a point that doesn’t impact our everyday life like it is now and we really want people to go out a get vaccinated, we must step up as leaders, take responsibility, and address the misinformation and mistakes us as leaders have made when we first talked about COVID-19. Don’t blame, but take responsibility and fix our past communication and mistakes.

Which comes to my final point: we need to talk about the science of COVID-19 and vaccines with empathy and accessibility.

Now, to my scientists, this is especially for you. The science community, we love making jokes about how terrible our graphics and presentation slides are. But like, even outside of a pandemic, this isn’t a good thing. Literally, a week ago, one of my friend’s sent in our group chat a graphic about activities that are safe and not safe with the new delta variant and when/where we should and not wear a mask. I’ve looked at that graphic 10 times but it has not gotten any clearer. My friend is currently doing her PhD in astrophysics, so needless to say she’s extremely smart. But she’s not a biologist. I got a degree in Creative Writing but I’m a pre-med who minored in Biology and my field of focus is immunology. But I didn’t understand the graphic, not one bit. If an astrophysicist and a future immunologist can’t understand a graphic that is supposed to help inform people to make smart decisions about continuing to wear masks in certain indoor/outdoor environments, how the hell is anyone going to be able to?

I’m getting trained to study and understand immunology, with my focus in autoimmunity and cancer. My friend, is not. Neither are my parents or some of my other friends. mRNA vaccines, DNA, attenuated vaccines, breakthrough infections, T Cells, B Cells, Cytokine storms, ACE2 Receptors, etc. These are important terms that has come up throughout the COVID-19 pandemic and I understand generally all of these things. But that is because I’m studying to be an immunologist. So when I hear mRNA v. attenuated vaccine, I automatically understand the difference. But not many people will. Science is inaccessible in so many ways, but the way we talk about science and vaccine research and immunology is only making it worse and making people hesitant.

People take years to study and learn how viruses like COVID-19 develop and spread, and take years, lifetimes, to find ways to create vaccines to address viruses like COVID-19. The field of immunology, microbiology and virology are extremely dense and complicated for a reason. If understanding and explaining how viruses and cancer work and how to cure them, we would’ve found a cure for so many immune-based disorders a long time ago. Their difficulty, is the reason why immunology is a growing field. So, we cannot be explaining COVID-19 and vaccines the way that I see in papers published in journals like Nature and Cell—papers that have literally, taken me hours or days to try to understand and many time I still can’t. We can’t be putting out graphics that cause people to flip their phone 180 degrees to try to understand what they are reading. This is a problem in science in general but in a public health crisis like COVID-19, the vocabulary we are using and our lack of EXPLAINING this vocabulary, is a significant and major failure and is inexcusable. And with the delta variant, continuing of this pattern is simply dangerous. Now more than ever, this pattern must come to an end. If we cannot explain and answer people’s questions about vaccines and COVID-19, we will never get out of this pandemic and we have failed what were are trained to do as scientists: do our best answer hard questions with evidence supporting us, in a language that can understood from someone with a preschool education, to someone with a PhD.

COVID-19 and it’s variants are going to continue to grow and spread unless we vaccinate people, continue to wear masks and be cautious. Just a reminder, July ends in about 4 days. September and the looming fall is not that far away. If we are not careful, we will have a repeat of last fall and winter. It is inevitable. So to any doctors, scientists or government officials who find this blog, and even to my friends, this is not the time to treat people who are not vaccinated with this fake superiority complex. Now more than ever, we must be empathetic, willing to listen and inform, and to help. I can’t lose anymore friends, family, mentors and selfishly, years of my life, to COVID-19.

Because COVID-19 is not a group project that everyone can slack on and one person can pull the group to an A.