We’re back for part two of our series with Dr. John H. Vassall, physician executive for Quality, Safety and Equity.
In our first conversation with Dr. Vassall, we covered the basics of vaccine safety and hesitancy. Dr. Vassall, one of our state’s top experts on vaccine safety, also shared his advice for discussing vaccines with loved ones.
These discussions are important, especially as we work toward full vaccination across Washington. In today’s post, we dive into how misinformation can grow into vaccine hesitancy. We also cover system inequities, and ways for addressing them in our communities.
A lot of hesitation can be attributed to misinformation. How can we address the false information on the internet? Or help our loved ones who are spreading this online?
Anyone with a computer can post just about anything on the internet, and some grossly inaccurate and misleading information can seem credible. We all need to be careful about what we’re consuming on the internet; we should seek out legitimate and authentic sources and we should encourage the people in our lives to do the same. The CDC and Washington State Department of Health have great, fact-based information in several languages. For data geeks, the University of Washington’s Institute for Health Metrics and Evaluation (IHME) can be very satisfying.
Some people hope that they can build immunity by getting infected with COVID-19. Is that safe?
Deliberate exposure to the infection is a dangerous idea because this disease is so unpredictable. Although some populations have a higher risk of severe infection or death, no individual’s response to infection can be predicted. There are chronically ill and very old people who have been ill, hospitalized and recovered, but tens of thousands of young and perfectly healthy individuals have contracted the disease and died. And not everyone fully recovers. Some relatively young people with clinically mild or moderate disease have developed lingering, sometimes debilitating symptoms and impairments for months, so-called “long COVID-19.” A few of these “long-haulers” have even died suddenly and unexpectedly. That’s frightening. When you weigh that against the risk of vaccination, the vaccine wins every time.
We know that communities of color distrust the medical establishment and for valid reasons. What would you say to people in these communities who are hesitant due to inequities in the system?
It’s important not to discount their concerns because many people have every reason to mistrust some of the systems and clinicians they’ve been exposed to. It would be incorrect to claim that there is no racism or discrimination in health care, so people must keep their own counsel and trust their own experiences. But just as bad experiences can occur in otherwise good systems, so too can good care be found in flawed systems, especially those health systems that publicly acknowledge an intent and effort to change. I encourage patients to hear the experiences of their family and friends and when possible to seek a system and health care professionals they can trust.
Was there much diversity in the clinical trials?
Race doesn’t exist biologically. Race is a social and political idea. People of color tend to inhabit environments and hold jobs that expose them to large numbers of strangers. As a result, they’re more likely to be exposed to the virus that causes COVID-19. Many don’t have good health care or the freedom to leave their jobs in order to avoid infection, or to seek medical care.
That said, there was a great effort to diversify the clinical trial subjects with people all over the world, as well as with older adults in clinical trials.
What helps you tailor your message to the specific needs of diverse communities?
I like to start with the basics to give people an idea of what they’re up against. I talk about COVID-19, how it spreads, the disease itself and what we all must do to stop the spread and protect ourselves and our loved ones. I explain the virus and how the different types of vaccines work. I explain how clinical trials work and talk about the effectiveness numbers and side effects. I know that I can’t anticipate every concern, so I answer a lot of questions.
Any closing thoughts for readers?
Everyone who has not yet been vaccinated should do so as soon as they are able. The longer we wait to get vaccinated, the longer it will take to reduce the prevalence of virus in our communities, and the more opportunities there will be for dangerous variants and strains to develop which could render the vaccines ineffective.
I am hopeful we are on the verge of getting this pandemic under control and I believe a return to normal isn’t far off. Getting there means wearing masks as appropriate and distancing as recommended and getting a vaccine to everyone who is eligible.
Originally published in Public Health Connection from the Washington State Department of Health.