Tag: vaccines

How to overcome COVID-19 vaccine hesitancy: Build confidence and establish trust

Countering misinformation, leaning on community leaders, using the proper terminology. USC experts explain why all this and more is needed to slow the spread of COVID-19.

By Leigh Hopper

LAC+USC Pharmacy Supervisor Kevin Weissman holds a vial of the Pfizer COVID-19 vaccine, Dec. 15, 2020. (Photo/Michael Owen Baker)

The COVID-19 pandemic has spiraled out of control as a more contagious version of the virus spreads, increasing the urgency to quickly vaccinate as many people as possible. Just this week, Los Angeles County and Orange County designated Dodger Stadium and Disneyland as vaccination supersites.

Yet polling over the last several months has shown that many Americans have safety concerns and don’t want the vaccine just yet. USC experts say that hesitancy can be overcome by normalizing the process surrounding the COVID-19 vaccine with straightforward information from trusted sources such as clinicians and pharmacists.

Lourdes Baezconde-Garbanati, a professor of preventive medicine and the associate dean for community initiatives at the Keck School of Medicine of USC, says mistrust and misinformation abound.

Among the false claims: vaccines cause infertility, vaccines give you COVID-19, vaccines alter your genetic makeup, vaccines are a ploy by the government to implant microchips to track people.

“We see a lot of concern about vaccines, fueled in part by an anti-vaccine movement that we happened to walk into with the COVID-19 pandemic,” she said.

“We’re seeing a trend where at first there was a high level of support for vaccines, but that started to diminish among the African American and Hispanic communities. Then we found health care providers were hesitant to get the vaccine.

“We see huge disparities in acceptance. Unless we get herd immunity with lots of people vaccinated, we’re not going to get this disease under control.”

To lessen hesitancy, bring the COVID-19 vaccine to the community

Tailoring the message to the audience, using simple information and making vaccination visible and accessible could go a long way toward creating buy-in, experts say.

“Converting Dodger Stadium from a testing center into a vaccine supersite, as L.A. is doing this week, makes COVID vaccination more visible in a positive way and helps normalize it — especially for a Black and Latino population that has historically been discriminated against in health care,” said April Thames, an associate professor of psychology and psychiatry at the USC Dornsife College of Letters, Arts and Sciences.

“Having a vaccination center in the heart of the community can open up lines of trust.”

Pharmacists are well-positioned to lead the way in vaccine encouragement — partly because many of them get to know their customers personally, says Vassilios Papadopoulos, dean of the USC School of Pharmacy.

“Pharmacists are the most-contacted health professionals for people with chronic conditions such as diabetes and hypertension — those at high risk for COVID-19,” he said. “At many independent community pharmacies, pharmacists know their patients well enough to be proactive in urging them to come in for a vaccination.

“The plan is to open dozens of additional vaccination sites, many of which will be retail pharmacies. Pharmacists are in a good place to lead COVID-19 vaccine encouragement efforts; 90% of the population lives within five miles of a pharmacy.”

Proper communication about COVID-19 vaccination is key, especially if the virus mutates

Using the wrong vocabulary can cause outreach efforts to misfire, says Wändi Bruine de Bruin, USC Dornsife Provost Professor of Public Policy, Psychology and Behavioral Science at the USC Price School of Public Policy.

In a 2008 study she conducted, she learned that parents seeking information about vaccination would search online using the word “shots.” The search results pointed them to anti-vaccine websites instead of the information from sources like the U.S. Centers for Disease Control and Prevention.

“Using a nationally representative survey that we’ve been doing every two weeks, we’ve been asking people since March 2020 how likely they are to get the coronavirus vaccine if it’s available. In March, 83% of our participants said they would get it. In December, that declined to 63%,” Bruine de Bruin said.

“That suggests we really need to get in place a good vaccine allocation and communication strategy to encourage people to get vaccinated.”

Recent news about the more contagious variant of the virus may cast doubt on the efficacy of the current vaccine — but those concerns aren’t warranted.

“The good news about our immune response to vaccines is that it’s multifaceted, creating antibodies, for example, that will recognize different parts of the virus spike protein,” said Paula Cannon, a Distinguished Professor of Molecular Microbiology and Immunology at the Keck School of Medicine and an expert in how viruses are transmitted and controlled.

“Even if the virus mutates and perhaps becomes resistant to one antibody, there will be others lining up to take its place. So far, very early lab experiments suggest that the new strains will be just as sensitive to the immunity created by these vaccines.”

Why COVID-19 vaccines need to prioritize ‘superspreaders’

Why COVID-19 vaccines need to prioritize ‘superspreaders’

How should COVID-19 vaccine be prioritized? AP Photo/Ted S. Warren, File
Dana Goldman, University of Southern California; David Conti, University of Southern California, and Matthew E. Kahn, Johns Hopkins University

Once safe and effective COVID-19 vaccines are available, tough choices will need to be made about who gets the first shots.

A committee of the National Academies of Sciences, Engineering, and Medicine – at the behest of the Centers for Disease Control and Prevention and National Institutes of Health – has proposed an equitable way to allocate the vaccine.

They recommend first responders and health care workers take top priority. Older adults in congregate living situations would also be part of a first vaccination phase, according to the plan.

We are faculty at Johns Hopkins University and the University of Southern California who have spent decades studying health economics and epidemiology. One of us is a member of the National Academy of Medicine.

Having seen firsthand the real risks of rapid, asymptomatic spread of COVID-19 among younger adults, we disagree with some of the recommendations. Asymptomatic spread is shutting down schools and universities nationwide and threatening surrounding communities.

We argue that this pandemic requires a different model for making vaccination choices. After taking care of essential workers, vaccinations should be given to the biggest transmitters of the virus – mostly the young – and only then to the most vulnerable.

Lessons from 2009 flu epidemic

The textbook vaccine model goes out the window when novel viruses emerge.

Some lessons can be drawn from the 2009 H1N1 flu epidemic, which killed an estimated 500,000 people around the world. In the U.S, President Barack Obama declared the spread a national emergency.

A vaccine was developed as early as the fall of 2009. However, only 16 million doses were initially available. The CDC was required to make some difficult decisions about allocation. Some states requested 10 times the amount they were allocated.

In the end, the CDC allocated the vaccine strictly in proportion to a state’s population – that is, on a per capita basis. States then allocated them, often with priority to infants and the elderly, along with people at high risk.

This priority – to protect the most frail – has been public policy since at least the 1957-1958 influenza pandemic.

Later studies, however, have shown that a better way to protect older people was to control spread among the young, which often has meant vaccinating school-age children early.

One of the lessons from these past pandemics is that vaccinating the likely asymptomatic spreaders early can avert multiple infections with others.

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The superspreaders

The experience of the past few months has shown how important it is to check transmission with COVID-19. A recent study found that as few as 10% of those infected lead to 80% of the infection cases. What has made it more difficult is that up to 40% of those who carry the virus, often known as superspreaders, show no symptoms at all.

Very few of the COVID-19 superspreaders are elderly. It is the younger people who have a much greater propensity to resume social lives at schools and in other venues.

Among the young are a subset of highly social people with wide circles of friends who become the most fertile ground for the spread of COVID-19. These young people also have a much lower risk of death or even severe symptoms, which also means they are more likely to infect others.

Cases have been spiking in the 15- to 25-year-old age group, another likely sign that they are propelling the spread of the virus. A recent outbreak on the University of Southern California’s fraternity row infected at least 40 people.

Several universities cancelled in-person classes after a spike in cases. AP Photo/Gerry Broome

The American Academy of Pediatrics and the Children’s Hospital Association reports that at least 338,000 children have tested positive for the virus through July 30, with more than a quarter of that number having tested positive in just the last two weeks of that month.

More broadly, younger residents in the virus hot spot of Los Angeles County make up the majority of positive new cases. In California, young people between 18 to 34 years of age account for more than one-third of cases.

Young versus old

Anticipating that young people will engage in activities that spread the virus, many universities put their fall classes exclusively online. Some that decided to go in-person had to close after as little as a week on campus.

With or without a vaccine, the best strategy for older Americans, especially those with underlying medical conditions, is avoiding contact with potential carriers.

Optimally, older people will drive down deaths by staying home in large numbers, and younger people will drive down infections by getting vaccinated in even larger numbers. It all works if the vaccine is effective and enough people take it.

We predict the pressures and politics around prioritizing vaccine distribution will be intense. We argue that they key will be to take the most beneficial route, not the most obvious one. With a full-scale public health campaign behind it, that will mean prioritizing those who are driving transmission, not those who are most vulnerable.

As counterintuitive as such a strategy may appear, plenty of evidence shows this would be the right approach.The Conversation

Dana Goldman, Leonard D. Schaeffer Chair and Distinguished Professor of Public Policy, Pharmacy, and Economics, University of Southern California; David Conti, Professor of Preventive Medicine and Associate Director for Data Science Integration, University of Southern California, and Matthew E. Kahn, Bloomberg Distinguished Professor of Economics and Business, Director of JHU’s 21st Century Cities Initiative, Johns Hopkins University

This article is republished from The Conversation under a Creative Commons license. Read the original article.