PUBLIC HEALTH UPDATE

Vaccine Hesitancy: Help Us Reach Our Shared Goal

BY DR. MAGGIE PARK, PUBLIC HEALTH OFFICER; AMY RHOADES, MPH AND CHERYL LAUGHLIN

As we approach the end of 2021, we are also heading toward nearly a 70% vaccination rate here in San Joaquin County among eligible residents, ages 12 or older, with at least one dose of the COVID-19 vaccine. Compare this to the state’s overall rate of just over 80% of eligible California residents fully or partially vaccinated and we can all appreciate the progress so far but the need to push those vaccination numbers higher. Throughout the vaccine rollout, San Joaquin County regularly lagged in vaccination rates compared to the state, particularly among certain zip codes and demographics. This chart shows vaccination data by race/ethnicity over the past year. Latinx and Black populations show the lowest vaccination rates and highest numbers of COVID-19 cases and deaths throughout the pandemic. Helping these underserved groups is even more vital as we focus on the final push toward higher vaccination rates in the county.

Source of data: California Department of Public Health

Community Partnerships Make a Difference

San Joaquin County Public Health Services (PHS) values our partnerships with a wide range of community- and faith-based organizations, who are vital connectors in our county. Throughout this pandemic, we have all rallied to make vaccines available and to get messaging and services to hard-to-reach areas. For example, PHS works with community partners

to mobilize a COVID-19 vaccination van throughout the county. These organizations have helped us to reduce barriers by pointing us to areas where transportation can be limited and transmission rates are often elevated.

But even with this support, vaccine rates throughout the county dropped considerably since last April. Those who were eager to be vaccinated waned, and those who had doubts were not yet convinced. We were at a bit of an impasse to move vaccination rates forward.

That’s when our community- and faith-based partners provided further insights into various groups and the common concerns. Overall, the issue of trust weaves into all the conversations with vaccine-hesitant individuals in this county. Many of our unvaccinated populations do not trust the government or do not want government dictating what to do. Others simply seek a nonjudgmental space to talk through questions regarding the vaccine. As health care providers, you can provide thoughtful, factual answers to any questions they have.

Vaccine Concerns and Helpful Answers for Your Patients

The first vaccine-hesitant group—those who are pregnant or breast feeding—often don’t realize being pregnant puts them at a higher risk for becoming severely ill from COVID-19. According to the CDC, only 31% of pregnant women have been vaccinated against COVID-19. At the same time, they also report pregnant women with COVID-19 symptoms are twice as likely to be admitted into intensive care with a 70% higher likelihood of dying. This group is at an increased risk for preterm birth, stillbirth, and admission into the ICU for a newborn also infected with COVID-19. Let patients who are pregnant know benefits of vaccination outweigh the risks, for them and their unborn child.

Hand-in-hand with pregnancy concerns is another common misconception—COVID-19 vaccinations cause fertility issues. Throughout the clinical trials, there were people who became pregnant after being fully vaccinated. Share with patients that no evidence shows the COVID-19 vaccine causes fertility problems in men or women. There is currently no evidence that ANY vaccines, including COVID-19 vaccines, cause fertility issues.

Many residents also believe—the virus that causes COVID-19 is in the vaccine. Remind individuals that the virus that causes COVID-19 is not in the vaccine, so it is impossible to get COVID-19 from the vaccination. Another concern—side effects from the vaccine or general uncertainty about what to expect. Be open and honest about the potential side effects, which include a sore arm at the site of injection, body aches, chills, fatigue, or fever. Side effects typically only last about 24 hours and are normal. These are all signs the immune system is building protection to the virus.

Others continue to question the speed of vaccine development—mentioning inadequate data exists on potential long-term side effects and safety. In truth, the COVID vaccine research is built on decades of scientific studies and moved quickly because of advanced technology already underway. Technology and available funding helped expedite the COVID-19 vaccine. Additionally, mRNA vaccines have been studied for decades and shown to be safe for use in humans. All three vaccines have undergone extensive clinical trials

and approval by the FDA and included people from varying demographics.

Some individuals feel the vaccine is not effective—noting that fully vaccinated people can still be infected with COVID-19. These people can benefit from learning that a fully vaccinated person is less likely to become severely ill, hospitalized, or even die from COVID-19 infection. And while people who have already had COVID-19 feel they have sufficient antibodies to protect against another infection, it is unknown how long or how much protection someone may have. The safest and most effective way to ensure everyone is protected against the virus is to be fully vaccinated.

Finally, when it comes to youngsters aged 12-17, all of these reasons for hesitancy are coupled with the fear of interfering with children’s growth and development. If you are providing vaccinations, this is another issue to discuss with each child’s caregivers. Assure them that every vaccine goes through rigorous, three-stage clinical development to ensure safety. And before being administered locally, those findings are reviewed and approved by four safety-focused organizations— the Centers for Disease Control (CDC), Food and Drug Administration (FDA), Western States Scientific Safety Review Workgroup, and California Department of Public Health. Your shared knowledge can help break down hesitations to vaccinations.

Getting Our Community to Immunity

COVID-19 vaccination guidance and eligibility change often, so it is important to stay current for yourself, staff, and patients by referring to local testing and vaccination information at www.SJReady.org. The best way to address common myths and concerns is to keep communication open and spread accurate information. For more details on the COVID-19 vaccine, visit covid19.ca.gov/vaccines/.

As with any vaccine, there will always be individuals who are resistant. We acknowledge that even with all the data and facts, someone may still not want the vaccine. It is still important to have these conversations with your patients. Health care providers continue to be a trusted source for individuals and families. Together, we can spread facts and increase vaccination rates in San Joaquin County and help end the pandemic.

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