The following is a guest post from Dr. Jaya Kasaraneni, MD, MHA, Community Health Leadership Development Fellow with the Department of Family Medicine at Georgetown University.
As a primary care physician working in one of the most underserved areas in Washington, D.C., I often don’t get asked about the COVID-19 vaccine. The population we serve has been underserved for decades and has not had the access to care required for best management. Often they are lost to follow-up even after initiation of new medication or abnormal labs. There is a widespread mistrust of the vaccine, partly due to the belief that the vaccine was developed too quickly, but also due to many people not having an established relationship with one primary care provider.
The Los Angeles Times reported on Dec 31st, 2020, that 50% of front-line healthcare workers (in Riverside County) and 20-40% of Los Angeles County’s frontline workers refused to take the vaccine. Dr. Lisa Cooper, M.D., director of the Johns Hopkins Center for Health Equity and a former MacArthur genius fellow for her work in health disparities, explained to NPR, “In the Black community, there is skepticism that relates to historical experiences, and mistrust based on the discrimination that Black Americans face in the health care system and in the rest of society. It’s really well-founded.”
The conversation needs to continue with emphasis on improving vaccine trust to stop the pandemic, with a focus on effective communication strategies to reach the populations most likely to refuse the COVID-19 vaccination. This needs to be done both with honesty and armed with facts by physicians interacting with coworkers and patients.
Time and again, we find that leveraging our established relationships to deliver a personal message has been the key to success—whether it is a patient becoming compliant with a medication regimen or getting the COVID-19 vaccination. Things to discuss—depending on the vaccine being administered— would be the contents of the vaccine, its mechanism of action, and expected side effects and their duration.
For instance, we know that the first two approved vaccinations are mRNA vaccines. They work at the most basic level by delivering a message to our cells and kickstarting our immune response. This becomes a memory for our body, and when exposed to COVID-19 and its variants it will awaken our immune system to fight against it. The vaccine and components typically disappear from our body in 24-48 hours of delivering the message. Most side effects (aka signs of our immune system working) start within six hours of vaccine administration and can last up to 72 hours. The symptoms typically present include: fever, chills, body aches, fatigue, injection side pain, and headache.
The decision to get the vaccine after having worked on inpatient medicine while in residency and treating patients was an easy choice for me to make. The research behind the development of vaccine had been in progress for more than 10 years, and the benefits of getting the vaccine far outweighed the risk of getting COVID-19. As the conversations continue, it makes a difference for me with every colleague and patient that I convince to get the vaccine.
Further Resources on Vaccine Trust and Equity from ACU
In addition to collecting COVID-19 resources for clinicians working with underserved communities, the Associations of Clinicians for the Underserved is partnering with Pfizer in a new initiative to improve health and vaccine equity for the underserved in the wake of the pandemic.
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