MUSINGS FROM A RETIRED EMERGENCY PHYSICIAN
The Reds and the Blues of COVID Vaccine Hesitancy By Wayne Barry, MD, FACEP Former FCEP Board Member
In my last column, I focused on dispelling the myths around COVID-19 vaccination hesitancy. At that time, the vaccine rollout was just beginning. The Trump Administration pledged to vaccinate at least 20 million people by the end of the year. This was an ambitious goal, and unfortunately it failed with only about 2 million people becoming vaccinated by that deadline. Newly inaugurated President Joe Biden promised to deliver at least 1 million doses of vaccines in arms per day during the first 100 days of his term. Fortunately despite many bumps in a decidedly uneven road to fully vaccinating the country, President Biden has exceeded his goal, and as of writing, over 3 million Americans were vaccinated against COVID-19 in one day! Moreover, he estimates that every American will have access to the vaccine who wants it by May 1 of this year. Yet I am still worried about vaccine hesitancy among the general population. I am convinced that the curse of COVID-19 will never stop plaguing us until herd immunity is established. Health experts are fuzzy about what density of vaccination will result in herd immunity. Best guesses are that 70-85% fully-vaccinated U.S. citizens and others living in this country will confer herd immunity to the whole nation. Some scientists admit that they are not exactly sure that this virus will actually disappear under these circumstances. Now that I am actively engaging in vaccine myth-busting and emphasizing the three pillars of vaccine success (1. Protect yourself, 2. Protect your loved ones, and 3. Do your part to ensure that herd immunity against Covid is achieved so that Covid vanishes), I have run into another obstacle. If 50
it reaches significant levels, vaccine hesitancy could thwart our collective desire to return to life as we knew it before COVID-19. My first area of concern involves a reportedly low vaccine acceptance rate among Black and and Latino people. Part of the reason may be backlash against what some consider blatant inequality in vaccine distribution, which seems to favor vaccine delivery to more upper socioeconomic neighborhoods in some states, including Florida. Even if this is true, I am not so worried because of the ever increasing availability of the vaccine and the resources to administer it to more and more people. However, there is documented distrust of the medical establishment among these populations in the U.S. with multi-cultural and factorial explanations, which are too complex for me to attempt to describe or even fully understand. These people need to be approached by credible, local healthcare personnel whom they know and trust, and then respectfully informed about the benefits and safety of receiving the vaccine. Another group of vaccine-reluctant people are, surprisingly, healthcare workers themselves. Some of these overlap the populations and their reasons mentioned above. But no matter what population groups they belong to, COVID-vaccine hesitators need to be reached out to by their trusted colleagues to convince them to take the vaccine. Polls have shown that 49% of predominantly male Republican voters have declared their refusal to take the vaccine. I do not know whether this reluctance is based in their strong beliefs about civil liberties, or whether they are just making a political statement. In any event, I believe their reasoning is misguided, and threatens the lives and safety of so EMpulse Spring 2021
many others. If you know any of these people, please use your relationships to try and convince them to change their minds. Finally, I would like to discuss the concept of vaccine passports. I strongly recommend you rewatch the film “Contagion” released in 2011 if you haven’t already. The screenwriter Scott Burns consulted with the World Health Organization (WHO) and was inspired by the SARS outbreak. I was amazed by the striking similarities to the presentday COVID pandemic depicted in this film. One of the features of the film was the fact that all vaccine recipients received a tattoo, which certified their vaccination status. The filmmakers must have thought this was a really good idea, and I agree with them. Identifying individuals as vaccinated would permit them to safely resume activities of normal life, such as travel, sporting events, concerts and theaters. In addition, the desire to obtain a vaccine passport may serve as an incentive for some vaccine hesitators to reverse their hesitation toward vaccination in order to resume doing some of the things we all enjoyed during pre-pandemic times. More than 65% of the U.S. population is in favor of vaccine passports, yet some elected officials have chosen to exert their opposition to this concept. I hope these elected officials will someday listen to the majority of their constituents. Remember, stay safe and get vaccinated! ■
