Delivering COVID-19 Vaccines to Hesitant Communities

John Whyte, MD; Jerry Abraham, MD, MPH

Disclosures

July 30, 2021

Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

JOHN WHYTE: Welcome, everyone. You're watching Coronavirus in Context. I'm Dr. John Whyte, the chief medical officer at WebMD. A recent study showed that for those persons that are currently unvaccinated, a very large percentage of them say that they're not going to get vaccinated no matter what. It doesn't matter what you tell them. So what do we do? Joining me is Dr. Jerry Abraham. He's the director of the vaccine program at Kedren Health in South Los Angeles. Dr. Abraham, thanks for joining.

JERRY ABRAHAM: Hello. How are you, Dr. Whyte?

JOHN WHYTE: I'm good. Now I have to tell viewers we literally made you stop driving because you're in a mobile van out in the community giving shots in arms, is that right?

JERRY ABRAHAM: Yeah, that's really where we are from those crazy long lines back in December, January, February to now mobile vaccination programs that are meeting people where they live, work, worship, play, go to school. We're vaccinating the homebound. It takes a lot more effort, but it really does mean that they put us behind vans. We take our vaccines out into the community and we really, unlike the early days of vaccine chasers, we're vaccine hunters looking for unvaccinated arms that still need vaccines.

JOHN WHYTE: What's the response you've been getting? Because we know in Los Angeles County, cases are increasing dramatically. And it's because of people who are unvaccinated. Let's put it out there. Breakthrough infections is a small percentage of that. So what's been the response? Is it stay out of my business, I was too busy? What's going on? How are you being successful?

JERRY ABRAHAM: Yeah. Well, first, I'll just say you said there are some folks that will never want one. But we are seeing many anecdotes and stories around the country, people begging for vaccines as they're being put on ventilators, taken to ICUs; really, it's far too late at that point. So lots of things can change people's minds.

We're hoping that the incentives help. We definitely believe that reminding people about family members, community members that we lost, that suffered, just really reminding people how serious a threat COVID-19 infection really is. The reality of long haulers and all that we still don't know about how COVID-19 infection affects the body; all of that helps.

There are clearly reasons why some eager beavers got vaccinated for 65 and older. It was a matter of life and death, and they knew that. But for the young invincibles, those that feel that they can work out and eat healthy and sleep off COVID-19, those arguments don't always work. So sometimes, some of these incentives work.

But really meeting people where they are, answering their questions, telling them what we know; the truth, what we don't know. This is not going to affect their reproductive organs. It doesn't affect fertility. We're not altering your DNA. You're not going to grow a tail. And those things really mean a lot coming from doctors and clinicians.

JOHN WHYTE: How much time do you need to spend with someone? I'm sure it's just not as easy as moving your van around almost like an ice cream truck. I have this idea of you in there. People aren't just going to come up and say give me a vaccine, or is that what you're seeing and we're not really understanding what the challenges are with vaccine hesitancy?

JERRY ABRAHAM: It really does feel like an ice cream truck. The county and L.A. Unified School District really wants us to pivot to all childhood vaccines and helping people catch up. These last few 20 months-plus have been hard on people. People have not been getting their routine health preventive maintenance.

And so in addition to these COVID-19 vaccines, in addition to COVID testing, of course, people need all vaccines. So it does very much start to feel like you're pulling up to an ice cream truck and ordering off of a menu. But I do think part of it is meeting people where they are, in the housing developments, at factories, churches, at their school, in their community, that means a lot. We hear that all the time.

Doctors must be serious. You came all the way out here to find me to get us vaccinated. I'm going to listen. I'm going to take you seriously. You haven't done that for anything else. If it wasn't serious, you wouldn't have come here. We've really stripped every barrier that stood in the way between people and their vaccines: no appointment, no internet, no email, no cellphone. I don't have transportation. I can't see, walk, talk. I don't speak English. I don't have documentation status in this country.

None of those reasons are reasons to not get vaccinated, and now we're realizing maybe going to a clinic and hospital is not really possible for a lot of folks. And we really got to move the care outside of the four walls of the traditional health care delivery model. And I'm really excited that I believe that this is really an important vehicle, literally, for how we're going to deliver and revolutionize how we care for people, starting with giving these vaccines out to people.

And it's not olive branch, it's that conversation. It's that visibility, and that really builds trust, especially in the Black and brown community where we know there are real fears about experimentation, where we know the history is lived and real. The Tuskegee syphilis trials, the abuse of Henrietta Lacks’ cells, undertreatment of black pain in our communities.

These are real things that my patients are struggling with. So I totally understand where people might fear, might not trust, may wonder: “Why are you all doing this? Why are you coming after us so hard?” And we have to tell them because these are the best tools that we really have at ending this pandemic.

JOHN WHYTE: What has surprised you in your interactions with people other than the fact that they see you in a van? What have they said that you thought, “I hadn't thought about that”?

JERRY ABRAHAM: People are reading. People are getting their information, whether it's on social media, Instagram, TikTok, Twitter. People are waiting for the emergency use authorization, for full FDA approval, for example. Some people want to wait a full year. Some people want their children to be through puberty. There's some interesting things, "I want to have my baby first." So these are all real considerations that people are grappling with.

So I have to remind people, America's obstetricians and gynecologists recommend these vaccines for people that are going to get pregnant, that are pregnant, that are breastfeeding, that recent studies show there are no associations with these vaccines and affecting people's fertility or reproductive organs.

We really have to do a lot of that health literacy patient engagement, helping people understand the science, the facts, the truth, because they are asking very important questions, and they want to wait. The only problem is we really don't have any more time to wait as the Delta variant is spreading. We're definitely at the dawn of this fourth wave here in L.A. and across the country.

And so everybody that's holding out on getting vaccinated is just really another host that this virus can infect, and that only means that there's a potential for more variants down the road. So I really beg and plead everyone to please get vaccinated if you haven't.

JOHN WHYTE: Dr. Jerry Abraham, I want to thank you for all that you are doing. You are literally on the front lines, going to people and delivering them the vaccine. So thank you for what you are doing.

JERRY ABRAHAM: Thank you so much, Dr. Whyte. Real pleasure speaking with you.

JOHN WHYTE: And if you have questions about the COVID vaccine, drop us a line. You can email me at drjohn@webmd.net or post on Instagram, Facebook, or Twitter. Thanks for watching.

This interview originally appeared on WebMD on July 30, 2021

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....