The World Health Organization (WHO) has identified vaccine hesitancy as a leading global health threat. Rejection of the COVID-19 vaccine lessens the probability of population immunity (aka herd immunity) and could extend the pandemic.
Population immunity occurs when a significant portion of a population achieves immunity to a disease, either through prior infection or vaccination, so that the disease is unable to spread from person to person. The percentage of the population that must have immunity in order to achieve that goal varies depending on how contagious the disease is. Since COVID-19 is a brand-new disease, no one quite knows what level of immunity might be required to stop SARS-CoV2 virus from spreading. National Institute of Allergy and Infectious Diseases Director Anthony Fauci, MD, stated that he thinks that 70% to 85% of the population might need to be immune before the coronavirus is effectively contained.
Population immunity is the ultimate goal. As more people are vaccinated, pockets of the United States might reach what some refer to as “community immunity,” where a combination of natural immunity and vaccinations keeps virus cases low in certain cities or states. We need your help to protect our community against the SARS-CoV2 virus and reach Population (herd) immunity as quickly as possible.
The “I Got My Shot” public safety campaign is designed to combat vaccine hesitancy by debunking vaccine myths, highlighting trusted voices in the community, and encouraging residents to get vaccinated and become advocates.
Generations of health inequities have caused Black and Hispanic/Latin Americans and other communities of color to be overrepresented in severe COVID-19 cases and deaths. People of color are vulnerable to COVID-19 risk factors, and are more likely to be working front-line, essential jobs that cannot be performed from home, increasing their chances of being infected.
Getting vaccinated can provide protection. At a recent COVID-19 Town Hall meeting hosted by AdventHealth, Mayor Demings told the story of the U.S. Public Health Service Syphilis Study at Tuskegee and praised the descendants whose male relatives were mistreated as part of that study. In an effort to dispel vaccination myths and encourage people to get vaccinated, the Mayor noted how descendants of these men, who he had recently met with, have been vaccinated against COVID-19. As Mayor Demings recalled from the meeting, “In spite of what happened, what they told me was they’ve gotten the vaccine, every one of them. They’re advocates for all Americans getting vaccinated.”
The Tuskegee experiments Mayor Demings referred to started in 1932 as an effort to study untreated syphilis in males. Men were recruited for the federally-sponsored study at Tuskegee Institute, a historically Black university in Alabama. What was intended to be a short-term study, turned into a multiple decade example of failed medical ethics. After the truth finally came out in 1972, the impact on the Black community was pervasive. Decades later, many in the Black community continued to distrust medical advice and public health campaigns, such as the COVID-19 vaccine, which is why the Tuskegee descendants’ advocating for getting inoculated is so important.
Another area of concern among those who have delayed getting the COVID vaccine is the perceived speed with which the vaccine were developed. Many believe that the COVID vaccines were developed too quickly to be safe.
In fact, the mRNA technology behind the Pfizer and Moderna vaccines has been around for decades prior to the creation of the COVID-19 vaccines. The years and years of research behind the technology made it possible to accelerate the development process. Also, the adenovirus backbone technology for the Johnson & Johnson and AstraZeneca vaccines has been around since the first vaccine was made in 1796. That is pretty compelling evidence that the vaccines were not brand new technologies and people can have confidence that the technology behind the vaccines has been tested over many years.
The concern about vaccine safety was born from the same politicization that created doubt about the use of facemasks to mitigate the spread of COVID. Accordingly, many people who do not want to get the vaccines are also people who are anti-mask.
Hopefully, Orange County’s efforts through the “I Got My Shot” campaign will convince the anti-mask, unvaccinated that once they get the vaccine, the masks will mostly go away.
Studies have shown that three main groups of people can positively influence vaccination decisions among community members: Healthcare workers, religious leaders, and family/friends. Healthcare workers are a trusted bridge between health care policymakers and the community who understand the science behind the vaccines and can provide valuable input into vaccine decisions. Local pastors and leaders in faith garner significant trust and can have a powerful influence over how the community members view the vaccination process. Lastly, people turn to family and friends to seek validation and reassurance about their vaccination decisions.
Orange County leaders understand the importance of achieving population immunity and the impact of certain members of the community on those who are vaccination hesitant. Their Communication Task Force is now expanding the “I Got My Shot” campaign by launching a targeted billboard campaign aimed to encourage residents to find a nearby location and to get vaccinated. Besides more than 120 vaccine locations to ease the personal logistics created roadblocks, there are mobile vaccine vehicles to provide addition convenience to residents of central Florida as well as travelers and visitors to the area.
The ‘I Got My Shot’ campaign will feature 10 local physicians on TV interviews, plus billboards of four families and four local places of worship from the community, who have gotten the COVID vaccine, and are advocating for the rest of the community to get their vaccinations.
The County is using data from the Florida Department of Health to show where the billboards are most needed based on vaccination rates in the area. The campaign’s goal is to make all residents aware of the safety, convenience and benefits of receiving the vaccine as soon as possible to build “community immunity.”
My family has the honor of being one of the four families chosen to represent Central Florida on the ‘I Got My Shot’ billboards. As a multi-generational family of healthcare providers, this was an exciting opportunity for us to stand behind what we advocate and support an incredibly important initiative in our community. Even though our son was in University of New Mexico for medical residency training at the time, we felt so strongly about participating in this campaign that we arrange to meet in Houston, Texas for the weekend to get our family picture taken for the billboard. As a cardiologist, I know first-hand the health implications that a virus like SARS-CoV-2 can have on the cardiovascular system. COVID is very similar to the Flu in the way that it can cause heart attacks, strokes, and blood clots due to virus triggered inflammation of the heart and inner lining of arteries and veins.
I have endeavored to provide public education in Mandarin and Cantonese languages to Chinese-speaking Asian American community over the years about the Flu vaccine because the effects of the flu go far beyond the respiratory symptoms that most people associate with the illness. The cardiovascular inflammatory effects of Flu are so significant that not receiving the Flu vaccine is considered a risk factor for cardiovascular events. During 2020 and 2021, I have continued those public health talks and videos to the Chinese-speaking Asian American community to provide them with COVID education in Chinese language that is lacking from many government-controlled sources they commonly use as their source for information.
Even though we had a collectively sigh of relief as hope and optimism increased for the first time in more than a year as the pandemic started to recede, there is still a concern that new mutations of the virus could bring it back, and it might be even stronger. The need for us to continue to progress toward community or herd immunity is becoming more urgent as the Delta variant continues to spread across the globe.
The Delta variant is a highly contagious and more severe mutation of the SARS-CoV-2 virus which started in India in December 2020, and quickly spread through India and Great Britain. Delta has left a new wave of infections and death in its wake. The first Delta case in the United States was diagnosed in March and now cases here are rapidly multiplying especially in Florida.
While all viruses evolve over time and undergo changes as they spread and replicate, one thing that is unique about Delta is how quickly it is spreading. Many experts point to the Delta variant as a new inflection point in the pandemic.
From what is known so far about Delta, people who are vaccinated against the coronaviruswith either the two-dose Pfizer or Moderna or the one-dose Johnson & Johnson appear to be safe from Delta. However, as in the pre-vaccine days of COVID, anyone who is unvaccinated and not practicing preventive strategies is at risk for infection by the new Delta variant.
Delta is estimated to be 75% more contagious than the original SARS-CoV-2 virus. In a group of people where no one is vaccinated or wearing mask, it is estimated that the average person infected with the original coronavirus strain will infect 2.5 other people. However, in the same environment, Delta would spread from one person to maybe 3.5 or 4 other people. This is especially troublesome for our younger people as a recent study in Great Britain showed that children and adults under 50 were 2.5 times more likely to become infected with Delta variant.
One factor that will play a role in the spread of the Delta variant is how many people in your area are vaccinated and if your area is adjacent to places that have low vaccination rate. This patchwork vaccination pattern will allow the virus to hop, skip, and jump from one poorly vaccinated area to another.
If this causes the infection rate to jump too quickly within a community, we could find ourselves back where we were in the early days of COVID with our healthcare system being overwhelmed with COVID patients.
The most important thing we can do to protect ourselves and our community from Delta is to get fully vaccinated. Of course, there are some people who cannot get the vaccine, because their doctor has advised them against it for health reasons.
We have seen that vaccination rates go up when there is an outbreak in a local community or if someone you know gets a severe case of COVID and is hospitalized. Hopefully, enough people will not need that to happen before their risk calculus change and they realize the benefits of getting fully vaccinated against COVID.
I am hopeful we see vaccination rates go up before the Fall and we will reach community immunity.
