Interview: Portland Physician on Coronavirus Vaccine, Reaching Out to Wary Communities

With more than 1,600 Oregonians having lost their lives to coronavirus, and 124,000 cases reported within the state, the delivery of two FDA-approved vaccinations gives hope for widespread inoculation and an eventual return to normalcy.

But experts are concerned that misinformation and misunderstanding about the vaccinations will undermine public health efforts to protect from a virus that as of Friday had infected 22 million Americans and claimed the lives of 367,000 -- especially within the Black community, the hardest hit by the pandemic and statistically, the most skeptical of it.

While Black Americans are dying of coronavirus at a rate of two-and-a-half times that of White Americans, fewer than half of Black American adults intend to get the vaccine, according to a survey by the Pew Research Center

Dr. Carl AndersonThere is significant distrust “in the Black and also in the Latinx and the Asian Pacific communities, simply because their experiences with Western medicine, at least in the US, has not always been trustworthy,” Dr. Carl Anderson, a local physician, told The Skanner.

Anderson served as a preventative medicine physician in the U.S. Army Reserve for nine years, and was deployed as a preventive medicine officer in Kuwait in 2012, where he tracked the SARS-like virus during Operation Enduring Freedom. In 2016, he served as acting chief of preventive medicine at Fort Sill, Okla., monitoring mosquito species capable of carrying the Zika virus.

He sat down with The Skanner to clear up confusion about the vaccination.

Two Vaccines Approved

The two vaccinations currently approved by the FDA are by Pfizer and Moderna, with each company under contract to reserve their first 100 million vaccine doses for the U.S. government, which is distributing doses in a taxpayer-funded effort. A third, the AstraZeneca vaccine, is currently under review in the U.S., with OHSU conducting a clinical trial of at least 13,000 volunteers.

So far. 6.7 million Americans -- about 2% of the population -- have received their first dose of the vaccine, which requires two shots spaced out over three weeks to a month. Vaccinations are currently being administered with the most at-risk populations being prioritized, including health care providers, hospital workers, elderly care facility staff and residents, and anyone over the age of 80.

President-elect Joe Biden this week announced his goal of distributing 100 million vaccinations during his first 100 days in office. On Friday, he announced he would free up all available coronaviruses vaccinations, overturning the Trump administration's plan to reserve half of the available doses.

But only 26% of the vaccines distributed to Oregon have been administered, according to the Centers for Disease Control and Prevention (CDC). Gov. Kate Brown has told the Oregon Health Authority to meet a goal of 12,000 vaccinations a day statewide. (For up-to-date information on statewide vaccinations, visit the Oregon Health Authority dashboard here.)

Myth: The Vaccine Gives You Coronavirus & Changes Your DNA

“Usually, vaccines are made from either live or very weakened viruses to encourage the body to develop antibodies to them, which then leads to immunity to those viruses,” Anderson said. But neither the Moderna nor the Pfizer vaccines contain a live virus. Instead, they use the emerging technology of messenger RNA (or mRNA).

“The mRNA vaccine encodes the protein spike of the virus, which will not cause the disease. When given it is inserted into cells in lymph nodes near the injection site to trigger immune response and create antibodies to fight infection,” Anderson explained.

At no point is the coronavirus itself introduced through the vaccine. The messenger RNA does not enter the cell nucleus, where DNA is kept. Because of this, the vaccine does not in any way impact or interact with genetic material.

“It does enter the cells, and in that sense, it causes the cell to in fact stimulate antibodies to the virus. It certainly changes the cells so that they’re able to better protect themselves and to help to develop antibodies to the virus.”

Myth: It Was Developed Too Fast

“I certainly am hearing people who are skeptical about the time it’s taken to develop the vaccine,” Anderson said. “Usually vaccines take five to 20 years to manufacture, to get right.

The thing is we have had an increase in technology over time, which has shortened the time period. And I think that that will continue. I think we will continue to see that, as new technologies emerge in the future.”

Anderson points out that vaccines rapidly developed in response to pandemics are, in fact, written into U.S. public policy.

“We do have a pandemic plan that was actually put into place in 2005, right after the SARS epidemic. And that was put in place by the administration of George W Bush. Certainly the Obama administration updated it, and put it into effect around H1N1 and also Ebola.”

The global magnitude, speed, and fatality rate of COVID-19 made it a top research priority, and this urgency has meant unprecedented financial and scientific resources have been devoted to developing a vaccine, tapping into the expertise of public, private, and top educational institutions worldwide.

Similarly, the flu vaccine is refined each year based on predictions of which strains are most likely to emerge.

Fighting Distrust

Public health officials must grapple with the history of medical racism in the U.S., ranging from White providers’ often institutionalized racial biases and misunderstanding of pain tolerance in Black patients, to violent medical experimentation performed on Black bodies without consent and often without knowledge.

"We tend to do things to people and not with people,” Anderson said. “And that has been the problem in the past.”

A report co-authored by the NAACP found that Black respondents who knew of the Tuskegee Syphilis study were significantly less likely to opt for the vaccine, and that only 14% of Black Americans surveyed trusted the vaccine was safe, and only 18% trusted it was effective.

It also found that Black Americans were twice as likely to trust messaging from someone of their own racial or ethnic group.

Anderson reported he had the Moderna vaccine.

“People have to realize that the people that are taking care of them in the hospitals are taking the vaccine.

"I just had mine last week,” he said. “So if we’re still here, it can’t be that bad.

“I think that they ought to know that the data has been peer-reviewed, by individuals who look like them. Also, I think it would be beneficial for a lot of doctors and nurses of color to certainly be the leaders in trying to get people vaccinated. I think that this is a great time for the

(Historically Black Colleges and Universities) to tout the expertise of the graduates, and to try to mobilize those individuals to encourage individuals of color to be vaccinated.”

Still, Anderson believes the best approach is for local organizations to identify vaccine-related apprehension within their respective communities.

“There are some things that might be universal, but I think the messaging has to be local,” Anderson said. “It’s just psychology. All politics is local. Well, so is healthcare.”

Vaccination is voluntary, and Anderson urges similar consideration when talking with people about their fears.

“I think that we do it conversation by conversation,” he said.

“That we tell the truth, and we keep telling the truth. We try to have a conversation with anybody who wants to have a conversation with us, and the second part is important.

“I just ask, ‘Do you plan to take the vaccine?’ We’re just having a conversation. So if I’m an Uber, I’m having a conversation with the Uber driver. I’m not trying to convince him so much as I’m trying to listen to why or why not he’s going to have the vaccine. I’m really listening to their explanations.”

Anderson offers a novel suggestion for demystifying the shot.

“I’ve also said that perhaps the one personal thing that everybody can do is when they get their vaccine, to post a screenshot on social media, and to have a conversation,” he said.