By Mike De Felice
Special to Kitsap Daily News
PORT ORCHARD – The demand for the Pfizer and Moderna COVID-19 virus vaccines is clearly outstripping demand as appointments for vaccinations get filled as soon as they are posted.
The effectiveness of the vaccines stands at an impressive 95 and 94 percent, respectively, for the Pfizer and Moderna versions, health officials say. Kitsap County residents from Poulsbo to Port Orchard are clamoring for the opportunity to get vaccinated; the number of doses going into arms locally in mid-February hovered around 1,000 per day.
But the eagerness to get vaccinated, however, is not shared by all. While nearly two-thirds of Americans are willing to take an FDA-approved vaccine, according to a Gallup poll, a significant one out of the three are hesitant to take a vaccination shot.
“Everybody’s decision about whether or not they want to be vaccinated is individual and very personal,” said Dr. Gib Morrow, health officer for Kitsap Health District.
To date, just over 14 percent of Kitsap County residents have received at least one dose of the vaccination while 7 percent have received their second shot, or are fully immunized, according to the health district.
Despite the reported effectiveness of the vaccines and their minimal side effects, individuals still refuse to get inoculated for a variety of reasons, Morrow reported.
Those reasons include concerns over side effects, a fear a person can actually catch COVID from the shot or believing the pandemic is not real.
One of the many other reasons centers on the speed at which the vaccines were developed.
“The name Operation Warp Speed may not inspire a tremendous amount of confidence,” Morrow noted. “I think people are concerned about the rapidity with which these were developed.”
By comparison, reports indicate the fastest any vaccine had previously been developed — from viral sampling to approval — was four years for the mumps vaccination in the 1960s.
Despite the fast-track approvals the COVID-19 vaccines have received, the health district’s leader is confident in them and fully endorses their use.
“They are incredibly safe and effective — and they work,” he said.
Morrow openly admits he is not an authority on why people are reluctant to take vaccines since they are not the people with which he interacts.
“People that are hesitant to take vaccines are not the ones contacting us right now. We are seeing the people that want [to get the vaccine] yesterday,” he said.
“Right now, the primary issue isn’t vaccine hesitancy — it is vaccine supply. We just don’t have enough vaccines right now to get them out to eligible people who want them.”
Invariably, in some cases, politics appears to play some role in whether someone is willing to be vaccinated.
The percentage of Democrats willing to receive the vaccine has risen in the most recent poll to 91%, while the percentage of Republicans lags at 51%, according to Gallup’s website. The divide seems to go along with the partisan divide over masks.
“I don’t know the extent to which politicization of this whole pandemic has impacted people’s willingness to take the vaccines,” Morrow confessed. “I think people, by and large, understand that this is a real pandemic, that’s it has been a huge global issue, that we had a half-million deaths related to it. I think people understand that at this point.”
There have been reports nationally that some non-citizens have been reluctant to sign-up for the immunization out of fear that doing so will raise a red flag with immigration authorities. That should not be a concern, Morrow stressed.
“I think it’s important to get out there that no provider who is giving vaccines needs to get your Social Security number. We need to get their name, date of birth and, where possible, their race, ethnicity, age and some sort of confirmation of their eligibility.
“We are really trying to make this a low barrier and make sure those kinds of constraints do not prevent people from coming to get vaccinated.”
Personal information gathered during the immunization process goes into national and state immunization databases and, as Morrow understands it, the information is solely used to track vaccinations.
Cost may also be an obstacle in the minds of some but that should not be the case, he said.
“It’s important for people know that there is no cost at this point for anything related to a COVID-related medical expense. That’s true for testing, for treatment and certainly true for vaccination. People are not going to be responsible or any out-of-pocket cost whatsoever for getting vaccinated.”
Members of minority groups have been distrustful of the vaccine based on a deep-seated historical distrust of the medical field — and of getting injections.
“Communities of color, including Black and Latinx, have been hit hardest by COVID-19 nationwide. People of color are more likely to be hesitant to pursue vaccination due to mistrust in government and healthcare systems,” according to the Kitsap health district’s website.
“Communities who have experienced discrimination and injustice in their daily lives are going to be less likely to trust that vaccines are safe and effective, especially when they are not run-of-the-mill routine vaccines — which these are not,” Morrow said.
“I think this has to do in part with some arguably justifiable mistrust in the health care and the public health systems that’s rooted in this history of injustice,” Morrow said.
The “Tuskegee Experiments,” which ran from 1932-1972, is a frequently cited example used to explain the mistrust shared by Black and brown people with the medical profession. During a 40-year study, African Americans from rural Alabama were experimented on without their consent.
A group of these subjects, some with syphilis, were given a placebo — or inactive drug — and then studied while their health deteriorated. President Bill Clinton issued a national apology to the victims in May 1997.
Only 14 percent of Blacks and 34 percent of Latinx said they trust the safety of a new COVID-19 vaccine, according to a report in September from UnidosUS, the NAACP and COVID Collaborative.
To address this historical mistrust, the Kitsap County Health District recently formed a group of community leaders and healthcare providers to focus on developing ways to promote confidence in getting a COVID-19 shot. The vaccine equity collaborative is co-chaired by Tracy Flood, an attorney and president of the Bremerton NAACP.
The new collaborative is designed to help the medical community build relationships with minority communities and promote equity in the distribution of the vaccine, Flood noted.
Dr. Morrow agrees: “It’s important to enlist the help of community partners, people that are of the same color, health care providers of color, and leaders in minority groups. These people are influencers. They can really help the cause of getting people to trust and accept these vaccines.
“The images of physicians and other leaders who are of color getting their own vaccines are really important,” he added.
Another group that has expressed a surprising hesitance in getting vaccinated is the caregiving workforce.
A December survey by the Kaiser Family Foundation found 29% of health care workers were hesitant about getting the vaccine.
“I personally don’t know anybody in health care who has been offered a vaccine that has declined it,” Morrow said. “I don’t know the demographic makeup [of those surveyed.] I do think there are workers in health-care settings that include food services and delivery [people] that may be members of ethnic or racial or minority groups that are more likely to be skeptical than others.”
Building trust
As reports surface of more transmissible COVID-19 variants, the pressure is mounting to get people quickly vaccinated to avoid another rise in COVID cases. This quickly evolving situation places a burden on medical officials like Dr. Morrow to convince skeptics to become willing participants.
The key question arises: how can medical personnel increase trust in the vaccine?
“I think the first thing to do is to lead with listening. Make sure you understand where each individual is coming from in terms of their reluctance. You need to give them the opportunity to share stories and their concerns. I think it’s really important to avoid being judgmental. Keeping an open mind is really important,” Morrow said.
“It is also important to acknowledge uncertainty. We have seen repeatedly throughout this pandemic that we really don’t know everything. As we go along, new information is always accruing — that’s really the nature of science. But it’s important to acknowledge that uncertainty.”
Finally, Dr. Morrow emphasized that the language medical experts use when dealing with the public is key.
“Where possible, use straightforward language that is accessible to people that they are able to relate to and understand. I think it’s important to share the information we know and do it in a crystal-clear fashion.”
