Transcription:
Promoting COVID-19 Vaccine Confidence Pt. 2

Melanie: Welcome to Back To Health, your source for the latest in health, wellness and medical care, keeping you informed so you can make informed healthcare choices for yourself and your whole family. Back To Health features conversations about trending health topics and medical breakthroughs from our team of world-renowned physicians at Weill Cornell Medicine.

I'm Melanie Cole. And today, we're discussing promoting vaccine confidence and Weill Cornell Medicine's efforts to combat the COVID-19 illness and promote vaccination. Joining me in this thought leader conversation, we have a panel today with Dr. Linnie Golightly, she's an associate Dean of Diversity and Inclusion and Associate Professor of Medicine in Microbiology and Immunology at Weill Cornell Medical College Cornell University, who specializes in infectious disease at Weill Cornell Medicine; and Dr. Susana Morales, she's the Vice Chair for Diversity in the Department of Medicine at New York Presbyterian Hospital Weill Cornell Medical Center, and the Director of Diversity in the Center of Excellence of the Cornell Center for Health Equity, and she's an Associate Professor of Clinical Medicine at Weill Cornell Medical College Cornell University.

Doctors, thank you so much. Vaccine confidence is so important and I thank you for joining us today. Dr. Morales, I'd like to start with you. For people that are hesitant, can you tell us a little bit about the history of vaccines in general and then include the Pfizer, Moderna, Johnson & Johnson COVID vaccines. Tell us a little bit about how they work.

Dr. Morales: Absolutely. And I just want to thank you for interviewing us. We believe really strongly about the importance of sharing what we've learned and what we know about vaccines and about COVID vaccines in particular. So of course, vaccines have been around for hundreds of years. And the very first vaccine was discovered. It was noticed that milkmaids didn't get smallpox. They didn't end up disfigured, because one of the things that smallpox would do be besides kill a third of its victims was disfigure with horrible scarring. And Jenner in England noticed this and decided to do experiments and realized that cow pox vaccination helped to prevent smallpox.

So the smallpox vaccination was the first vaccine and it was introduced into this country in the 1700s or so. General Washington mandated smallpox vaccination for the revolutionary troops. And since that time, multiple vaccinations have come our way. Smallpox was eradicated in 1980 around the world, which is an amazing victory of medical science. Before that, 5 million people used to die every year from smallpox. And now we have vaccines, of course, against measles, mumps, Rubella. Polio is almost at the stage of being eradicated around the world.

So vaccines are really miracles of medical science. Vaccines work by teaching our immune system what a germ looks like, a bacteria or a virus, and teaching our immune system to fight it. There are many different types of vaccines that work in different ways. The COVID vaccines that are approved in our country, there are three of them so far. Two of them are called mRNA vaccines and one of them is what's called a viral vector vaccine, that's the Johnson & Johnson vaccine. The Pfizer and Moderna are mRNA vaccines.

And mRNA vaccines are newly approved as a technology, but had been studied for many years. So one of the important things that I started to hear from my own patients was that fear about people that the vaccines came about too quickly. But what I don't think people are fully aware of is that there was a backstory that this mRNA research had been going on for a really long time. And also there was evidence and knowledge about how to fight coronaviruses because there were other bad coronaviruses that had come around before. And so it was known that you needed to attack the spike protein. So all three of the currently approved vaccines help our bodies develop antibodies against the spike protein. And they are really a miracle of international cooperation, of investment of all the brilliant minds, vaccine scientists getting together around the world to work on this.

Melanie: Well, thank you, Dr. Morales, for that. And Dr. Golightly, tell us a little bit about what Weill Cornell Medicine is doing in the local communities in terms of education, administration, and really what you're doing in your efforts to combat COVID illness and promote vaccinations of all kinds.

Dr. Golightly: Well, I think that the best thing that any of us can do is to be well-educated so that you can make an informed decision. And that's where we have been putting our efforts, is to try to get out real information, fact-based information, so that people can make a decision so that they're not just going on YouTube or the internet, or no offense, but asking a distant cousin who may or may not know what is the scientific basis for the vaccines, how have they been tested and vetted, what is the real incidence of side effects. All of those things that are critical when you're considering whether you want to make a healthcare decision.

I think that's consistent with our philosophy at Weill Cornell regarding healthcare. And we've been working out in the community to promote information. Dr. Morales has been involved with setting up courses so that people can educate themselves and educate their friends, relatives, and other family members. So we really think that people need to be educated, to trust reliable sources and find out information about the vaccine and that then they can come to a conclusion, which I think they will find that the vaccines have been vetted, that they have, as Dr. Morales mentioned, a long history of investigation of mRNA vaccines. That's not their only option. Another vaccine is available. And we've also been involved with getting out the vaccine themselves. And that many of our healthcare professionals have been involved with volunteering at the different sites around the city to help provide vaccines for individuals who would like to have them.

Dr. Morales: One thing that Dr. Golightly referenced in terms of our community education efforts that I've been very involved in is a collaboration with five other medical schools in New York City to develop something called the COVID-19 Community Education and Empowerment Internship. And it's a virtual internship for young people. Initially, it was college students and now we're welcoming juniors and seniors in high school to our next cohort, which starts next week.

So far, we've trained a thousand STEM college students from around the country and the world, because some students are tuning in from Macedonia and Nigeria and the Philippines to learn about COVID, public health and vaccine science and how to talk to people about vaccines. And we ask them each to commit to talk to 10 people about vaccination and to make social media product about COVID or COVID vaccination that's reviewed as a little capstone project that they post.

So we are really interested in helping our community here in New York City, but really also reaching out around the country and even the world to try to make a little dent in some of the misinformation that's out there.

Melanie: And Dr. Morales, as we've heard, data has shown that people from racial or ethnic minority groups are less likely to receive preventive healthcare screenings, including and especially vaccines in light of the impact that COVID-19 has had on their communities. Can you tell us a little bit about your top recommendations to help overcome some of those disparities and how healthcare workers can also work to break down those barriers? What are you doing at Weill Cornell Medicine as far as outreach and to help these underserved communities?

Dr. Morales: Yeah, I think COVID-19 has unfortunately illustrated some of the health disparities faced by poor people and by minority people very obviously, so that, for example, Latino, African-American and native American people are at least twice as likely to die from COVID-19 as their white counterparts. And there are large disparities in hospitalizations as well.

So the reasons for disparities are complex, but include historic, structural inequities. And especially with COVID with the infectious disease, a lot of minority folks who are frontline workers don't necessarily have access to care and so forth. What we've been working on is especially doing outreach to communities of color, although, of course, we've reached out to everyone. We've been working with national organizations, the National Medical Association, the National Hispanic Medical Association, to unite with other providers of color and trusted messengers. I was involved with something that the Kaiser Family Foundation put together with other groups called the greaterthancovid.org. And they're actually several New York Presbyterian doctors and nurses and community health workers that worked with that project to make videos about COVID-19 questions that people have both in English and in Spanish.

The Dalio Center for Health Justice part of NYP is a collaborative effort with Cornell doctors and Columbia doctors and other providers. And Dalio has been working as well with us to provide multilingual education efforts. So there's a lot of work going on. And I think we're pretty excited that the numbers in New York City are a lot better than the rest of the country. But now, we are concerned about still pockets in New York city that have low vaccine uptake. We're working with the Department of Health as well, the New York City Department of Health to increase vaccine access. So we've been doing a lot of work, just trying to address this from many different angles to see whether we can help people over the hump to get vaccinated.

Melanie: Which leads beautifully into my next question. Dr. Golightly, if people are nervous at the thought of getting vaccinated and we've mentioned our, Facebook MDs, Google MDs, talking to their uncles on social media and getting their better information or what they think is. So let's break that down a little bit. If they're nervous about getting vaccinated and we've already said education and dispelling misinformation is the key, what do you tell them when they ask you directly? "I don't trust these vaccines or somebody said this," what do you say?

Dr. Golightly: I ask them what it is that concerns them. Everyone has something specific that concerns them. And I try to answer the questions that they have. We can't be dismissive of people's concerns and worries, particularly in our communities of color, where there has been a history of mistrust and for good reason. And so I ask them, "What is it that you're concerned about? What is it that worries you?" And I try to answer their specific concern. I tell them that they are trusted sources, that if they go to the CDC website, the NMA was mentioned, the Weill Cornell site, we have information available to them, and to reach out to their healthcare professional, to their personal physician, who in most cases, people trust and ask them their questions.

I think that we can't ignore these concerns. They're real. Most of them are based on a little bit of facts somewhere as Dr. Morales actually reminds us many times and we need to take them seriously and make sure that they feel comfortable, but again, that it's based in science and the facts and not these random things that unfortunately are out there.

Melanie: And now Dr. Morales, if vaccinated, as many of us are, hopefully more of us than less of us, but as a result of the variant, and we've been hearing about the Delta variant. We've even heard some recent news about a very, very few, very small number of people that have gotten this breakthrough infection. Tell us about mask wearing because I myself, double Vaxxed waiting for my booster, am a masker everywhere I go. I barely leave my house without wearing this thing, but why are we doing that? Why is it important that the World Health Organization is telling vaccinated people, even vaccinated people, that wearing a mask can still help protect us. I mean, you doctors have been wearing masks for decades and centuries. So tell us what you want people to know about that.

Dr. Morales: Yeah, I think part of the thing that's confused the public is that initially the evidence about whether masks were absolutely necessary was unclear early in the pandemic. At this point, the evidence is very clear that masks are important. COVID spreads primarily through respiratory droplets, small droplets, but it also does something called aerosolizes, teeny weeny, little droplets that float in the air, even when the person, you know, already walked by can also infect people.

So at this point, the recommendation is and the evidence shows that the masking protects both the wearer and other people from the wearer. Because, of course, one of the challenges and one of the reasons that COVID has been so horrible is that people can be infectious a couple of days before they actually develop symptoms on themselves. And so it's really important for us to protect each other and ourselves.

The dilemma with Delta in particular is it's much more contagious, much more deadly affecting younger and younger people, including children and that little kids aren't yet eligible for vaccination. And of course, a lot of people just haven't been vaccinated yet. There's still a lot of anxiety. So, the only way that we're going to really get beyond the pandemic is using all the methods available to us, both vaccination and masking, especially in indoor locations. It seems that outdoors unless you're really on top of each other, you're safer. And that's what the CDC is recommending, that if you're going to be together with other people, outdoor is better. But masking works. It's not dangerous like you said. We doctors in the hospital wear masks all day long. The only thing it does is sometimes my nose is a little sore.

Dr. Golightly: And if I could just mention those of us that are vaccinated can certainly be asymptomatic, yet be infectious to other people. So I could be just fine and never know that I had acquired the virus, yet pass it on to someone else. And so I think in consideration to my neighbor, I wear a mask. I'm very careful and I don't want to ever think in my life that I have caused someone else theirs.

So I think that you mask up to protect yourself, to protect others and that we as a society need to come together in order to defeat this virus. And as Dr. Morales mentioned, it's a little thing, really. And I think that, and I would hope, that we could all work together to mask up, get our vaccines and get rid of this virus.

Melanie: Hear, hear.

Dr. Morales: One thing I wanted to add about this breakthrough thing, the fact that there are some vaccinated patients that have gotten COVID has been disappointing to a lot of people and misinterpret it as meaning that the vaccines don't work, that's not true. The key thing that it's really important to remember is that almost always the people that have been vaccinated and get COVID are much less likely to be admitted to the hospital or to die from COVID, which is the main thing that we care about. Of course, it would be wonderful if it was 100% effective against all COVID. But even in the original clinical trials, there were some vaccinated people that got COVID, but none of those people ended up in the hospital or dying.

But because occasionally, you know, especially very elderly people are very sick people may get really serious COVID even if they're vaccinated, that's one of the reasons that boosters are being recommended for certain people. And the final recommendations about the Moderna and the Johnson & Johnson are about to come out. And that I think masking is still going to be important, even if you're vaccinated.

Melanie: Well, it certainly shows how as a caring society we can go about protecting our most medically vulnerable. I'd love to give you each a chance for a final thought here today. So, Dr. Morales, starting with you. I want you to reiterate how important it is to review those findings from reputable sources and anything else that you have felt frustrated about or excited about or hopeful about that you would like listeners to take away from this episode, this really important episode today. And you doctors are so knowledgeable on these topics of vaccines. I would like you to speak to the listeners and tell them what you would like them to know about vaccine confidence and talking to their trusted providers at Weill Cornell Medicine.

Dr. Morales: I really do believe that vaccines in general are really a miracle of medicine. They have probably saved more lives than anything else except maybe clean water. And these COVID vaccinations were certainly an answer to my prayers. I was taking care of people with COVID and I was very frightened. And the day I got my vaccine, I danced. I've just gotten my booster. I was pretty excited about that. Got my mom get her booster. I really, you know, practice what I preach. I talk about vaccines every day. I'm a primary care doctor. I really believe that these vaccines are safe, that they're are effective and that we all need to put our trust in science. Remember that when we vaccinate ourselves, we're also vaccinating for the people around us, for our communities, our loved ones. I really do believe it's an act of love. So I wish everybody good health and safety.

Melanie: Beautifully said. And Dr. Golightly, last word to you. I'd like you to emphasize the importance of getting vaccinated even for flu because we don't want this really twindemic coming on because it is starting to be flu season with co-infection present and how Weill Cornell Medicine can help with this information, vaccines and in-person or virtual appointments. So tell us a little bit, wrap it up for us. Tell us a little bit about how you're working to put all of this together so that we can be a safer community.

Dr. Golightly: I would remind people that they've had many vaccines. We've had mandates for vaccines for generations, and that they protect us against many diseases, which are still rampant in other parts of the world. And so it's really a privilege to be able to get the COVID-19 vaccine. And that it is recommended that you can get it safely -- this is per the CDC -- with the flu vaccine. And again, flu is out there as are the many other illnesses that we protect ourselves against.

And so I would remind people that they can get information from Weill Cornell Medicine. They can get both vaccines through our services. They can become educated and I would remind them to just reach out and educate yourself. Make sure that your decision is based upon a trusted source and that you have the correct information because there's a lot out there that's not true. And it's not that we're saying anything bad about the people that are saying that, but try to make sure that you go to your trusted source, go to your physician and have the correct information. And then I think that they will find that as in the many other vaccines that they've had throughout their lifetime, that this will be another one that they'll add in, and that we can have a safer society for all.

Dr. Morales: If you want to get a vaccine at Cornell, you can go to Weill Cornell Connect, myconnectnyc.org, or you can call in to (646) 697-8222 if you don't have computer access. And at this point it's also pretty easy to get vaccines with the New York City Department of Health. There's a New York City Vaccine finder and they have a call-in number, which is (877) 829-4692. They even are doing COVID vaccines at home for the homebound. So at this point, it's easy to get vaccinated. It's just a matter of everyone getting the right information to conquer their own doubts and hopefully join the ranks of the vaccinated. I think people will feel a lot better when they know that they're protected.

Melanie: I think so too. Thank you so much for joining us, doctors, really and sharing your incredible expertise. And patients can schedule their vaccine via Weill Cornell Connect and Weill Cornell Medicine continues to see our patients in person, as well as through video visits. And you can be confident of the safety of your appointments at Weill Cornell Medicine.

That concludes today's episode of Back To Health. We'd like to invite our audience to download, subscribe, rate, and review Back To Health on Apple Podcasts, Spotify and Google Podcast. For more health tips, go to weillcornell.org and search podcasts. Parents, don't forget to check out our Kids Health Cast and please share this show with your friends and your family on your social channels, because we are learning from the experts at Weill Cornell Medicine together. I'm Melanie Cole. Stay safe.

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