Episode 7
Vaccination Hesitation: COVID-19 Vaccine Safety & Efficacy w/ Christina Cady
Published on:
8th March, 2021
On this episode we discuss the safety and efficacy of vaccines with guest, Christina Cady. We also discuss some of the literature related to reduced vaccination rates in communities of color.
Show Notes
- Influenza vaccination rates compared by Race
- Influenza vaccination is widely recommended and fully covered preventative service under the ACA
- Data show flu vaccination rates remain low and there are persistent racial disparities in uptake of flu vaccine
- 2018-2019 CDC flu vaccine data
- Adults by race
- Whites 49%
- Blacks 39%
- Latinos 37%
- AIAN 38%
- Factors leading to lower rates
- Less insurance and less likely usual source of care
- Critical factors
- Blacks perceive a higher risk of side effects
- Lower knowledge of flu vaccine
- Less trust in the vaccine
- Black patients do not always receive
- Strong recommendations
- Specific offers for vaccine
- Decreased acceptance of new vaccine with highest level of worry amongst Blacks
- Perception of racial fairness and influence of race in health care settings and experiences with discrimination are associated with attitudes and beliefs about vaccinations which can influence getting vaccinated
- POC have more missed opportunities for vaccines, but would be more willing to accept if strongly recommended
- COVID-19 Vaccinations
- Available evidence:
- 15,474,800 cases from Jan 21st to Dec 10th
- Hospitalization rate: 278.7 per 100,000 people
- Mortality: 291,522 COVID-19 associated deaths
- 2,740 new deaths per day
- In LA (recent LA County public health lecture 1/5/21)
- Death rate is 4 times higher in areas of poverty
- COVID-19 Vaccination Evidence to Recommendations from the CDC ACIP
- Population: >16 yo
- Intervention: Pfizer-BioNTech COVID-19 vaccine (BNT162b2)
- Comparison: No vaccine
- Outcomes
- Symptomatic lab confirmed COVID-19
- Hospitalization secondary to COVID-19
- All cause death
- SARS CoV-2 Seroconversion to a non-spike protein (date pending early December)
- Asymptomatic SARS Cov-2 Infection (data pending early December)
- Serious Adverse Events
- Reactogenicity Grade >3
- Do desirable effects of vaccine outweigh undesirable effects? A resounding Yes, benefits outweigh harms in most settings
- Pfizer vaccine demonstrated VERY HIGH efficacy (95%) post 2 dose regimen against symptomatic lab confirmed covid infection
- Level of evidence: High certainty
- Across all groups (age, gender, race, with comorbidities)
- Not included: children, pregnant women, immunodeficient individuals
- Limitations
- Only 2 month f/u
- Limited power to detect rare adverse events
- Vaccine effectiveness against hospitalization 100%
- L of E: low certainty because rare outcome
- Deaths uncommon
- 2 in vaccine
- 4 placebo
- L of E: very low certainty because rate outcome
- Serious adverse events very similar in vaccine vs placebo groups
- L of E: moderate
- Severe reactions (>3 grade)
- 8.8% vaccinated
- 2.1% placebo
- L of E: high certainty
- Uncertainty about vaccine by surveys
- Scientific articles 272, 14 included
- News/media, 19 included
- Intentions
- Acceptance lowest among Black respondents
- 25-55% for Black
- 37-70% for White
- > with higher SES
- > with hx of flu vaccination
- > with healthcare provider recommendation
- Concerns
- Vaccine side effects
- Uncertainty of efficacy
- Speed of approval process
- Low risk perception of disease
- High vaccination rates require addressing the previous mentioned barriers
- Access
- Cost
- Federal law states insurers provide COVID-19 vaccination for free
- Trump admin has said free for uninsured but there are questions about funding
- People need to know where to access
- Distrust
- Safety concerns
- What are the risks of side effects?
- Strategies to increase vaccination rates
- Healthcare providers can increase vaccination rates by pairing recommendation with offer at same time
- Provide info in linguistic and culturally appropriate ways
- Proactively address peoples concerns
- Use trusted individuals from the community as messengers
- References
- Artiga S. Orgera K. Key Facts on Health and Health Care by Race. Kaiser Family Foundation. 2019
- Quinn SC. African American adults and seasonal influenza vaccination: Changing our approach can move the needle. Human Vaccines & Immunotherapeutics. 2018;14(3):719-723.
- Rahimi H, Picaud Y, Costanzo S, Madhusudan G, Boissier O, Singh kamal D. Design and simulation of a hybrid architecture for edge computing in 5g and beyond. arXiv:20090041 null. Published online August 31, 2020.
- Quinn SC, Jamison A, Freimuth VS, An J, Hancock GR, Musa D. Exploring racial influences on flu vaccine attitudes and behavior: Results of a national survey of White and African American adults. Vaccine. 2017;35(8):1167-1174.
- Maurer J, Harris KM, Uscher-Pines L. Can routine offering of influenza vaccination in office-based settings reduce racial and ethnic disparities in adult influenza vaccination? J GEN INTERN MED. 2014;29(12):1624-1630.
- Artiga S. Michaud, J. Kates, J. Orgera K. Racial Disparities in Flu Vaccination: Implications for COVID-19 Vaccination Efforts. Kaiser Family Foundation. 2020
- ACIP COVID-19 Vaccines Evidence to Recommendation Framework. 2020
- Contact/Support/Questions/Comments
- How to contact the initiative to support, collaborate, ask questions:
- Email: atlast@atvantagepodcasts.com
- GoFundMe
- https://www.gofundme.com/f/increasing-diversity-in-athletic-training
- Guest Contact info
- LinkedIn: https://www.linkedin.com/in/christinamcady/
- Gratitude and Blessings
- Artwork by Jason Eisenberg
- Instagram: @dots_and_squares
- LinkedIn: https://www.linkedin.com/in/jasoneisenberg00/
- Intro/Outro music by Willie B the Ichiban Don
- Instagram: @ichibandon
- LinkedIn: https://www.linkedin.com/in/william-brown-25945b168/
- Production / Engineering / Editing / Content Creation
- Joseph “J Pash” Patrick
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- Gerson Sandoval
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