I can help people overcome COVID vaccine hesitance, but I have no shots to give: Doctor
I had “the discussion” again on Friday, the one where a vaccine-hesitant patient explained to me why he wasn’t ready to get a shot. He was, he said, still thinking about it.
He was close to 60 years old, overweight, with high blood pressure. I cut through some of the main myths about the mRNA vaccines (Pfizer and Moderna) quickly – they will not alter your genetics or get inside the cell, they will be out of your system in two days, they have been given safely to well over 100 million people in the United States alone. I could see that I was making progress. He asked me about fertility, though it didn’t seem to apply to him, but that furthered my concern that he might be following social media as so many of my patients are.
“There is zero evidence that it affects fertility,” I said, “and in fact pregnant women need to be far more concerned about the impact of COVID than of the vaccine.”
My patient wanted the shot from me
He asked about the Johnson and Johnson vaccine and I explained that the extremely rare risk of a blood clot was way offset by the far greater risk of blood clots from COVID. For good measure, I explained to him the important impact that his having one of these vaccines would have on helping to decrease circulating SARS COV 2 virus, and it turned out he was community-minded, and this notion of protecting the community was what put him over the top.
So he said he’d get a vaccine and asked which one I had to give him.
And then I had to explain that I didn’t have the vaccine in the office yet, though I wanted to be able to administer both the Johnson and Johnson and the Moderna shot, storing the first in my refrigerator and the second in my freezer.
Dr. David Kessler, former Food and Drug Administration commissioner and the Biden administration’s Chief Science Officer in charge of COVID and the vaccine rollout, told me in a SiriusXM interview to air Friday that he’s proud of the rollout but concerned about pockets of non-compliance. As for the role of family doctors, he said the vials of mRNA vaccine work well in large clinics and hospitals, but contain far too many doses for most doctor’s offices. He said the team is trying to find ways to provide smaller vials for use by individual physicians.
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In the meantime, my patient would have to go to either a pharmacy or my medical center’s well organized vaccine center, a quick step that was very easy to accomplish. Unfortunately, any step is sometimes too much for a vaccine-hesitant patient. He hesitated again, and I knew that he would only take the vaccine once I had it available to give to him.
This was our bond, and it was how I administered vaccines regularly to so many of my patients, from flu shots to tetanus boosters to shingles to pneumonia vaccines. In fact, a large percentage of the vaccines administered in the U.S. are by primary care physicians and probably most of these encounters include a one-on-one vaccine-oriented conversation. COVID is certainly no different, despite how severe the disease and therefore how crucial the vaccine.
And despite how effective this vaccine is, administration is now falling off by over 40%, from 3.5 million doses per day to 2 million. While 57% of American adults have already received at least one dose, the latest Kaiser Family Foundation poll reveals that only 9% of those who are still unvaccinated plan to receive a shot as soon as they can.
Pfizer vaccines to kids won’t help much
The FDA extended the Pfizer vaccine to 12-to-15-year-olds on Monday and a Centers for Disease Control and Prevention advisory panel added its recommendation Wednesday, but it is unlikely that these young teens will pick up the slack of the falling vaccination numbers. For one thing, they are more tied in with social media and its proclamations, myths and conspiracy theories, where the supposed threat to fertility and the implantable microchip theories have gotten a lot of play.
Meanwhile, new cases and deaths from COVID are dropping off too, with 22,000 new cases on May 5 the lowest number in almost a year. In order to sustain these gains we need to continue to vaccinate, yet the demand in many states is dropping off, with Wisconsin only planning on using 8% of its offered supply this week, Iowa 29%, Illinois (outside of Chicago) 9%, and the Carolinas, Connecticut and several other states taking less than their allotted doses.
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For another, parents will play a cautionary potentially obstructive role despite the overwhelmingly positive safety and effectiveness data. The same KFF poll reveals that only three of 10 parents of children aged 12 to 15 say they will get their child vaccinated as soon as a vaccine is available. The need for vaccination to protect grandma, whose vaccine may not be as effective because of an immunodeficiency, has not been conveyed well enough.
What can still work is turning to the carrot rather than the current governmental stick. Reopen society, remove all mask mandates, reward the 57% who have received vaccines and are fully protected from the virus. For the rest, it is time we rely on personal choice and responsibility to help bring the immunity ball over the goal line. I and my fellow primary care providers want to serve as coaches, but we need the tools to do so.
Dr. Marc Siegel, a member of USA TODAY’s Board of Contributors and a Fox News medical correspondent, is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. His latest book, “COVID: the Politics of Fear and the Power of Science,” was published last fall. Follow him on Twitter: @DrMarcSiegel