Editor's note: The opinions expressed by the author do not necessarily reflect the opinions of the AAMC or its members.
“What would you do, Doc?”
It’s a question I’ve heard many times over the years I’ve practiced medicine. It’s often asked in the midst of a difficult decision my patient or their family member faces — one where there may be new or so much information that it’s difficult to process. They rely on me, an expert, to say what I would do if I faced the same choice.
Last week I faced one of those choices: I pulled up my sleeve to receive a vaccination against COVID-19. And I hope all of my fellow health care workers will make the same decision.
My decision made me think about “Ann,” a COVID-19 patient who recently asked me, “What would you do?” Ann, in her 70s, was admitted to our intensive care unit at UVA Health with respiratory failure. We were discussing whether to connect her to a ventilator. I held her hand as her family tearfully participated over video chat.
Ann had run a neighborhood restaurant for several years and was loved by everyone who met her. Upon learning of her illness, hundreds of members of the community had sent prayers and well wishes. For a woman routinely enveloped in so much love, in her moment of need, I yearned for her family to be present for such a consequential decision. But the coronavirus has fractured these moments, and we health care workers on the front lines have borne witness to the toll it has taken on our patients and their families.
After I received the vaccination, I felt the weight that I have carried around begin to lift ever so slightly. How amazing that an almost invisible substance in a tiny vial can ease a burden and carry the hope we so desperately need.
I received my vaccination because I am sick and tired of the coronavirus destroying the fabric of our society. In less than a year, COVID-19 has become one of the leading causes of death in the United States. Hospitals across the nation are strained. Children are not exchanging hugs before the holiday break. There has been so much suffering. No one has been spared.
What went into my arm can end this.
How amazing that an almost invisible substance in a tiny vial can ease a burden and carry the hope we so desperately need.
Aside from feeling the sheer urgency to end this tragedy, I also believe the Pfizer and Moderna vaccines are safe and effective. The massive investment from the federal government allowed the development of mRNA technology, which has been around for well over a decade, to accelerate. That allowed clinical trials to be stood up rapidly, combining phases in some circumstances. Clinical endpoints to evaluate efficacy were met quickly because the pandemic has, unfortunately, been worsening. Manufacturing lag time was cut significantly because manufacturing began in concert with the clinical trials.
The medical field mobilized like never before but maintained the integrity of the science. Independent experts advising the clinical trials, the Food and Drug Administration, and the Centers for Disease Control and Prevention all approved moving forward with these vaccines as they would for any others under normal circumstances.
Despite this remarkable achievement, there remains public hesitancy and skepticism. While a recent Kaiser Family Foundation survey found that 71% of Americans indicate that they would likely receive the COVID-19 vaccination, skepticism is greater in some higher-risk communities — such as among Black Americans, who have borne a disproportionate share of deaths from COVID-19.
Many of these concerns are rooted in a simple information gap. For example, in the same survey, 50% of Black Americans who said they probably or definitely won’t get vaccinated are worried they may get COVID-19 from the vaccine. (The first two approved vaccines cannot transmit the disease, as they do not contain any live virus.) There are also rampant conspiracy theories gaining traction, such as that the vaccine contains a microchip or has a tracking capability linked to 5G cellular technology.
One of the hardest barriers to break is a distrust of the federal government to look out for the safety and security of Black Americans. Sadly, this is an earned distrust. The federally sponsored Tuskegee Study on Black men with syphilis, which ended only in the 1970s, is one example; there are many others that have cut deep into our psyche and left multigenerational scars. The University of Virginia, the institution where I work, was historically a proponent of race eugenics, advocating in the early 20th century for sterilizing Black Americans against their consent to prevent a so-called inferior race from propagating.
As health care providers, we must address these issues head on with accurate information and appropriate attention to our patients’ concerns.
Our nation needs this pandemic to end. There is light at the end of the tunnel. I encourage everyone in health care to get vaccinated.
This takes me back to Ann. As with everyone else who had met her, my entire unit fell in love with Ann and her spirit. We cheered her on as she went for several days before requiring a ventilator. By the time we withdrew care, the hand I earnestly held had turned cold from vasopressors, the warmth and spirit I felt before having transferred to my memory.
Ann deserved better than what this virus took from her. Her family deserved to say goodbye to her in a proper way.
Our nation needs this pandemic to end. There is light at the end of the tunnel. I encourage everyone in health care to get vaccinated. Speak with your health care provider if you have concerns about the vaccine’s effect on your health or that of your family. It’s on us to lead by example.
So, what will you do?
Taison Bell, MD, is director of the medical intensive care unit at UVA Health in Charlottesville, Virginia. Follow him on Twitter at @TaisonBell.