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    Transcript: VaccineVoices: COVID-19 Vaccine Myths Debunked

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    Introduction: The CDC reported in mid-April that more than 50% of Americans above the age of 18 have received at least one shot of a COVID-19 vaccine, but there are still many others who do not want to get vaccinated.

    Concerns around the speed at which the vaccines were developed, along with questions about the government’s involvement, the risks for pregnant women, and skepticism about whether the vaccine will work on coronavirus variants have all been circulating around the country. Meanwhile, conspiracy theories and misinformation circulating on social media and within certain communities have boosted concerns and myths about vaccines. And herein lies the challenge for health care personnel trying to convince a wary portion of the public that the COVID-19 vaccines are safe and effective.

    On this episode of “Beyond the White Coat,” we’ll talk with health care providers and experts to share accurate information about the COVID-19 vaccines. This conversation was recorded on May 4, 2021, and all data and information are accurate at the time of recording. This is the second of three episodes we’ll be sharing as part of an AAMC project funded by a cooperative agreement from the Centers for Disease Control and Prevention.

    Rosha McCoy, MD: Welcome to today's podcast. I'm Dr. Rosha McCoy, the AAMC senior director for advancing clinical leadership and quality and the principal investigator for the AAMC cooperative agreement with the CDC to promote confidence in the COVID-19 vaccines. Today, I have the pleasure of talking to Dr. Zanthia Wiley, an infectious diseases expert and director of antimicrobial stewardship at Emory University School of Medicine in Georgia; Dr. Earic Bonner, a primary care physician and medical director from Vidant Health in eastern North Carolina; nurse practitioner Mamie Williams — soon to be Dr. Williams as she's finishing her PhD in nursing — who serves as the director of nurse safety and well-being for Vanderbilt University Medical Center in Tennessee; and the AAMC's very own Dr. Ross McKinney, our chief scientific officer and an expert in infectious diseases. We're fortunate to have all of them as advisors for our vaccine confidence project with the CDC.

    So, thank you for joining me, and we're going to dive right in. So, in all the conversations that health care providers may be having with their patients and communities right now, so many of these conversations are around vaccines — and some of them are around concerns that folks have about vaccines. And it's important, really, to not dismiss these concerns that people may be having. And let's be honest, we're all navigating this with our friends and family too. We must really work to understand why people believe what they believe. And sometimes some of those beliefs may not be based in the current science, but we also have to acknowledge that some of the signs and medical recommendations regarding COVID-19 — because it's a novel virus — have changed over time and that may contribute to some of the confusion. So, let's really face these questions and concerns head-on and really think about this together. So, I'm going to ask all of you to tell me what you think is the most common or the most difficult myth or concern that you've had to deal with. Maybe we'll start with Zanthia on that one.

    Zanthia Wiley, MD: Absolutely. So, Rosha, a lot of the questions that I receive have to do with how quickly the vaccines were developed — and that's the vast majority of the questions that I receive: “Is this safe? This seemed to have happened within nine months; how do I know that it wasn't developed so quickly? Were any steps skipped?” So, what I always start off by telling people is that their questions and their concerns are totally valid, that these are great questions to ask, and that a lot of this work that was done on especially the messenger RNA technology — that this work started way before we even knew what COVID was, before COVID was even a thing.

    So up to 10 years ago, a lot of this work was being done with messenger RNA technology on the Ebola vaccine and with MERS as well so that we had some basis to start off with respects to the vaccines. And that most importantly, none of the steps were skipped — that the FDA goes through several different phases and that none of these phases were skipped. And that a lot of the research was done on young, healthy people to start. And then it was transitioned to older people and other people with medical conditions. So, it's all about ensuring and making sure that everyone knows that — did it happen quickly? Yes. But were any steps step skipped? Absolutely not.

    Rosha McCoy, MD: Very helpful. Very helpful to hear. Ross, do you have anything to add to that? I know you're probably hearing this a lot as well from lots of different folks.

    Ross McKinney, MD: Well, there are a couple of myths that I pay attention to. One is that this is experimental. And as we've just heard, it's not. It's now been given to more than a hundred million people, so it's not an experiment. And it wasn't that rushed, as we've heard. Also: “Is it contagious or is it going to stick around in my body?” And the answer is no — it degrades. So, the vaccine is there and then it's gone, but the immune response lasts.

    And then there seems to be this concern that, at some point, there's going to have to be a booster. And that doesn't worry me because there are lots of vaccines that have required boosters. But I often get that as a question: “Will there need to be a booster?” And even if the answer is, “Yes, sometime in the future there will be,” that doesn't sway me from suggesting that it's a good vaccine to get now.

    Rosha McCoy, MD: Great. Thank you. Mamie, anything specific that you hear all the time that you want to share?

    Mamie Williams, MPH: Yes, absolutely, Rosha. So, I was able to volunteer as a contact tracer beginning of March 2020 for a full year, speaking to middle Tennesseans who were either recently diagnosed with COVID or had been in close contact with someone. And I often heard, despite the person being positively diagnosed as COVID-positive, that they did not believe COVID was real and that they did not consider it anything they needed to concern themselves with, despite the positive diagnosis. So, they would refute that the diagnosis was accurate somehow. It was inaccurate.

    So, having to talk to folks about their symptoms, and how their symptoms were in fact a representation of them having COVID, and having repeat conversations with them when unfortunately their illness would progress and they would have more severe symptoms. And so, just having to work with folks to have them believe that the illness they were currently diagnosed with actually existed and then going on to have to speak with them about the need to — "Yes, you have been infected with it, but you will still need to vaccinate so that you're not able to spread it and that you're not able to contract it." Although it's a small number of folks who contract the illness a second time so that they wouldn't be at risk for that. So that was...

    Rosha McCoy, MD: Yeah, I think working with folks who don't even believe that COVID is real makes it extremely difficult to have a vaccine conversation with them — and trying to come to really understand why they got to where they were, I think, is a really important piece, and spending that time to try to understand. Earic, I know you work in rural eastern North Carolina; are there things that are unique maybe to that population that you've heard that are a little bit different, or not?

    Earic Bonner, MD: I wouldn't say anything unique. I think we all get pretty much the same questions and concerns across the country. I would say one of the things that I battle at this point are people's fears of what they've heard from other people who've gotten a vaccine — potential side effects and that kind of thing, and especially now with some of the concerns about Johnson & Johnson.

    And so, I like to let people know that you're going to feel your immune system working, and you are going to know for the most part that you got a vaccine, and that's okay. Some people may have fatigue or a little bit of fever and chills like I had, but they don't last long. Mine lasted about 12 hours. I've heard a couple people say a couple of days. We've seen “COVID arm,” as we call it — which is harmless, just a little annoying. But none of these are as significant as some of the issues we see when people get COVID — and trying to make sure that we not only look at risk but also look at benefits. And there are not any patients that I've ever seen that the risk of the vaccines outweighs the benefits. So, we pretty much recommend it for about everybody, and the vaccine is safe. That's why we all got it and why we recommend it for our families.

    Rosha McCoy, MD: Yeah. I think that emphasis on the fact that we as physicians and nurses and other health care personnel are lining up to get this vaccine — and pretty high rates of vaccination, particularly among physicians and other clinical folks. So, I think that's a really good point to make. Say a little bit about COVID arm, because I know that it's coming up more lately — that I've heard of a little bit more, just because we're giving more vaccines. So, say a little bit more about that.

    Earic Bonner, MD: I've had a few people that have had a little swelling and soreness of their arm — mostly soreness. I try to educate people on how the vaccine works. So, as Dr. McKinney said earlier, this shot works in your shoulder muscle. It doesn't last long enough to really get into your circulation and all of that — especially Pfizer and Moderna. And so, when that immune reaction's happening in the shoulder, then you may have some soreness. And like I said, that's OK. I usually tell people, "Look, if it's really bothering you after a day, you can take a Tylenol and use some ice, but it does go away. It's not a big deal, just a little annoying, but that's the extent of it." If it is something of concern, call your doctor, but they're pretty much going to tell you, “Take a Tylenol and put some ice on it. And we'll see you again in a few weeks, it'll be gone.”

    Rosha McCoy, MD: And some people are getting that a little bit — even later, right? Some COVID arms, some swelling even a little bit later, which is also totally normal and tends to go away with time. So, yeah. So, Mamie, one of the things we tend to hear is that, “These vaccines weren't tested on people like me, and I want to wait until more people get the vaccine.” Is that something you've heard? And if so, how do you respond to that?

    Mamie Williams, MPH: Absolutely, Rosha. It is something that I hear, and I hear it frequently. And as Zanthia pointed out, the vaccine has been given to more than — here in the U.S. — 40 million folks. 240 million doses have been distributed. So about 30% of the U.S. population is fully vaccinated and at least 50% of the U.S. population has had at least one dose. So, it's been given to a number of folks. It's very safe. There are mechanisms in place that monitor the vaccine, once it's administered, to ensure that people are safe. A great example, as Earic pointed out, is the Johnson & Johnson, where after 6.8 million doses, six 18- to 48-year-old females developed blood clots and it was removed from the market so that they could further study it. And that is all a part of the ongoing monitoring that happens after folks are vaccinated. So, it's been shown to be both safe and effective.

    It's been given to a number of Americans, and it was tested, as Zanthia pointed out, extensively across — as an example, the Pfizer was tested in Germany, Argentina, Brazil, the U.S., and South Africa. And about 30% of the participants were racial and ethnic minorities in U.S. terms and amongst folks who were 50 and older as well. So, it was tested across a wide swath of folks, across a wide demographic, and shown to be as effective and as safe in all of those different demographics. So — just one of those things we have to deal with and just be prepared to answer anytime we hear it from folks.

    Rosha McCoy, MD: Yeah. And I think that point you made — that millions of doses are also now being given and all of that is being monitored very carefully, and we're getting data from that, again, showing very significant safety profile — is very important. Let's talk a minute about the J&J. Do you think that that has created more concerns in your practice, Earic? What — are you hearing that from folks?

    Earic Bonner, MD: My practice is tough as an example because most of my patients were already vaccinated, but in the community, I do hear more concern. But it has been an interesting opportunity to explain to people why their concern is a little bit misguided because, as Mamie said, the pause was proof of how closely these vaccines are watched and scrutinized. And so, for everybody who's ever had a concern about them, that pause is like confirmation that it's going to be OK. The chances of having the clotting that happened with Johnson & Johnson are slightly less than the chances of being hit by a falling satellite. And I am thankful that there is enough scrutiny that we say, "Hey, let's pause this for a little bit," to make sure that all of our physicians and nurse practitioners and PAs (physicians assistants) know how to recognize this and how to treat it because that's really what the pause was all about.

    And I do believe that if Pfizer and Moderna weren't available, we probably wouldn't have paused it because then the risk wouldn't have outweighed the benefit. But when there are other options, it's OK to say, "Hey, let's stop this for 10 days. Let's make sure everybody's on the same page." It was the equivalent of a timeout in sports, and then we get it back and now we're doing it again. And we're fine. Some of my family has gotten J&J after the pause, because I still feel that the benefit of it outweighs the risk.

    Rosha McCoy, MD: That's a great analogy, like a timeout. I think that's a really good point that this is how science is supposed to work. It's — we're supposed to study these issues. This happens with drugs. It happens with other medications and vaccines, and we watch that very carefully and the information is fully available to everyone. And the treatment issues were the most pressing to stop and make sure people can identify it and treat it appropriately. So that was really, really helpful.

    Ross, one of the things a lot of folks who are nonmedical are now talking about herd immunity. So, let's talk a little bit about herd immunity and some people saying that, "I'd rather get COVID and get immunity that way and achieve that in the population by actually getting the disease rather than the vaccine." So, we heard a little bit of that early on, even before the vaccines were developed. So, what do you say to that?

    Ross McKinney, MD: Oh, when people mention, "Oh, I'd rather get the virus," I just say, "Well, think about people who lived in Manaus, Brazil." Because in Manaus, Brazil, there was a large community who had COVID with the original strains. Then the variant P1 came through. All those people got it again. And they got sick enough that many of them died. So, it is far better to get the vaccine, which is protective against that P1 strain, than to just rely on immunity. We also know that for people who have a relatively mild case, the immune reaction is not enormous. Yet, it almost always is against particularly the mRNA vaccines. Johnson & Johnson also does a good job of kicking up a very good — what appears to be — long-lasting immune response. So, that would be my response.

    Rosha McCoy, MD: Great, thank you, absolutely. So, Zanthia, one of the things we often hear with the flu vaccine — and now we're hearing it with the coronavirus vaccines — is, "I am worried about getting coronavirus from getting the vaccine." I know we touched on that a little bit, but I really want to focus on that one because I think we keep hearing it, even among health care personnel. I know we hear it for the flu vaccine as well. So, can you talk a little bit about — I know the coronavirus vaccines are a little bit different from the flu vaccine even, but can you talk a little bit about what you say when you hear that?

    Zanthia Wiley, MD: Absolutely, Rosha. So, what I start off by saying is that definitively, without a doubt, this is not a live vaccine — that there is absolutely no live virus present. And I like to explain to people that with the messenger RNA, what you have is a blueprint. So, the messenger RNA is a blueprint for your body to make a protein — just the protein, not the entire virus — to make that protein. Then your body responds to that protein and appropriately thinks that it's actually the virus. And that's what gives you the symptoms that you should actually expect. What I tell people is: If your arm was sore, if you had some low-grade fevers, if you had a headache, this is totally to be expected. And it lets you know that your vaccine is working appropriately. So, I think that the key is — is being very definitive and saying, "This is not a live vaccine." There are some that are live, but the COVID vaccines are not.

    Rosha McCoy, MD: Very helpful, thank you. I think that's a really important message to deliver because I do think we hear that quite a lot from folks and then some people interpret the side effects as getting sick from the vaccine. So — really important to make sure we're making those differentiating points. Now that the variants — that there seems to be a lot of focus with the media and others about the variants... So, there's some concern that the vaccines won't work in the variants. Earic, is that something you're hearing among your patients? Are you hearing some of that? Of course, most of your people are vaccinated, you said, but...

    Earic Bonner, MD: Yeah, we do. I mean, that's the concern, even for vaccinated people. Like what we talked about before that we're going to need boosters because of variants. So, I think that question is pretty common. But a few people are saying, "Why do I need to get the vaccine if it's not going to work with the variants anyway?" And so — just trying to educate them on getting it and we'll cross the variant bridge when we get to it. But as far as the variants we have now, we do know that the vaccine works.

    Some of them may not work equally with all of the variants — like the South African variant, for instance, with Pfizer and Moderna, it doesn't create quite the same immune response, but we know that the immune response is good enough for some immunity. And so, you're protected with the vaccine against those variants. But it's still important, because of the variants and the risk of more variants, to still wear the mask, wash the hands, keep the distance, even if you're vaccinated. So, I think just reminding people that just because you've had your vaccine, you can't completely relax yet, is the important conversations to have about variants.

    Rosha McCoy, MD: People seem to get very focused on a specific variant or want to talk about all the different kinds of variants, where I think we need to get them focused on the vaccine and not so much the variants. I think there's wording used around mutations and people are imagining things about the virus that's happening. Is that — Ross, can you just speak a little bit about mutations? And is that something to be expected obviously in viruses? And can you just speak a little about that for us?

    Ross McKinney, MD: Sure. Well, viruses frequently mutate, and RNA viruses are particularly susceptible to mutating because they don't do what's called error checking. When they make a copy of themselves, it's a sloppy copy. And so, the virus constantly changes itself. But coronaviruses are different. They actually have what's called proofreading. So, they actually have an enzyme that checks to make sure they're correct. So, they mutate at a slower rate than a lot of other RNA viruses, which means the same strains keep going around. Because if we have lots of mutation, we'd be seeing many strains. And as I said, we see strains that are defined spreading through communities.

    So, it's an expected part of a virus and it's something that we actually can adapt with and deal with because, for example, we know that people who had the South African strain — the B1351 — those people are pretty much immune to all the other viruses that we know about, because they've taken their sera and studied the other viruses and shown good immune reactions. So, we could make a virus using that — or a vaccine using that virus as the core and probably create what would be a pan-COVID vaccine in the future.

    Rosha McCoy, MD: Yeah, I think that's really an important point — that the technology that we've used to develop the vaccine so far are going to help us react to the variants if they developed, become a problem against these particular vaccines. So, I think that's a really good point. Earic, did you have a point to make?

    Earic Bonner, MD: And I'd also say to my patients, especially, the quicker everyone gets vaccinated, the less likely that we're going to see more variants. And so, being afraid of variants is more of a reason to get vaccinated soon because a virus that doesn't have a host can't change. And so, that's a really important point for pretty much all the people who are a little hesitant about getting it because of that.

    Rosha McCoy, MD: Yeah. That's a very good point. The best way is to decrease the amount of virus that's circulating. And the way to do that is to get vaccinated and get as many people as possible vaccinated. So, that's very, very helpful information. So, I'm going to probably come to all of you just to get your view on this. I think the issues around infertility have been really perpetuated in many different settings that we've been hearing, whether people are meaning to do it with accurate... There's no accurate information here, but it almost, at times, seems it can be somewhat malicious because there's so much misinformation. But let's talk a little bit about infertility, separate from pregnancy. We'll talk about pregnancy in a minute. But what are you hearing around the issues of infertility and people's concerns? Are you hearing concerns, Zanthia?

    Zanthia Wiley, MD: I'll be honest with you, not often. I hear it, I feel like, more in the media and sometimes on social media than what I'm actually hearing from patients. I did have one young woman — she was an ICU nurse in her early 30s looking forward to having a child, and she had some hesitation about getting it done. She asked great questions. I answered those for her, letting her know that we have absolutely no data, no scientific evidence saying that there is any association with infertility. And I also send people — because sometimes them listening to an infectious diseases doctor or their family practitioner isn't enough — I send them and say, "Speak to your gynecologist about this. Go to the American College of Obstetrics and Gynecologists. Go to their website because it's wonderful that they actually have it there in black and white, that there is no evidence behind this."

    So, it's easy to hear from your primary care doctor, easy to hear from me as your infectious disease doctor, but go to the source of who can give you the best information, and that is your OB-GYN. You can go to the CDC website. So, I think it's all about talking to individual people, talking to individual patients, and letting them know that that's not the case, answering all of their questions, no matter how and no questions are trivial. You may think, "Hey, tell me why you think that," but open those ears, listen, and explain things to people. And you'll be really surprised at how often, at the end of the conversation, she says, "OK, sure. That sounds like a plan." And she ended up getting vaccinated. It's all about being a listening ear and answering those questions from anyone who asks.

    Rosha McCoy, MD: Yeah, that's exactly right. That's fantastic. Mamie, is that something the infertility question that's coming up in folks that you're talking to as well?

    Mamie Williams, MPH: It has recently. And I think part of it is that there is a very savvy social media person who propagated that myth and that rumor, and the platform that they use looks really official. So, as Zanthia mentioned, one of the ways that we try to refute it is to have folks to go to the places like the CDC website that discusses it in particular and how that particular social media post talked about the proteins being the same. And it sounded really scientific, but it just was not true in any way, shape, form, or fashion. And so, having folks to go to reputable resources to get their information seems to help with those fears.

    Rosha McCoy, MD: Yeah, that's a really good point. It is hard for folks to sometimes sort out what's official information on social media and what's a reliable, accurate source. So, trying to lead people to the places that there is accurate information that they'll trust is a really, really good point. Ross, anything on this? Because this infertility question — I know young men have heard about this on college campuses — is also causing issues. Have you heard anything more?

    Ross McKinney, MD: I haven't heard anything on the male side. What I've read has been mostly because of those fake social media posts. It's been made into something that looks real when it isn't real, which seems to be all too common these days. And my answer would be, “Think about it. What would be more likely to damage you in the long run: Having COVID or getting the vaccine?” And I can assure you getting COVID is much more likely — and particularly if you are pregnant — it's much more likely to lead to a bad outcome than getting the vaccine.

    Rosha McCoy, MD: Yeah. I think we definitely know that pregnant women are at high risk with COVID infection. So, I think that's a really, really good point around pregnancy. Earic, did you have anything that you've come across?

    Earic Bonner, MD: Just to echo Ross' point, there is a study going on right now in Florida looking at how the virus affects fertility in males. And so, that will be interesting to see the results, but we do know the vaccine doesn't cause any issues. I will say, as far as pregnancy, I think it was Zanthia earlier who mentioned the American College of Obstetrics and Gynecology, and they have come out over the last couple of weeks and said that there is data now that pregnant women are able to pass those antibodies on to their babies through either pregnancy or through breastfeeding. And so, during pregnancy, getting vaccinated as early as possible in the pregnancy is better. And so, we really recommend it for our second trimester ladies, and we do know that it's safe for them to be able to get vaccinated and much better for the baby after the delivery.

    Rosha McCoy, MD: Yeah. And I think the CDC is also tracking all those deliveries and have seen no negative outcomes in babies at all. So that's great, and if anything, very positive outcomes. I guess the one other thing to discuss is around some of the ways to approach folks that may come from different points of view. We are hearing more about maybe rural populations of folks and conservative folks who have concerns. Are you running into those patients, Mamie, that require maybe a little bit of a different approach? Have you heard some of those concerns?

    Mamie Williams, MPH: So, I will say this — not so much rural, unbelievably in middle Tennessee, but I'm in Nashville, a fairly urban area. But what I will say is that we hear from the same patients over and over again the same concerns and the same myths that they wholeheartedly believe. And so, finding a way to give them the information in fresh and new ways to help them to — as Ross pointed out — realize which would be worse, contracting the illness or getting the vaccine, can be where you spend a lot of your time.

    And part of what I've been able to do — going out into the community and to churches and talking to folks — is that I'm able to connect because I'm a member of the community. I'm a member of those church settings, and I've been vaccinated. My mother's been vaccinated. We talk about that in and around our circles and that's helped. And so, I think that's one thing that health care providers across the board will have to be more willing to do — is to continue to have the same conversation sometimes with the same people to be able to help them to realize which would be a better outcome for them, getting the vaccine or not.

    Rosha McCoy, MD: Yeah, I think that's a really good point of making sure that when somebody maybe initially says no, that we don't just say, "OK, they said no," but to reengage folks — continuing to engage folks so that we keep them, know that we care about them and make sure that we're coming back to them. Is that... Earic, I know you're in rural. You work in rural communities. Yeah. Tell me what you're hearing around some of these issues.

    Earic Bonner, MD: Yeah. I'm in a “no stoplights” kind of area, but the interesting thing here has been — there have not been a lot of people who are just unreasonable. I think there are people who believe what they believe because of the media outlets that they're watching or the social media people that they follow. But people tend to trust their physician or their health care provider if they're seeing an APP. But I think being able to have a conversation where people feel heard and are able to voice their concerns and have their questions answered in a way they understand from a person they trust. I think we've seen that that works. Unfortunately, having one-on-one conversations with 300 million people takes time, but it works. And I think that we have to continue to have those conversations — as Mamie said, continue to remind people how important this is and how they're part of a group project is the way I tend to say it.

    Everyone remembers the group project in high school where a couple of people didn't do their part and everybody gets the same zero. And so, we have to hold each other accountable for being a part of the group and just to make sure that everyone understands how they fit into the bigger picture, because currently, we live in a world of individualism. We don't always see each other as a part of this big group project. So, I try to remind them of that and answer questions and be completely honest and transparent with people. And I think that's a recipe for eventually getting more people vaccinated.

    Rosha McCoy, MD: I love your analogies: timeouts, group project. This is perfect, yes. But yeah, I think the idea of the — engaging with the primary care physician who people trust is something we've got to continue to understand better, especially as we get to the folks who may be in this movable middle, and even folks who initially refused. If we can really get people who they trust, like their primary care provider or local pharmacist or nurse practitioner, I think all of those folks are really important in the work that we're doing.

    Let's talk a little bit — I think you mentioned the individualism. I think we are hearing from some individuals who won't get the vaccine because they believe their rights are being infringed, right? That somebody's telling them what to do. And in other examples, there are some consideration about colleges and others mandating the vaccines. What kind of response are you hearing from folks you're dealing with, particularly those you're working with around those kinds of issues? Zanthia, is that anything you've heard about?

    Zanthia Wiley, MD: So, I'll be honest with you. Not really, but I think it's because I live in Atlanta around Emory, and a lot of people in my inner circle are all about vaccines. But things are different when I go home to southern Alabama. People definitely are saying, “Oh, it's my right not to have to get the vaccine. We don't want big government, etc.” But what I like to tell people is, “There are rules that we have for your individual safety and for public safety. We have to wear our seatbelts, you have to go through security when you go fly, so a lot of these things are not just about us, but they're also about the big picture.”

    And another thing that I found really helpful in connecting to folks when they say, "Oh, I feel like people are trying to make me do something that I don't want to do" — I really think that what connects us all is we all love our families. We all love our friends. And when I'm talking to people about vaccines, I always ask, “Who do you live with? Who's the closest to you?” And sharing with them how them getting the vaccine will decrease the likelihood of them transmitting something to their grandmother with diabetes, their nephew with sickle cell, their loved one who happens to have cancer. So, taking it from an individual conversation about how it may affect you — and some people aren't really feeling the responsibility of everyone in the United States, but what people love are their loved ones. Yeah. So, having those conversations with them about what they can do to protect their families.

    Rosha McCoy, MD: Yeah. I think that's really important. I think, again, emphasizing that there may be people — you mentioned the loved one with cancer, that loved one with cancer may not be able to mount as good an immune response as a healthy person. So, we need to make sure everybody's protecting all these vulnerable folks within our communities. Even if they're vaccinated, I think is an important piece. I mean, the vaccine will be protective, but it may not be as protective for some folks with chronic health conditions like cancer, for example, who are on chemotherapy, for example. I think that's important. Ross, does that make sense? Is that how we would...

    Ross McKinney, MD: That makes very good sense. I like to think about it, or I have people ask the person, “Are you worried about COVID? Are you worried about catching it? Are you worried about spreading it to friends? Are you worried about going to the store, to church services, to getting together with people, either because you'd catch it or spread it?” And if any of the answers is yes, then you could be relieved. You don't have to have that worry, because the vaccine will take care of it. And then you don't have to be so concerned about these things, or you don't have to worry about infecting your grandmother or infecting somebody else that you care about. I tend to try and make it personal and say, “I acknowledge,” and most people are worried who aren't vaccinated. And I can say, even in my case, getting my second dose two weeks later, I just felt like a weight was off my shoulders.

    Rosha McCoy, MD: Yeah. Very much so. Very much so. I think I'm going to end with one question maybe for Mamie and Earic to think about and give us their best answer. If you could speak directly to folks who are concerned about getting the vaccine, what's the one message you would want them to hear right now? Earic, any response to that?

    Earic Bonner, MD: Yes. I would say, “Remember that you always have someone you can talk to.” Primary care, urgent care. That most people, if you really try, have access to a health care provider. And if you ever have questions that are specific to your condition, your issues, things that you've heard, then there are people who are available to answer those questions. And a lot of times, random people on the internet probably aren't the best option, so please talk to someone who gets paid to answer those questions for you and who you can trust. And that would be my advice. If you don't have a physician, you are probably healthy enough to get your vaccine. And so, we recommend it and we stand behind it. It's why we got it. And I would say, “Please do your part.:

    Rosha McCoy, MD: Great. Mamie, anything else?

    Mamie Williams, MPH: Sure, I'd like to just piggyback on what Earic said — and I think, of course, speaking to your trusted health care provider is of course a great way to approach it, but also if they would talk to the folks in their circle who they know that have been vaccinated and find out from them what was the deciding factor for those folks? Talk to them about what it's been like since they've been vaccinated. As Ross pointed out, that sense of relief of knowing that you won't be able to transmit this to a loved one. And as Zanthia said, those are the folks that they love.

    So, if you have someone in your circle who has been vaccinated, after you've exhausted talking to health care providers, and maybe you're still leery or whatever, speak to those in your circle who have gotten it, and what convinced them. And just have a real robust discussion around how well they feel now that they've been vaccinated. And I think for a lot of folks, just reminding them that we won't get to this new version of the pre-COVID normalcy until we have enough folks vaccinated — and that's one thing that I always work with folks to understand.

    Rosha McCoy, MD: Very good. Thank you to all of you for joining us on “Beyond the White Coat,” and we want to thank you for everything each of you is doing in your communities during these very, very difficult times. I've learned a lot from all of you. And for those who are listening, if you're not already vaccinated and still have questions about COVID-19, just like Dr. Bonner said, and Mamie — also soon-to-be Dr. Williams — said, talk to your doctor, your nurse, your local pharmacist, or a vaccinated family member. And visit cdc.gov and your local county health department website for the latest information on COVID-19, the COVID-19 vaccines, and where to find them. Thank you very much.

    Closing: This Association of American Medical Colleges project is funded by a cooperative agreement from the Centers for Disease Control and Prevention (CDC): Improving Clinical and Public Health Outcomes through National Partnerships to Prevent and Control Emerging and Re-Emerging Infectious Disease Threats (Award # 1 NU50CK000586-01-00). The Centers for Disease Control and Prevention is an agency within the Department of Health and Human Services (HHS). The information included does not necessarily represent the policy of CDC or HHS and should not be considered an endorsement by the Federal Government.