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States Grapple With Disinformation Amid Vaccination Efforts

So-called vaccine hesitancy — often but not always based on misinformation — has emerged as a barrier in the effort to reach the “herd immunity” needed to extinguish COVID-19 as a serious health threat.

Asian elder finishes receiving vaccine from inside their car.
(TNS) — A nurse colleague of Dr. John Goldman forwarded him the information that turned her against the COVID-19 vaccine.

Goldman, an infectious disease specialist at UPMC Harrisburg, could easily disprove some of it, including the argument the vaccines don’t prevent the spread of COVID-19. In fact, the U.S. Centers for Disease Control Prevention has concluded evidence points to reduced spread, although it will take more time to know the full extent.

But some took more time and effort, such as the claim 3,000 people died after getting the shot. That’s a true statistic and comes from the CDC’s Vaccine Averse Events Reporting System. In fact, the system logged 4,647 reports of people dying after being vaccinated as of May 17.

However, the CDC stresses, “A review of available clinical information, including death certificates, autopsy, and medical records has not established a causal link to COVID-19 vaccines.” People also must consider the deaths in light of the 273 million doses that had been given.

“They were technically true, but incredibly misleading,” Goldman said of the deaths.

Experts also say even if that many people had died from the vaccine, the odds of dying from the vaccine would still be less than the odds an unvaccinated person who gets COVID-19 will die. About 33 million people in the United States have been infected and nearly 590,000 have died.

“I think we really have to encourage people to get information from reputable sources, and Facebook is not a reputable source,” Goldman said.

So-called vaccine hesitancy — often but not always based on misinformation — has emerged as a barrier in the effort to reach the “herd immunity” needed to extinguish COVID-19 as a serious health threat.

In Pennsylvania, as with many parts of the country, the pace of vaccination has fallen off a cliff, potentially jeopardizing the effort to reach herd immunity and confine COVID-19 to the history books.

Suddenly, the time when people all over Pennsylvania were spending days and weeks trying to line up a vaccination appointment seems a distant memory. “Where the clinics used to be full, now they are not anywhere near full,” Goldman said.

This week, the vast drive-through clinic on the HACC campus on the edge of Harrisburg will stop giving first doses. It will shut down for good after everyone has received their second dose.

Another huge central Pennsylvania site, the Vaccinate Lancaster clinic occupying a former Bon-Ton store near Lancaster, has been giving about 800 shots per day, down from about 3,300 daily doses in early April, according to Dr. Michael Ripchinski, the medical director.

Volume at WellSpan Health, which had been giving about 16,000 first doses per week, fell below 4,000 per week, said Stephanie Andreozzi, the co-leader of vaccination. It got a slight boost after children 12-15 recently became eligible, but it remains to be seen if the uptick will last.

At Geisinger, vaccination sites that had operated six days a week are now open only two days a week, said Dr. Gerald Maloney, the chief medical officer.

“The number of vaccines per day that we’re giving is getting extremely low,” he said.

Statewide, Pennsylvania is averaging about 65,000 doses per day, down from a peak of about 107,000. Nationally, 1.78 million doses per day are being given, down from a high of 3.38 million on April 13.

The good news is it’s easy to walk into a vaccine provider and get a shot with no appointment or wait.

The bad news is Pennsylvania is still a long way from herd immunity, which doctors say requires at least 70% of the overall population to be vaccinated.

Every shot is ‘hard-earned’

As of the beginning of the week, only 42% of all Pennsylvanians were fully vaccinated, with 57% having received at least one dose. Gov. Tom Wolf plans to eliminate the mask mandate when 70% of Pennsylvanians 18 and older are vaccinated. As of Tuesday, 52.1% of Pennsylvanians in that age group were fully vaccinated.

“From here on in, each shot is going to be hard-earned,” Acting Secretary of Health Alison Beam said.

Beam expressed confidence the state will reach Wolf’s goal. She pointed to the number of Pennsylvanians who have received a first dose and are within the three- or four-week waiting period for the second dose that will make them fully vaccinated.

“We’ve seen folks follow through with that second shot and so in the requisite three- to four-week period we are likely going to be very close to meeting that 70% goal,” Beam said.

The challenge now, she said, is “making sure that folks feel educated and confident in the safety and the efficacy of the shot, so that they actually get it when it is so accessible to them.”

Still, Wolf’s mask threshold, based on people 18 and older, is short of the threshold recommended by most experts, who say it will require vaccination of at least 70% of people of all ages, and possibly as much as 85% of the full population.

Doctors and public health officials across Pennsylvania say most people who were eager for vaccines have been vaccinated. They figure there remains a group who are at least somewhat open to vaccination, but haven’t done so because it hasn’t been conveniently available, or they need a little more information to overcome their uneasiness.

“We need to search out the groups that statistics tell us aren’t being vaccinated, yet don’t seem to be in the anti-vaxx group,” said Geisinger’s Maloney. Finding them is no simple task, he noted.

Beyond that, there’s a group of people who are hard set against a COVID-19 vaccine. Much of it seems to result from vaccination becoming politicized. Recent studies, for example, find about 40% of Republicans don’t intend to get vaccinated.

Misinformation plays a role.

Maloney described “popular misconceptions” he encounters. One involves the belief COVID-19 vaccination interferes with fertility, especially among young women, which he calls “entirely false.” Another involves a belief the vaccine contains cells from aborted fetuses, which is also false. Another is that vaccination is “all about the money.” That one, he said, was boosted by recent news that people might eventually need a booster dose to stay immune.

However, Geisinger has hundreds of employees who have been devoted full time to vaccination for months, but receive no reimbursement for their work, according to Maloney.

“We’re not making money on the vaccine effort,” he said.

Ripchinski, the leader of the Lancaster mass vaccination site, is a family physician with Penn Medicine Lancaster General Health. He said Lancaster General surveyed employees regarding vaccine hesitance. The survey found concerns related to the speed with which the vaccine was developed, and the safety of the technology used to develop the Pfizer and Moderna vaccines, called mRNA. Yet mRNA was discovered nearly 20 years ago at the University of Pennsylvania, the parent of Penn Medicine.

Meanwhile, with news such as recent images of bodies being burned outdoors in India because the funeral industry was overwhelmed, Maloney marvels that such disagreement over COVID-19 exists.

“Why people just don’t seem to be able to look at all the evidence and come to the same conclusion is very, very frustrating and concerning,” he said.

Taking shots to neighborhoods

As an incentive toward vaccination, some states are holding lotteries with prizes of $1 million or more for people who have been vaccinated. Some cities and businesses are doing things such as offering a free beer after vaccination, a different twist on a shot and a beer.

Beyond that, the overall strategy in many places has shifted to a more deliberate, time-consuming ground game, where each dose, as Beam said, is “hard won.”

In Pennsylvania, it includes a shift away from mass vaccination clinics to mobile efforts aimed at finding people who aren’t vaccinated and bringing doses as close as possible. Much more of Pennsylvania’s vaccine supply now goes to local doctor’s offices and pharmacies, with most pharmacies in Pennsylvania giving shots.

Another big part involves local health care providers and the state collaborating with local leaders and organizations such as churches to find and take doses to people who often struggle to obtain quality health care, such as racial minorities.

Beam said “we continue to make strides” in reaching minority and underserved groups. But she added, “I think we all know that we still have work to do to make sure more Pennsylvanians are vaccinated, across all of our communities, but particularly those that might have less access to health care traditionally.”

WellSpan Health has begun deploying teams to take vaccines as close as possible to the underserved and the hesitant. It collaborated with LifePath Christian Ministries to vaccinate the homeless, Andreozzi said. It has focused on the homebound and is collaborating with community groups, churches, schools and businesses.

“We have employees of companies saying if you bring the vaccine to us, we’ll consider the shot,” she said.

Doctors say persuading the hesitant to accept a vaccine involves a “shared decision” based on information and trust.

“That’s what we need to do next,” Ripchinki said. “That is the heavy lifting of what is public health. Whether it’s air, water, you name your initiative … it requires communication and engagement of leaders across the community to help people understand and, hopefully, make a good choice for themselves, their families and the community.”

Andreozzi expects the shift to vaccinating people in their doctor’s office or pharmacy will chip away at hesitancy.

“Setting up large-scale vaccination sites is not the way we typically receive other vaccines,” she said. “Getting back to that model where people feel a little more comfortable and have those conversations, one on one, I think will be very impactful.”

UPMC’s Goldman believes “a decision not to get the vaccine is a decision to get COVID.”

He brings up a statistic shared on Facebook which says 199 out of 200 people who get COVID-19 survive. Yet based on that, if 30% of people go unvaccinated, it would equal roughly 100 million people in the United States, resulting in 500,000 deaths.

“Those are a half-million deaths that don’t have to happen,” Goldman said.

He noted it would amount to 25 times the death toll of a normal flu season and 10 times the toll of a severe one. Plus, the evidence shows people who get a COVID-19 vaccine rarely end up in the hospital, let alone die.

Goldman, although frustrated by the prevalence of misinformation, remains confident we’ll reach herd immunity by way of vaccination, rather than by natural infection and the unnecessary deaths it would entail.

“I think we’re gonna get there,” he said.

In fact, Goldman marvels at how many doses — nearly 289 million as of Monday — have already been given in the United States.

“We asked a huge percentage of the population to be early adopters of a new medical treatment quickly, when it first came out. That’s a very hard thing to do,” he said. “I think the number of vaccines that have ended up in arms is actually kind of amazing.”

© 2021 Advance Local Media LLC. Distributed by Tribune Content Agency, LLC.