Transparency, equity key to COVID-19 vaccine rollout

As the nation prepares to vaccinate millions of people against COVID-19, making sure community members — especially in communities of color where vaccine hesitancy can be high — play a role in vaccine outreach and education will be key to success.

"It's important that we ask these communities, ‘Who do you trust right now?’" said Noel Brewer, a professor at the University of North Carolina Gillings School of Global Public Health, during the latest COVID-19 Conversations webinar hosted by APHA and the National Academy of Medicine. "We can no longer have only Dr. Fauci up there."

Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, is widely seen as a respected and trusted public health voice who’s been calming fears and elevating science since the beginning of the pandemic. As widespread vaccination efforts ramp up in the coming months, his voice should be heard alongside people living in higher-risk communities, as well as local public health officials and trusted providers from hospitals, clinics and pharmacies, said presenter Katie Greene, visiting policy associate at Duke-Margolis Center for Health Policy.

"States are really where the rubber hits the road,” said Greene, who had a hand in the report released this week by Duke-Margolis, the COVID Collaborative and National Governors Association on “Supporting an Equitable Distribution of COVID-19 Vaccines: Key Themes, Strategies, and Challenges Across State and Territorial COVID-19 Vaccination Plans.” She and other webinar presenters covered the breadth of vaccine-related challenges in the coming months, including:

• How to convince everyone to continue wearing masks, keep physically distancing and washing their hands as the vaccination process stretches on.
• How to ensure priority groups, such as health care workers, get vaccinated, while also readying the rest of the nation for a two-dose vaccine.
• How to counter the vaccine hesitancy and skepticism that can spread like wildfire during such contentious and stressful times.
• How distribution could and should differ between rural and urban areas, particularly considering one of the top vaccines requires ultra-cold storage.

Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, is a member of the Food and Drug Administration advisory committee that met the day after the webinar to vote on granting emergency use authorization for Pfizer’s COVID-19 vaccine. That vaccine, and a Moderna-produced vaccine the committee will vote on next week, have great safety and efficacy records so far.

"We know that these vaccines appear to be 95% protective against disease, 90-100% effective against severe disease, up to 95% effective for people older than 65," Offit said during the webinar, titled 'Vaccines: The Realities of the Next Steps.' "It's remarkable."

But Offit agreed “it’s reasonable to be skeptical of anything you put into your body, including vaccines." However, data from the vaccine trials "should calm fears."

"I think it's reasonable to be skeptical. We want to see the data. And I think the challenge for us as this vaccine rolls out is to make it clear to people what we know and what we don't know," Offit said. "There is a humility that has to be associated with this endeavor."

That means everyone involved in the vaccination effort should be transparent. As Offit said, make sure people know we don't know everything.

Webinar moderator Jewel Mullen, associate dean for health equity at the University of Texas at Austin Dell Medical School, made sure equity was top of mind throughout the conversation.

"Equity and ethics can inform every element of vaccine distribution," she said, reminding webinar participants that the best way to ensure an equitable plan is to keep asking, ‘Who are we leaving out?’”

Watch the entire webinar and check out the presenters’ slides at COVID19Conversations.org.

Top photo, clockwise from top left: Noel Brewer, Jewel Mullen, Julie Swann and Katie Greene near the conclusion of the webinar. Second image: a snapshot of a presenter's slide.