Study Takes Look at Decision Making in Getting a COVID-19 Vaccine

Published in the Pawtucket Times on January 25, 2021

Last month, the first shipment of COVID-19 vaccines came to Rhode Island. With limited stockpiles, debate in the state is heating up as to who gets priority in getting vaccinated. While many Rhode Islanders are waiting for the opportunity to be vaccinated, it has been reported that others, including health care workers, are declining to be inoculated. They turned down the chance to get the COVID-19 vaccine because of their concerns it may not be safe or effective.  Now research studies are being reported as how to increase a person’s likelihood to be vaccinated.

Last week, the COVID-19 Vaccine Education and Equity Project Survey, a group whose mission is to increase public dialogue on vaccine education, released survey findings that ranked preferred locations to receive COVID-19 vaccines, as well as leading information sources that would influence a person’s decision to get vaccinated. 

The CARAVAN survey was conducted live on December 18-20, 2020 by ENGINE INSIGHTS, among a sample of 1,002 adults over the age of 18 who had previously volunteered to participate in online surveys and polls. The data was weighted to reflect the demographic composition of the population. 

The researchers found that nearly two-thirds of the public (63 percent) say they will “definitely” or “probably” get vaccinated against COVID-19. The numbers of those indicating they would “definitely” or “probably” get vaccinated varied widely by race. While 67 percent of white respondents indicated they would get a vaccine, the numbers fell to 58 percent among Hispanic respondents and only 42 percent among Black respondents. 

Influencing a Person’s Decision to Get a COVID-19 Vaccine 

This study, commissioned by the Washington, DC-based Alliance for Aging Research, one of the three nonprofit organizations leading the project, found the majority (51 percent) of respondents ranked their healthcare provider or pharmacist as one of the sources most likely to influence their decision to get a COVID-19 vaccine. Almost two-thirds (64 percent) of respondents said they would prefer to receive a COVID-19 vaccine in their healthcare provider’s office. 

After healthcare providers and pharmacists, when asked to provide the top two additional sources of information about COVID-19 vaccines that would most influence their decision to get vaccinated, 32 percent of respondents cited nationally recognized health experts, and 30 percent named family and friends. However, older respondents were increasingly more likely (75 percent ages 65 and older) to trust their healthcare provider or pharmacist, followed by 43 percent (ages 65 and older) trusting nationally recognized health experts. 

“While we’re encouraged to see the majority of respondents planning to get vaccinated, we need to continue to educate about the safety of receiving COVID-19 vaccines from various healthcare professionals, including pharmacists in drug stores, supermarkets, and vaccine clinics,” said Susan Peschin, President and CEO of the Alliance for Aging Research, in a Jan. 14 statement released announcing the study’s findings.  “It is critical to our pursuit of health equity that all Americans have confidence in and access to COVID-19 vaccines,” she said. 

Overall, the researchers say that survey responses provided important information about the factors influencing the likelihood to get vaccinated and where respondents prefer to receive COVID-19 vaccinations. As to the likelihood to be vaccinated, the study’s findings reveal that about a quarter (24 percent) of respondents said they would “probably not” or “definitely not” get a vaccine, with Black respondents more likely to say they would not receive the vaccine (25 percent), compared to Hispanic (15 percent) and white (13 percent) respondents. Respondents that said they will “probably not” get a vaccine also tend to be younger (13 percent ages 18-34, 14 percent ages 35-44). 

Identifying Preferred Locations to be Vaccinated 

Researchers looked into what is the preferred location to be vaccinated. The survey asked respondents to select one or multiple locations where they would prefer to receive a COVID-19 vaccine. The majority (64 percent) of respondents indicated they would prefer COVID-19 vaccination in their healthcare provider’s office, while 29 percent prefer a pharmacy, 20 percent a drive-thru vaccine clinic, and only 13 percent would like to receive the vaccine at a grocery store pharmacy. 

Researchers found a generational split among these options (health care providers office, pharmacy, drive-thru clinic and grocery store-based pharmacy). When asked about their top two considerations, older respondents were much more likely (72 percent ages 65 and older) to cite preference for receiving COVID-19 vaccines in their healthcare provider’s office, compared to over half (56 percent) of respondents ages 18-34.

More than a third (36 percent) of those ages 18-34 prefer to be vaccinated at a pharmacy. In evaluating location preferences, nearly two-thirds (61 percent) of respondents said they would prefer to get vaccinated from a healthcare provider they know. This percentage was higher when looking at respondents over the age of 65 (74 percent). Additional factors driving the location where respondents would like to receive the vaccine included the ability to get the vaccine quickly or not have to wait in line (45 percent) and a location close to home (41 percent), the study found. 

Debunking Some Myths and Misconceptions 

RIDOH has compiled a listing of frequency asked questions about COVID-19.  Here is a sampling: Some believe that vaccines are ineffective due to the vaccine’s fast track development, fearing corners have been cut during the clinical trials. The Rhode Island Department of Health (RIDOH) stresses that “the vaccines are 95% effective in preventing symptomatic laboratory-confirmed COVID-19 and in preventing severe disease.” 

It’s been reported that some people may choose to not get vaccinated because that believe that the vaccine contain a microchip.  That’s not true, says RIDOH. “There is no vaccine microchip, and the vaccine will not track people or gather personal information into a database. This myth started after comments made by Bill Gates from the Bill & Melinda Gates Foundation about a digital certificate of vaccine records. The technology he was referencing is not a microchip, has not been implemented in any manner, and is not tied to the development, testing, or distribution of COVID-19 vaccines,” says RIDOH.  

Others express concerns that MRNA vaccines can alter your DNA.  “The COVID-19 vaccines currently available, which are messenger RNA (mRNA) vaccines, will not alter your DNA. Messenger RNA vaccines work by instructing cells in the body how to make a protein that triggers an immune response, according to the Centers for Disease Control and Prevention. Messenger RNA injected into your body does not enter the cell nucleus where DNA is located and will not interact with or do anything to the DNA of your cells. Human cells break down and get rid of the messenger RNA soon after they have finished using the instructions,” states RIDOH.  

A vaccine will not give you COVID-19.  RIDOH says: “None of the COVID-19 vaccines currently in development or in use in the US contain the live virus that causes COVID-19. The goal for each of the vaccines is to teach our immune system how to recognize and fight the virus that causes COVID-19. Sometimes this process can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building immunity. It typically takes a few weeks for the body to build immunity after vaccination. That means it’s possible a person could be infected with the virus that causes COVID-19 just before or just after vaccination and get sick, but this is not because they got the vaccine. This is because the vaccine has not had enough time to provide protection.” 

For more resources on the impact of COVID-19 vaccination uptake in protecting individuals, families and communities, and for details on how organizations can partner with the COVID-19 Vaccine Education and Equity Project, visit https://covidvaccineproject.org. Want to know more about COVID-19 Vaccinations?  Go to https://health.ri.gov/publications/frequentlyaskedquestions/COVID19-Vaccine.pdf

AARP: Vaccinate seniors now!Leaders respond. Add YOUR voice.

Published in RINewsToday.com on January 25, 2021

The debate heats up as to how Rhode Island should distribute its limited stock of COVID-19 vaccine. Days ago, AARP Rhode Island urged state officials and lawmakers to put seniors on the top of the list to protect their lives. Older Rhode Islanders should be a priority in getting vaccinated, says the state’s largest nonprofit. 

AARP Rhode Island, generally speaking, reserves sending public letters to public officials for the most critical of issues. Because of the pandemic, a critical issue, AARP is reaching out to its 132,000 Ocean State members and the public at large to demand immediate change.

“The message AARP wants sent to the Governor and State Leaders reads, in part, “Rhode Islanders 50 and older account for 98% of the state’s more than 2,000 COVID deaths. Yet only a quarter of vaccinations to date have been administered to older Rhode Islanders. You must revise the plan to vaccinate the most vulnerable among us. I am therefore calling on you to revise the state vaccination plan immediately to prioritize vaccinating our 50 and older population. There is no time to waste,” said AARP Rhode Island State Director Kathleen Connell.

A Call to Revising the State’s Vaccination Distribution Plan

Connell added, “Now that the state has responded to AARP Rhode Island’s call to make the state’s COVID vaccination plan and its execution more transparent, I am alarmed and dismayed to find data only now available reveals that just 25% of vaccinations to date have been administered to Rhode Islanders age 60 and older.”

“The current disparity — which flies in the face of federal health recommendations and causes great concern for many older Rhode Islanders and their families — is inexplicable, life threatening and unacceptable,” says Connell. 

AARP Rhode Island’s work is part of a nationwide effort, says Connell. “AARP is advocating hard to ensure every older American who wants to get the vaccine can get it,” said AARP Executive Vice President and Chief Advocacy & Engagement Officer Nancy A. LeaMond.

“It’s also vital that distribution plans for authorized vaccines are smoothly implemented,” LeaMond added. “There’s no time to waste: it’s time for full-scale mobilization, and any delays or early bottlenecks in distribution systems need to be addressed urgently. AARP remains committed to protecting the health and well-being of our nearly 38 million members and all Americans as we work together to defeat this virus,” she said.

Rhode Island leaders respond to AARP’s call

Speaker of the House of Representatives Shekarchi:

“We all want the most at-risk people, including our seniors, to have access to the vaccine absolutely as soon as possible. My father is 94, and it will be a tremendous relief to me and my family when he is protected,” said House Speaker Joseph Shekarchi (D-Dist. 23 Warwick). “President Biden’s timeline includes prioritizing access to the vaccine for those 65 and older, and it’s important that we comply with it,” he says.  

“I understand we need greater supply. Our House COVID-19 Vaccine Task Force will vigilantly monitor the distribution to ensure our state is doing everything we can to get the vaccine to those most at risk, particularly those 65 and older, as soon as possible, in cooperation with the federal government,” adds Shekarchi.

Dr. Chan, RI Dept. of Health:

In a Jan. 22 email vaccine update, Dr. Phillip A. Chan, MD, MS, the Rhode Island Department of Health’s (RIDOH) Consultant Medical Director, reported that 66,070 doses of vaccine had been administered in Rhode Island (52,925 first doses, and 13,145 second doses). “We are working hard to distribute vaccine, but supply remains very limited. Right now, we’re receiving enough first doses each week for about 1.5 percent of our population. While other states are in the same position, Rhode Island ranks among the top states nationally in terms of the rate of second doses administered,” he said.

As to the vaccination distribution timetable, Chan noted that nursing home residents and staff began to get vaccinated in December. “This week, we started to vaccinate in assisted living facilities and other congregate living settings.  By middle of February, we expect the vaccine will be available for adults 75 and older,” he says. 

According to Chan, there are 187,000 Rhode Islanders age 65 or older. “Since we are only getting 14,000 first doses of vaccine a week, we are taking a stepwise approach to this group as well,” he noted in RIDOH’s vaccine update.  “Please note that there is no action older adults need to take at this time to get a vaccine. When we are ready to start vaccinating this population, we will communicate with the public, healthcare providers, and community organizations to provide instructions.”

Incoming Governor, Lt. Gov. McKee:

Meeting outside Lt. Gov. Dan McKee’s Cumberland home, WPRI reporters, Eli Sherman and Brittany Schaefer, got insight into McKee’s thoughts about the state’s COVID-19 vaccine rollout strategy and issues surrounding this distribution. They report the details in a Jan. 23 WPRI blog article, “McKee: Teachers should get vaccine before others in Rhode Island.” McKee will move into the governor’s seat once Gov. Gina Raimondo is confirmed as U.S. Commerce Secretary.  

Here are some points from McKee’s interview in the Sherman and Schaefer’s blog article: 

“We need to really move up on the list teachers and the support staff in schools,” McKee said. “We’re not going to open the economy until we do that, and teachers are not going to feel comfortable by and large until we get them vaccinated.” (Teachers are not in the Rhode Island Department of Health’s phase one vaccination rollout)

“Prioritizing educators would inevitably delay vaccinations for all non-educators, and McKee did not name any other group Saturday that he thought should be prioritized. When asked specifically about adults 65 years and older, McKee said he expected they would also be prioritized, but underscored the state is only receiving a limited amount of supply of the vaccine from the federal government,” says the WPRI blog.

President Joe Biden encourages states to make it a priority to vaccinate people age 65 and over, along with grocery store workers and teachers. No specifics have been released yet by his administration. 

“I think it’s a supply issue, but that age group is a priority,” McKee said. “We’re going to follow the lead of the Biden administration”.  

Stay tuned as the debate continues on how Rhode Island should disseminate its limited COVID-19 stockpile – and what it can move to when the flow of vaccine becomes more generous.

Give Governor Gina Raimondo your thoughts as to AARP Rhode Island’s call for vaccinating people age 50 and over “immediately”.  Here’s the governor’s contact details:  Governor Gina Raimondo, 82 Smith Street, Providence, RI 02903; email: governor@governor.ri.gov; phone: (401) 222-8096. 

Ramping up COVID-19 Vaccine Plans

Published in RINewsToday.com on January 17, 2021

As state health officials say they are clamoring for more doses of COVID-19 vaccine, just days ago, Health and Human Services Secretary Alex Azar said in an interview with NBC’s Lester Holt there is no “reserve stockpile” of COVID-19 vaccine doses left to release to states, and all vaccine has now been released to fulfill orders by the states. Azar’s comments come after his announcement on January 12th that the states no longer need to hold back a second shot because there is confidence that Pfizer and Moderna, manufacturers of the vaccine, could keep up with the demand.

In the January 12th announcement, Azar noted several steps the states should take immediately, and the federal government was taking:

Expand groups getting vaccinated to include all those over the age of 65 – Vaccinate those 16-64 with co-morbidities – Expand channels to include those more familiar with people to reach them where they are, such as pharmacies – release all supply to order by states.

Azar encouraged states that are holding back “second shots” to not do so, saying, “Every vaccine dose that is sitting in a warehouse means another life lost…”

In response to the rollout of COVID-19 vaccines, Katie Smith Sloan, president and CEO of Washington, DC-based Leading Age and acting President and CEO, of the Visiting Nurse Associations of American, had some thoughts. “With COVID-19 death tolls topping 4,000 a day, it’s chilling to hear that vaccine stockpiles may have been misrepresented, and that older Americans who have been dying in record numbers might suffer as a result,” she said in a Jan. 15 statement.

Making it a Priority of Giving COVID-19 Vaccines to Seniors

“We hope these reports are not true. For weeks, state policy makers, distribution partners and aging services providers have been basing their vaccine allocations and strategies on vaccine stockpile estimates,” Sloan noted.    

“Because more than 265,000 people 65 or over have died of COVID, we have been pleased that many states have made the right decision to prioritize older Americans and their caregivers for immunizations, and that the process is underway in long-term care.  We hope this news is not a setback for those people, as well as others waiting for vaccinations in home health, hospice, PACE programs, adult day or other settings,” says Sloan.  

Rhode Island’s plan not changing

However, Rhode Island has chosen not to prioritize the distribution of it COVID-19 vaccine to older Rhode Islanders. The Rhode Island Department of Health (RIDOH) expects residents age 75 and older who reside in the community to be vaccinated in February or possibility March. Specifics as to vaccinating residents ages 50 to 74 have not been announced. While other states are beginning mass vaccination sites at stadiums, no such plans exist in Rhode Island.

AARP Advocates for those over 50

“Since the start of the pandemic, over 95 percent of the deaths from COVID-19 have been among people 50 and older,” AARP Rhode Island State Director Kathleen Connell and State President Phil Zarlengo said in a Jan. 8 letter to Gov. Gina Raimondo, urging the state’s top official to “ensure that Rhode Islanders age 50 and older are prioritized to receive a vaccine.”  (see Weiss Commentary printed here on January 11). 

AARP is fighting for older Americans to be prioritized in getting COVID-19 vaccines because the science has shown that older people are at higher risk of death.  On Jan. 11, the Washington, DC-based AARP sent a letter to HHS Secretary Alex Azar calling for his agency to take immediate action to address the issues that have slowed down vaccinations across the country.

RIDOH’s plans

On Jan. 15, in a Vaccine Update, Nicole-Alexander Scott, MD, MPH, Director, Rhode Island Department of Health, stated: “There was a lot of news this week about the federal government urging states to vaccinate people who are 65 years of age and older. We want to get vaccine to people older than 65, too. The limiting factor is not federal rules, or our approach in Rhode Island. The limiting factor is the amount of vaccine we are getting. We are getting 14,000 first doses of vaccine a week. There are close to 190,000 people in Rhode Island who are 65 years of age and older. It would not be honest or fair of us to say that all Rhode Islanders older than 65 can get vaccinated tomorrow, because we just don’t have the vaccine.” 

It is unclear if RI is holding “second shot” vaccine doses in storage. There is about a week’s lag from receiving the doses and distributing them. On January 15th, the state said they had administered a total (first and second shots) of 51,220 shots. On January 12th, the most recent report provided, the state says it has received 72,175 doses from the federal government.

Scott added:” We’ve seen the confusion and frustration that has resulted in states that have opened eligibility to groups that they did not have enough vaccine for. In Rhode Island, we are vaccinating older adults incrementally and thoughtfully. That means that when we tell you you can get vaccinated, you know that there is a real, physical vaccine waiting for you – not just that you fall into a broad category that is eligible to get a vaccine when we eventually have one. Please know that if we could, we would make sure that everyone got vaccinated immediately. But we’re just not getting enough vaccine right now, so we’re doing the best we can with what we have.”

Rhode Island’s report

After listening to the state’s reports on plans for getting out the vaccine to the group the Centers for Disease Control and Prevention is recommending, those over 65, and those under 65 with underlying medical conditions, there seems to be an overall lack of urgency in ramping up for this new directive, said Nancy Thomas, Publisher of the RINewsToday.com, who was on the update webinar this week, with other reporters. “There are no plans – or none they are willing to announce – for how people will register, or sign up, for when the 65 and over category is ready to go. Questions about how people will identify themselves at the site also were yet to be determined. When asked about mass vaccination sites, officials said they may consider schools, but had no plans for using McCoy Stadium or other large sites. We’ve seen states all around us opening up stadiums – many of whom are still vaccinating medical workers – but ramping up to do as many as they can until supplies are exhausted for that day. Massachusetts even has swag – pins, wristbands, and banners – to build up the sense of excitement, which also builds compliance. We have asked RIDOH about public education campaigns and they say they have a campaign coming.  

With such a large percentage of seniors in Rhode Island, are we ready to ramp up? Some states are vaccinating 24/7, with appointments at 2am and such. I guess a sense of frustration weighs on me and on others who do not see big plans, forward looking plans in the near future. Meetings with the public focus more on reporting of what has been done and where we’ve been, rather than where we’re going,” Thomas said.

Biden Releases COVID-19 Vaccination Plan

President-elect Joe Biden, speaking a day before he unveiled his COVID-19 Vaccine Plan on Jan. 15 in Wilmington, Del, unveiled a $1.9 trillion “American Rescue Plan” to combat COVID-19 and to shore up a wobbly economy. The emergency vaccination and relief package combine funding to reduce the economic impact of the pandemic (including direct stimulus payments of $1,400 per person, extending unemployment compensation, raising the minimum wage, continuing eviction and foreclosure moratoriums to increasing the Child Tax Credit) with strategies to fight to combat the virus itself.

About $400 billion of Biden’s “American Rescue Plan” is directed to controlling the virus by setting up mass vaccination centers, funding more sophisticated scientific analysis of new strains and creating teams of local health workers to trace the contacts of infected people.

President-elect Joe Biden’s Jan 15 press conference, lasting a little more than 19 minutes, warned that “We remain in a very dark winter. He noted that COVID-19 infection rates are creeping up 34 percent, COVID-19 related hospitalizations are increasing, and 3,000 to 4,000 people are dying every day of COVID-19.  “Things will get worse before they get better,” he said.

When releasing his five step COID-19 Vaccination Plan, Biden stated, “This is the time to set big goals and to pursue them with courage and conviction because the health of the nation is at stake.”  His strategy of getting 100 million Americans vaccinated during his first 100 days in office relies on the following steps: encourage states to vaccine more people age 65 and over including front line workers; creating thousands of community vaccination centers at gyms, sports stadiums and community centers; activating local pharmacies to give vaccines; ramping up supplies of vaccines by triggering the Defense Production Act and distributing vaccines quickly; and regularly updating state and local officials as to how much vaccine they are getting and when to expect the delivery.  Biden promised to give regular updates pertaining to the meeting of his goals, “both the good news and the bad.”

Mask Mandate – Wear that mask

During his first 100 days, Biden will be issuing an executive order to require masks for federal workers, on federal property, and on interstate travel, like trains and planes.  He is also urging governors to require masks in cities and states.

“I know masks have become a partisan issue,” says Biden, stressing “it’s a patriotic act.  Experts say that wearing a mask from now until April will save more than 50,000 lives, he noted.

Biden called on Congress to make his COVID-19 Vaccination Plan happen. “I’m optimistic. I’m convinced the American people are ready to spare no effort and no expense to get this done,” he said, stressing it “will take many months to get where we need to be.”