How the medical community is fighting vaccine hesitancy and misinformation in LA

Written by Amy Ta and Andrea Domanick, produced by Jenna Kagel

A woman receives a COVID-19 vaccine from a nurse at a vaccination clinic held by the LA County Sheriff's Community Advisory Council. Photo by Ringo Chiu/Shutterstock.

The coronavirus pandemic worldwide is as bad as ever, driven by surges in India and South America. But you wouldn’t know it from the strides Southern California has made. New cases and hospitalizations in LA County are down far enough to qualify LA for the least restrictive yellow tier of Gov. Gavin Newsom’s reopening plan. 

The city and county have a plentiful supply of vaccines, and they’re offering appointment-free shots at multiple locations. 

But while a little more than half of all Angelenos 16 and older have had at least one shot, vaccination rates are now plunging. If not enough people get vaccinated, the county won’t reach herd immunity, making it more vulnerable to new outbreaks and new variants.

KCRW speaks with Dr. Oliver T. Brooks, Chief Medical Officer of Watts HealthCare Corporation, and Barbara Ferrer, director of the Los Angeles County Department of Public Health.

KCRW: Coronavirus is still bad around the world, such as in India, but California now has the lowest case rate in the U.S. We still need a lot more people to get vaccinated though, right?

Barbara Ferrer: “Of course. And the good news is, obviously, we have about 40% of people living in LA County that are fully vaccinated. … Slightly over 60% of our residents here have had at least one dose. 

But that means there's lots of people that still haven't had even their first dose, and many people that have to come back and make sure they're getting their second dose. And I do appreciate [that] this is millions and millions of people that have come in to get vaccinated. 

We've administered collectively across the county over 8 million doses. And that's a really remarkable accomplishment. And I don't want to diminish it in any way by noting that the last couple of weeks demand for vaccines has dropped considerably. 

I always think that when you're in the kind of race we are in to end the pandemic, it's really important to acknowledge that for every individual, there are different priorities in their lives. And there are different considerations that they need to take into account when they make a decision about getting a vaccination. 

Our job, and I think Dr. Brooks is a leader in this field, is to make it as easy as possible for people to come in and get the vaccinations, and as easy as possible for them to feel like they have access to good information, and to be able to talk to trusted leaders in their community about any of their concerns, and to be able to get their questions asked. And that's the work we're doing now. So I feel pretty comfortable that over the next month or two, we will be able to get more and more people to come in and get their vaccines as we make it easier and as we answer their questions.”

Dr. Brooks, what have you been doing over at Watts Healthcare to overcome issues around vaccine hesitancy and access in your community? And what do you think works?

Oliver Brooks: “There are three primary reasons why people have hesitancy or mis-confidence. The three Cs: confidence, convenience, and complacency. The big one right now seems to be confidence in the vaccine. People mistrust the government, they mistrust the pharmaceutical manufacturers, and they mistrust those that are advocating for it. 

So what we are doing, first of all, is ensuring people that the vaccine is safe and effective. I work with the National Medical Association, African American physicians, and we put out a statement categorically endorsing the vaccines. 

The other thing is we make the vaccine readily available. We have vaccine clinics in our health center. We are now open to the public. … We even have expanded hours. We have it on Saturdays. 

… We also will be working with trusted leaders in the community. I've gone on numerous shows like this and spoken and said, ‘I've been vaccinated. My family's been vaccinated.’ What we see is that people trust those that are around them. If their friends get vaccinated, their family gets vaccinated, they are more likely to get vaccinated.”

How do you overcome the misinformation that's out there?

Ferrer: “I think Dr. Brooks said it best earlier when he talked about really making sure that trusted leaders in the community have access to good information, and that they can then provide that information to people that they're close to or that they're working with. And that's why the network in LA County is so huge — 739 sites are open this week.” 

Dr. Brooks, what about the mistrust in communities of color? How are you overcoming that? 

Brooks: “You go to the exact concern that a person may have. ... If they ask about the government and this Bill Gates chip, I say that ‘People are saying that, in my opinion, just to get you not to take a vaccine. So why would you believe that? I am a physician, I'm a pediatrician, a chief medical officer, I study vaccines, I get the vaccine, my family is vaccinated. Don't let these people fool you.’ 

… The manufacturers, they generally make more money on pharmaceuticals than vaccines. And they got this vaccine out very rapidly because we couldn't wait. People worry about ‘Oh, it came out too soon.’ Oh, what? We're gonna wait three years for a vaccine and then have 3 million people dead? I say, ‘This is a technological miracle. And you're going to walk away from a technological miracle?’ On December 10, there were 0% of LA County vaccinated. And here we are at about 40% fully vaccinated 16 months later.”

Experts are now predicting that maybe herd immunity in the U.S. is unlikely, but the country can focus on containment. Do you agree that herd immunity is out of reach? Can we reach it here in LA County? And what do you do if that doesn't happen? Can we still achieve at least containment if that herd immunity isn't there?

Ferrer: “I think about it a little bit differently. One thing is it's a new virus and a new vaccine. It’s not really clear exactly what that number will be for herd immunity. And because of that, I tend to focus less on [whether] there is an exact number that we need to reach. The one thing that's really abundantly clear at this point is: The more people get vaccinated, the more protection we have, both as individuals … but just as importantly, as a community. 

It's really upon all of us to try to do the best we can to get more people vaccinated. Whether we get to 75% or 80%, or some people say it's 85%, I think what we have to do is continue to make progress, we have to continue to be able to explain to people the importance of this vaccine. And  just as you're seeing now, we are already reaping the benefits of having 40% of people fully vaccinated. That number goes way up when you look at people [ages] 65-plus, and that was the population that was hit the hardest. 

I think if we continue to make gains on getting more and more people vaccinated, we build that protection. And the most important thing right now is we build protection against having new variants circulating in LA County that may not respond as well to the vaccines that we're using today. So that's the race: to not have new variants cropping up here, not give chances for there to be both a lot of mutations, and then the ability to transmit what we call ‘variants of concern.’”

There are people who get the double dose of Pfizer or Moderna, and then afterward get a Johnson & Johnson dose. Is that dangerous? Do we know anything about it?

Ferrer: “We don't know a lot about it. And there's actually no evidence that that gives you any added protection. What we do know is if you're getting Moderna or Pfizer, you need the second dose to be fully protected. And if you're getting the Johnson & Johnson, you just need that one dose. Johnson & Johnson is equally effective at preventing hospitalizations and deaths as are the Pfizer and Moderna vaccines. So we would urge people not to go ahead and do that because it's just not necessary.”

LA is in the yellow tier, and the economy is almost fully open. Can we say that the pandemic is kind of behind us now?

Brooks: “Clearly, the pandemic is not behind us, because people are still getting infected, hospitalized, and dying. I think the yellow tier was done scientifically. So it's not just someone decided, ‘I think let's open up.’ And if things turn around and rates go up, testing more positive individuals, hospitalizations, then we will move away from yellow. So I think that people need to follow the guidelines, period. 

… We're worried we may never get to ‘community immunity.’ I use that instead of ‘herd immunity.’ But I'm optimistic. First of all, we got Pfizer coming on board soon with a childhood vaccine for 12 to 15 years of age, and hopefully that gets approved. Those that are affected have some immunity, though they still need to be vaccinated. 

And then as Dr. Ferrer said, the highest rate of those vaccinated are those 65 and over. The concern about coronavirus is infection, hospitalization, and death. All that stuff is down. So I think as we move to [the] yellow tier, we will see some coronavirus, but we will also see life better. As people feel their life is better, that in and of itself may make some want to get vaccinated. ... Those that are fully vaccinated will have a certain feeling of confidence, and that'll be exerted on those that aren't vaccinated. So I think that the decision was made appropriately. And I believe in it. 

… I'm fully vaccinated. Obviously I will follow the guidelines. … If there's a large gathering indoors, I will likely still wear a mask.”

Credits

Guests:

  • Dr. Oliver T. Brooks - co-chair of California’s drafting guidelines workgroup, chief medical officer of Watts Healthcare Corporation
  • Barbara Ferrer - Director of the Los Angeles County Department of Public Health