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Vaccine Hesitancy, Even by Healthcare Workers, Means Shots Expire, Variants Emerge, Pandemic Drags On

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As President Biden pledges to buy half of a billion COVID-19 vaccine doses to give to the world, many Americans are refusing to get vaccinated, and thousands of Johnson & Johnson shots will expire soon. This week, Houston Methodist Hospital suspended 178 staff members who refused to abide by its mandate that employees be fully vaccinated. We speak with infectious disease epidemiologist Dr. Syra Madad, who heads the largest public healthcare system in the United States and says we must counter vaccine hesitancy. She also describes her own struggle to encourage health aides in her own household to get the shot. “It’s been an uncomfortable reality to see that we are now in June and nearly 50% of healthcare workers remain unvaccinated and unprotected.”

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Transcript
This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman, with Nermeen Shaikh.

Well, in the coming days, President Biden is expected to engage in vaccine diplomacy at the G7 summit in the U.K. and announce a vaccine plan for the world. Reporters asked Biden about the plan as he left for the first foreign trip of his presidency.

REPORTER: Mr. President, do you expect to come out with a vaccine strategy for the world?

PRESIDENT JOE BIDEN: I have one, and I’ll be announcing it. Thank you.

AMY GOODMAN: Today, President Biden will announce the United States plans to buy half a billion doses of Pfizer’s COVID vaccine to donate to more than 90 countries. His administration is also negotiating with Moderna. Health experts warn vaccination inequity could prolong the pandemic if the coronavirus continues to mutate, possibly making it more infectious and resistant to vaccines.

This comes as many Americans are refusing to get vaccinated, and thousands, if not millions, of Johnson & Johnson shots will expire soon, including some 200,000 doses of the vaccine in Ohio alone. Top infectious disease expert Dr. Anthony Fauci acknowledged Tuesday the U.S. is struggling to meet Biden’s goal of vaccinating 70% of Americans by July 4th.

DR. ANTHONY FAUCI: There are some states that are falling well below the 50%. And those are the states that we are, in many respects, I use the word, “almost pleading” with them, on the basis of what I showed in my presentation just a few minutes ago of why it is so important to get vaccinated. And if we can galvanize that group, that still, for one reason or other, does not want to get vaccinated, we can reach the 70 and go well beyond it as we get into the summer.

AMY GOODMAN: Meanwhile, in Texas, Houston Methodist Hospital has suspended 178 staff members who refuse to abide by its mandate that employees be fully vaccinated by Monday. It’s one of the first hospitals to require vaccinations. Workers have filed a lawsuit alleging the policy violates their rights. They spoke to ABC13 during a protest Monday.

PROTESTER 1: I’m not willing to risk my life to save my job. But I do love what I do. I love Houston Methodist. And it’s unfortunate that they’re willing to let us go over something like this, instead of giving us more time.

PROTESTER 2: We’re all suspended right now. So, he can choose to let us go back to work, but if he doesn’t and we get fired, we’re going on to the Supreme Court for a wrongful termination lawsuit.

AMY GOODMAN: The lawsuit by the Methodist employees was filed by a conservative lawyer and activist. The case is being closely watched by other hospitals, employers nationwide. On Wednesday, many hospitals in Washington, D.C., and Maryland announced they’ll soon start requiring employees to be vaccinated.

For more, we’re joined by Dr. Syra Madad, an infectious disease epidemiologist who leads the Special Pathogens Program for NYC Health and Hospitals, the nation’s largest public healthcare system. She recently wrote an opinion piece published in The New York Times headlined “Why Are So Many of My Fellow Health Workers Unvaccinated?”

So, let’s start there, Dr. Madad. We had you on toward the beginning of the pandemic. You’ve worked throughout. It might surprise people to know that the first people offered the vaccine, healthcare workers, the surprising percentage of them across the country that are saying no to vaccines. What have you found is the reason? And what do you think needs to be done?

DR. SYRA MADAD: You know, the healthcare workers have been offered the COVID-19 vaccine starting December, so it’s been an uncomfortable reality to see that, you know, we are now in June and nearly 50% of healthcare workers remain unvaccinated, unprotected. And so, this is certainly a dilemma, not just here in the United States, but around the world.

Some of the reasons that we found that healthcare workers are hesitant are the same reasons we find in the general public. And this is the newness of the vaccines or the long-term side effects. And so, when we talk about vaccine hesitancy, we need to address it in all its forms and facets, for healthcare workers along with the general public. The strategies and the tactics continue, which includes education, but also includes making strong recommendations for everybody to get vaccinated.

The one thing that I’ll mention — and we’re seeing it around the world, obviously. The COVID-19 pandemic is far from over. But one of the greatest threats to our current vaccination program here domestically and around the world is not just vaccine hesitancy and the slow rollout, you know, that we’re seeing around the world; it’s the emergence of variants that’s going to threaten our vaccine-induced immunity. And so we need to not only work on getting people vaccinated that are hesitant, but also look at it from those that are not vaccinated and the variants that are circulating. So, we need to look at it from both fronts.

NERMEEN SHAIKH: Dr. Madad, could you say more, differentiate between the different kinds of healthcare workers, those who are more likely to receive the vaccine and those who are more hesitant or have outright refused to do so?

DR. SYRA MADAD: Absolutely. So, the term “healthcare worker” is a fully loaded term. And what I mean by that is there’s many different types of healthcare workers. You know, you have the full gamut, from providers, like doctors and nurses, to support staff. You know, this could be medical assistants. These could be individuals like home health aides.

So, when we talk about home — healthcare workers, you look at it from a standpoint of those that, for example, provide diagnosis and treatment to patients, like doctors and nurses, and about seven out of 10 are vaccinated. So a large chunk of individuals that are providers and nurses are vaccinated. But when you look into those that are healthcare workers that provide more administrative support or help with bathing or feeding patients, about four in 10 are vaccinated. So there is a stark divide between — you know, within healthcare workers in the various categories, as well.

And then, this also relates to educational level. So, as I mentioned, difference in occupation, but also those that are less educated are more hesitant to get the COVID-19 vaccine. Additional kind of areas that we’ve seen generally around the United States is, you know, race, ethnicity also matters in terms of accepting the COVID-19 vaccine, your political affiliation. So, these are all different types of factors that go into the decision to get vaccinated.

NERMEEN SHAIKH: The fact that you mentioned earlier — and, of course, we know the widespread phenomenon of variants, most recently the Delta variant, which was first identified in India. And the only way, as many medical professionals say, yourself included, that the only way to make sure that people are safe from these variants is by getting vaccinated. Do you think there should be a vaccine mandate, not just in hospitals and healthcare facilities, but also, for example, in schools, with teachers, students, and anyone, really, who’s interacting regularly with the public?

DR. SYRA MADAD: I do think my personal opinion is that anyone that has a public-facing occupation or role that comes in contact with other individuals, there should be a mandate to get vaccinated. Nobody has a right to spread a deadly, highly infectious disease to other people. We still have a large population, both here in the United States and around the world, that are vulnerable to infection. And now that we’re talking about these variants, like the Delta variant, that is said to be more transmissible, over 40 to 50% more transmissible than the B.1.1.7 or the Alpha variant, which was already more transmissible, to begin with, with the original virus strain, we’re looking at individuals that are not vaccinated are now at higher risk of getting infection, of succumbing to disease and requiring hospitalization. So we need to make sure that we’re looking at it from that lens. And so, we want to do a much, much better job here domestically and around the world to get more people vaccinated.

And this also includes — you know, I think when we look at the global equitable sharing of COVID-19 vaccines, the U.S. certainly is not absent from it. In fact, the U.S. is one of the leading countries that is supporting equitable vaccine distribution. And you’ve seen President Biden’s recent announcement of providing tens of millions of Pfizer vaccines to many different countries. And so, it’s time that other countries also step up, because the World Health Organization has mentioned that we need about 11 billion vaccines to vaccinate about 70% of the population around the world. And only as of today, we’ve only administered over 2 billion. And so, we need to make sure that we’re in a phase of this pandemic where, when we look at now these vaccines made available, these life-saving, preventative vaccines, they need to go into arms of people around the world, if we are to truly end this pandemic for everybody.

AMY GOODMAN: Before we go to the rest of the world, can we stay in your own family? Because you begin your New York Times op-ed saying, “In April of last year, I along with my entire family — my husband, my three children, in-laws and at least one of our four home health aides — came down with Covid-19.” Can you talk about what happens? So often one family is a microcosm of what happens in the world. But here you are, an epidemiologist who is leading the New York City response. And explain how the whole issue of vaccine hesitancy, talking to the home healthcare aides, how you believe you came down with it?

DR. SYRA MADAD: Well, you know, I think no one is — you know, when we talk about the virus, it’s ubiquitous, and anybody could get infected. And even when you are applying these preventative measures, these risk reduction measures, there’s still a chance of getting infected if there’s a slip-up.

And so, here, in my own household early on last year, it was hard to see who brought the virus into our home. Many of us have occupations where we’re in hospitals, where we’re interacting with many different people. And our home health aides, that we have four of, that care for a family member that requires assistance around the clock, they were living in some of the hardest-hit areas, that were experiencing very high volumes of infection of COVID-19.

So, back in April, we started to have all of us come down with this disease, and it was probably one of the most frightening experiences of my life. And I’ve responded to multiple different infectious disease outbreaks, from Ebola to Zika to measles to many others. And so, this has been, certainly, one of the experiences where it involved my family, my children.

And so, when we look at the early days and how I responded to it at home, it was very similar to how I was looking at it from a hospital standpoint. I was standing up protocols and processes to ensure that we were limiting transmission to one another. This includes opening windows and having less people in the kitchen or areas where we’re congregating more. But it was definitely — you know, it was a challenge. And somebody like myself, who’s knowledgeable, who’s an ID epidemiologist, it was a challenge for me, so I can just imagine what was happening in other households. And that’s where it was starting.

But now that we’re in a phase where we have vaccinations available, my four home health aides, many of them remain reluctant. They don’t want to get vaccinated, even though they — you know, many of them experienced COVID-19. They know the complications. They saw it firsthand, you know, what was happening in New York City. And so, I’ve been working actively since December, when these vaccines have been made available, and home health aides were eligible starting in January. And as of today, we have two that are fully vaccinated and two that are — you know, one that made an appointment and one that’s completely on the fence.

And so, you know, it’s these conversations that I have with them on an ongoing basis. And so, when I talk to them about the vaccines, it’s a lot with responding with empathy and caring and not being judgmental, asking them what their concerns are and providing tailored information. And I do that on an ongoing basis. I feel like it’s probably almost every day that I speak to those that are not vaccinated, to encourage them to make the informed decision, and providing them with the benefits of why vaccination is important for them and their family and their community, especially with the variants circulating. But these are not one-and-done conversations.

And so, it’s one thing to have these conversations on an ongoing basis, but it’s another to mandate it as a condition of employment. And that’s what you’re seeing many employers and many healthcare systems are starting to implement, which, you know, is a — personally, is a decision, as I mentioned, that I think mandating it is the way to go.

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