Vaccination Hesitation: COVID-19 Vaccine Safety & Efficacy w/ Christina Cady

The AT Last Podcast

Mar 8 2021 • 1 hr 50 mins

On this episode we discuss the safety and efficacy of vaccines with guest, Christina Cady. We also discuss some of the literature related to reduced vaccination rates in communities of color.

Show Notes

  1. Influenza vaccination rates compared by Race
  2. Influenza vaccination is widely recommended and fully covered preventative service under the ACA
  3. Data show flu vaccination rates remain low and there are persistent racial disparities in uptake of flu vaccine
  4. 2018-2019 CDC flu vaccine data
  5. Adults by race
  6. Whites 49%
  7. Blacks 39%
  8. Latinos 37%
  9. AIAN 38%
  10. Factors leading to lower rates
  11. Less insurance and less likely usual source of care
  12. Critical factors
  13. Blacks perceive a higher risk of side effects
  14. Lower knowledge of flu vaccine
  15. Less trust in the vaccine
  16. Black patients do not always receive
  17. Strong recommendations
  18. Specific offers for vaccine
  19. Decreased acceptance of new vaccine with highest level of worry amongst Blacks
  20. Perception of racial fairness and influence of race in health care settings and experiences with discrimination are associated with attitudes and beliefs about vaccinations which can influence getting vaccinated
  21. POC have more missed opportunities for vaccines, but would be more willing to accept if strongly recommended
  22. COVID-19 Vaccinations
  23. Available evidence:
  24. 15,474,800 cases from Jan 21st to Dec 10th
  25. Hospitalization rate: 278.7 per 100,000 people
  26. Mortality: 291,522 COVID-19 associated deaths
  27. 2,740 new deaths per day
  28. In LA (recent LA County public health lecture 1/5/21)
  29. Death rate is 4 times higher in areas of poverty
  30. COVID-19 Vaccination Evidence to Recommendations from the CDC ACIP
  31. Population: >16 yo
  32. Intervention: Pfizer-BioNTech COVID-19 vaccine (BNT162b2)
  33. Comparison: No vaccine
  34. Outcomes
  35. Symptomatic lab confirmed COVID-19
  36. Hospitalization secondary to COVID-19
  37. All cause death
  38. SARS CoV-2 Seroconversion to a non-spike protein (date pending early December)
  39. Asymptomatic SARS Cov-2 Infection (data pending early December)
  40. Serious Adverse Events
  41. Reactogenicity Grade >3
  42. Do desirable effects of vaccine outweigh undesirable effects? A resounding Yes, benefits outweigh harms in most settings
  43. Pfizer vaccine demonstrated VERY HIGH efficacy (95%) post 2 dose regimen against symptomatic lab confirmed covid infection
  44. Level of evidence: High certainty
  45. Across all groups (age, gender, race, with comorbidities)
  46. Not included: children, pregnant women, immunodeficient individuals
  47. Limitations
  48. Only 2 month f/u
  49. Limited power to detect rare adverse events

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