Russ White 0:00
Dr. Deborah for Holden is an epidemiologist and CS Mott endowed Professor of Public Health integration at Michigan State University and Associate Dean for public health. She also directs the Flint Center for Health Equity solutions when it comes to vaccine acceptance, Dr. furr Holden thinks we may have done ourselves a disservice. With the term operation warp speed, as

Debra Furr-Holden 0:24
I talked with community, I realized we made a big mistake, and even how we named and frame this, we said operation warp speed. And what a lot of people heard was corner cutting or skipping steps or, you know, quick and dirty, there was a very rigorous process in place. And the great thing about innovations in medicine and science is through mRNA vaccine technology, we are now able to take the code the genetic code of a vaccine, and within two weeks make a candidate vaccine. I mean, this is going to transform how we deliver health and healthcare and vaccinations. So there were no steps that were skipped. But I can understand why people may feel that way. She

Russ White 1:04
says myths and misinformation around the vaccines are a problem. So she encourages us to seek out more than one sole source for information

Debra Furr-Holden 1:13
that the myths and misinformation I know are a big problem. We know this. I think people have just enough information to be dangerous to themselves right now. Because you know, we've all sort of learned a lot about vaccines and viruses and spike proteins, things that we've never heard about before. And then I think we also have some gaps in information. And so I want to answer one specific question and give you a sort of big, bigger picture way of thinking about how and where to get trusted and credible information. So the first thing I'll say is there's no one sole source. I think the CDC is great to have many colleagues who work at the CDC, I told people all during this pandemic, the CDC is filled with some of the nation's greatest scientists and clinician scientists and researchers and epidemiologists, etc. And I think we've seen with our new administration, they've really gotten their mojo back. And they are only one source of information. So there was a specific question posed about the safety of the vaccine during pregnancy. And I think that's a really great question because I myself have that news. I'm going to be a grandma, my oldest daughter is pregnant. And so we really had to roll up our sleeves and look and figure out, you know, what was going to be the decision that she would make, and she's actually also a frontline health care worker, she works in a hospital as a patient advocate. And so we went to the trusted, credible source for pregnant and postpartum women, the American College of Obstetrics and Gynecology. These are the types of groups these professional societies and organizations who have rolled up their sleeves to really do the work and look more deeply when it comes to specialized populations. As an African American, we know that sickle cell trait and sickle cell disease is overrepresented in the African American community, the National Medical Association did a deeper dive into the data that came out of the FDA. And they're working and looking at the data as we rolled out the vaccine, and we get greater numbers of people who have sickle cell trait, and sickle cell disease. So I really encourage people to not just go with some of the usual suspects. Do not get your information from the newspaper, we have great trusted sources of credible information included in that our local health department's, especially as it relates to vaccines. That's a very, very important resource. Why? Because vaccines are actually being rolled out at the local level. So if you want to know what's happening, your local health department is it is a trusted, incredible place to get that information. And going back to the point that people have enough information to be dangerous. One of the questions that my own daughter raised and I want to touch on this just because somebody posed this. She said, Well, Mom, if you can't get the vaccine under 16, how is that vaccine okay for my fetus? And I thought that's a that's a really great question. And what we did is we went to the a cog website, and we looked, and we looked at what their recommendation was, and they are very clear, they've looked at the data as it relates to pregnant and lactating women. And their recommendation was that that group, when they're eligible, not be excluded from the opportunity for vaccination, because they saw no indication that it would pose harm to the mother, that it would pose harm to female fertility, or that it would pose harm to the fetus. So again, I really encourage people get

Russ White 4:27
that trusted, credible information. Dr. Holden stresses the importance of a medical home. And when she says equity, she means fairness.

Debra Furr-Holden 4:36
Another gap that I'd like to speak on that really points this issue around equity, is we've seen now the critical importance of the need for medical home. If you didn't have a medical home coming into this pandemic, I really encourage people take that seriously not just you but for your loved ones and the people in your community and the people that you come in contact with. I always tell people, your medical provider is not the The person in charge of your health and wellness you are, but they're a critical player on your health team. And so if you don't have a health care provider, I'm encouraging people. If you'd like insurance, reach out to your local health plan, their local health plans, who are charged with the task of making sure that everybody in their community has access to health coverage. If you don't have health coverage, if you fall in that weird spot where you make a little too much to qualify for, you know, Medicaid or other supports, and not quite enough to be able to afford it out of pocket, please reach out to your local federally qualified health center, you might say, Well, I'm an MSU. employee, I have health insurance, but you may have others in your life who don't have that luxury or that benefit. The federally qualified health centers, the Fq h C's are charged, they are the stake in the ground for ensuring that everybody in the community has access to a medical provider. On the issue of equity, we have major major gaps in our system. We saw huge breakdowns in both distribution and the data infrastructures that are needed for us to answer the question, are we not only getting the vaccine to community fairly and equitably, but are we also getting into people's arms fairly and fairly and equitably. And I sit on a federal partners call, there's about 13 federal agencies who again, have their sleeves rolled up and are really doing the work to try to backfill those gaps, and make sure that we're doing a good job and being a good steward of the vaccine, I consider the vaccine the dose to hope. And I personally believe hope is something that should be fairly and equitably distributed to all people. So just know that we know we have problems. The State of Michigan is the only state that I know of that close the racial disparity, and COVID cases and deaths. We did that by July and September, we declared it a victory because that gap remained close and it stays close, we've now got to roll up our sleeves and do the same work around vaccine administration and distribution. One of the problems that we have is there actually right now is no federal mandate for that. And I am want to push to mandate equity. And when I say that, what I mean is some requirement that who actually gets the vaccine administered injected into their arm very closely mirrors the population, the community where that vaccine is being administered. And that goes beyond racial equity. We all have elderly loved ones. And we've watched people jump the line and get the vaccine ahead of them. We have people in our families with pre existing health conditions that predispose them to a bad outcome from COVID. So when I say equity, I just mean fairness, fairness for all people. And I will tell you, our federal partners are fired up, and figuring out how we can get that push in place to get our states to really make that a value, and something that's at the forefront of how we're getting this vaccine out to people. I know there might be a lot of confusion for people, you say my numbers come up, I'm in category one, B, I'm 65. I'm 66. I'm now I'm a teacher. And now they've been brought online. And they're unfortunately again, a gap in our system and how things are being done is vaccines are not going to states through one single source. Some are coming to the States, the states are distributing it through county health departments, and through large hospitals. And the federal government is also doing direct distribution to pharmacies and big box stores in other places. So I do realize that it can be confusing. Dr. For Holden wants us to be good stewards of the opportunity to be vaccinated and take control of our health care, you have to stay on your toes and you have to stay informed. Again, our local health departments I think are doing the best job that they can, and making sure that they get information even for vaccine that's not in their hands that's not in their control that were distributed directly to pharmacies without their knowledge or their input. So if you sign up, if you're eligible, I encourage people to sign up. And if you sign up on multiple lists, you sign up through your health department, you sign up through local pharmacy, when you get your first dose of vaccine. I'm asking people to be a good steward of that opportunity. And go back to the second list and cancel that appointment. Don't do it too, you get that first dose. But please be a good steward of the opportunity. And know that we're also working hard to get the data infrastructure in place so that we don't have so much duplication of effort and so much burden on people and already overburdened organizations to ensure equity in distribution and administration. While Dr. Deborah for holding believes in the efficacy of the vaccine. She doesn't tell anyone whether they should or shouldn't get it. The choice of whether or not to get the vaccine is yours. I don't tell people to get the vaccine. What I tell people is this. If you don't grapple with it right now, if you don't make do the work and get all the information and get all of your questions answered and we saw this happen, your number will come up. You might be a no or no for now. You won't lose your right to be in line. But you may lose your place in life. I live in Genesee County, we have a 57,000 person waitlist right now, I got that number from my health officer yesterday, and the list grows by 2000 people a day, they estimate that about a third of those people are actually in category one a. And they were no when their number came up, they had a change of heart. And now they're 57,000 people potentially buy back in line. So I really encourage people do the work grapple, now, we want to get to herd immunity. The way to get to herd immunity is through prevention. I'm an epidemiologist by training, I heart public health, it's like the thing that wakes me up and lights me up every day. herd immunity is not about allowing a significant proportion of our population to get sick, it's about preventing them from getting sick in the first place. So as you grapple with the decision about whether or not to get the vaccine, well, this vaccine is giving you a very small piece of that virus, that spike protein, which is the whole molecule gets in your body, that spike protein is like a key, it unlocks your cell and it lets the whole viral molecule and this spike protein is turning the key your body's building anybody's to stop it from ever being able to get in. If you have concerns about getting this little piece of the of the virus, that's not going to actually get you sick, that's going to help your body mount a credible defense if you actually get exposed to the virus. I asked you to weigh that against what happens if you actually get the virus. So please let your concerns be balanced by you'd rather deal with a sore arm and maybe a fever, chills or a headache for a few days, then deal with the consequences of being infected

Russ White 11:48
continue to stay informed as Dr. furr Holden reminds us that the science on COVID continues to evolve,

Debra Furr-Holden 11:55
be prepared for a game changer every two or three days. Right? Remember, science is not about, we've got it all figured out. This is the truth. At one point, they said the world was flat. Thank God, somebody ventured beyond that point. And we, you know, have learned a lot about how our world world works. We're learning a lot about how to do the rollout distribution and administration of this vaccine, it would not surprise me, if by the time we get to phase two, we see better systems for ensuring those who need it the most. And those who are at risk for the worst outcomes move higher up in the priority chain. So I just ask everybody be patient. That's why it's also so important for people to do that work now. So that when your number does come up, you don't lose your place in line. But I would I would venture to guess changes come in on that one

Russ White 12:47
can vaccinated people still be infected by the virus? And can they spread it once they've been vaccinated?

Debra Furr-Holden 12:53
The thing that we know, like we know, we know we know, is the vaccine is super great at preventing severe illness. So if you were to be exposed, and you're vaccinated, it's very good at preventing severe illness. Think about it, this viruses is brought into the body through the respiratory tract, through your mouth, through your nose, impossibly even through your eyes. So there is a remote possibility that you could be out, you could inhale, virus, and you could exhale it in even though you're vaccinated, you can still pass it on to somebody else. That's a very small possibility, but it's possible, and there will be people for whom they will have been vaccinated. And there's a little bit of a complexity because the full effect of the vaccine happens weeks after you've gotten the first and then the full 94 95% happens, you know, two to three weeks depending on which one you got after you get the second dose. So let's just pretend we're in the best case scenario, you've gotten your first dose, depending on which one you got, you got in the right timeframe window, you got the second dose, you're three weeks out, so you have the full benefit of the vaccine, there will be some very small percentage of people who will actually still get the virus. And if you get the virus, they still may have the potential to spread the virus. But that likelihood goes way way down relative to if you were not vaccinated. And more importantly, it gives you the the tremendous benefit of avoiding these very negative outcomes that we've seen people have. And there's something worse not worse than but also really bad short of death. And we're learning now that even people who were asymptomatic or had very few symptoms, we're starting to see these won't be long term effects that people are dealing with. So it goes back to the point that I made that you would much rather get the vaccine than the virus. So it's a imperfect but important layer of protection imperfect, but critically important

Russ White 14:50
for holding was appointed by Governor Gretchen Whitmer. To be a member of the Michigan Coronavirus taskforce on racial disparities.

Debra Furr-Holden 14:58
I think that we have An opportunity before us, I've been telling people and I've had the experience myself that I feel like as a nation, and as a global community, we are at our most vulnerable right now. You know, people I think, have really just this has taken a toll on everybody independent of race, economics, gender, you know, gender identity, and all of these things, we, we just, this is just made us all very vulnerable, and in some respects, has allowed us to understand See, process and digest, you know, and kind of almost be forced to confront the world that we live in. And fundamentally, we know that we don't live in a world where, you know, opportunity for health and growth and development is realized equally and equitably by all people. And so I just encourage people to, you know, really, really take this opportunity to, you know, be willing to look at, where, because the thing about privilege, privilege is a really funny thing. There are a lot of people who experience privilege, who never asked for it, they are champions and believers in a world that works for everyone. In a world that's fair and equitable. And I think a lot of us have now had to confront that, that is not actually the society that we live in, either, you know, at a national level or at a global level. And, and, and some of us sort of knew this and innovate different lived experience that experiences that speak to it, but now it's become inescapable. And so I really just encouraged people to use this opportunity. While we are in this, you know, period of modified operations, and people are at home and sort of, you know, almost forced to digesting and consume media and other things that are happening, not to be overwhelmed by it. But to really say, okay, like, if I didn't see it, or understand it before I can see it and understand it now. And really stand in, what can I do? And who can I be as a champion for a world that really works for everybody? You know, I think many of us on the front lines of healthcare, this is always, you know, been our mission. Right? That health is something that people experience as a right and not as a privilege. And in a nation as rich and as, you know, capable and innovative as ours. I think we should be global leaders in developing and implementing a world that works for everyone. And so I do encourage people to stay safe, continue to practice all the protocols, but there is an opportunity before us to really just now confront some of our gaps and having health, health and health care. be something that is a right and not a privilege.

Russ White 18:07
That's Dr. Deborah for holding an epidemiologist and CS Mott endowed Professor of Public Health integration, and Associate Dean for public health at MSU. She also directs the Flint Center for Health Equity solutions. Find more at public health, that msu.edu and she's on twitter at Dr. Deb for Holden. I'm Russ white, this is MSU today

Transcribed by https://otter.ai