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
50. Vaccine effectiveness against hospitalization 100%
51. L of E: low certainty because rare outcome
52. Deaths uncommon
53. 2 in vaccine
54. 4 placebo
55. L of E: very low certainty because rate outcome
56. Serious adverse events very similar in vaccine vs placebo groups
57. L of E: moderate
58. Severe reactions (>3 grade)
59. 8.8% vaccinated
60. 2.1% placebo
61. L of E: high certainty
62. Uncertainty about vaccine by surveys
63. Scientific articles 272, 14 included
64. News/media, 19 included
65. Intentions
66. Acceptance lowest among Black respondents
67. 25-55% for Black
68. 37-70% for White
69. > with higher SES
70. > with hx of flu vaccination
71. > with healthcare provider recommendation
72. Concerns
73. Vaccine side effects
74. Uncertainty of efficacy
75. Speed of approval process
76. Low risk perception of disease
77. High vaccination rates require addressing the previous mentioned barriers
78. Access
79. Cost
80. Federal law states insurers provide COVID-19 vaccination for free
81. Trump admin has said free for uninsured but there are questions about funding
82. People need to know where to access
83. Distrust
84. Safety concerns
85. What are the risks of side effects?
86. Strategies to increase vaccination rates
87. Healthcare providers can increase vaccination rates by pairing recommendation with offer at same time
88. Provide info in linguistic and culturally appropriate ways
89. Proactively address peoples concerns
90. Use trusted individuals from the community as messengers
91. References
92. Artiga S. Orgera K. Key Facts on Health and Health Care by Race. Kaiser Family Foundation. 2019
93. Quinn SC. African American adults and seasonal influenza vaccination: Changing our approach can move the needle. Human Vaccines & Immunotherapeutics. 2018;14(3):719-723.
94. Rahimi H, Picaud Y, Costanzo S, Madhusudan G, Boissier O, Singh  kamal D. Design and simulation of a hybrid architecture for edge computing in 5g and beyond. arXiv:20090041 null. Published online August 31, 2020.
95. Quinn SC, Jamison A, Freimuth VS, An J, Hancock GR, Musa D. Exploring racial influences on flu vaccine attitudes and behavior: Results of a national survey of White and African American adults. Vaccine. 2017;35(8):1167-1174.
96. Maurer J, Harris KM, Uscher-Pines L. Can routine offering of influenza vaccination in office-based settings reduce racial and ethnic disparities in adult influenza vaccination? J GEN INTERN MED. 2014;29(12):1624-1630.
97.  Artiga S. Michaud, J. Kates, J. Orgera K. Racial Disparities in Flu Vaccination: Implications for COVID-19 Vaccination Efforts. Kaiser Family Foundation. 2020
98. ACIP COVID-19 Vaccines Evidence to Recommendation Framework. 2020
99. Contact/Support/Questions/Comments
100. How to contact the initiative to support, collaborate, ask questions:
101. Email: atlast@atvantagepodcasts.com
102. GoFundMe
103. https://www.gofundme.com/f/increasing-diversity-in-athletic-training
104. Guest Contact info
105. LinkedIn: https://www.linkedin.com/in/christinamcady/
106. Gratitude and Blessings
107. Artwork by Jason Eisenberg
108. Instagram: @dots_and_squares
109. LinkedIn: https://www.linkedin.com/in/jasoneisenberg00/
110. Intro/Outro music by Willie B the Ichiban Don
111. Instagram: @ichibandon
112. LinkedIn: https://www.linkedin.com/in/william-brown-25945b168/
113. Production / Engineering / Editing / Content Creation
114. Joseph “J Pash” Patrick
115. Website: https://www.passionnetpro.com/
116. Twitter: @passionnetpro
117. Instagram: @passionnetpro
118. Facebook: https://www.facebook.com/passionnetpro/
119. LinkedIn: https://www.linkedin.com/in/passionnetpro/
120. Gerson Sandoval
121. Instagram: @thesoundarchitects
122. Websites: 
123. https://thesoundarchitects.com/
124. https://soundbetter.com/profiles/347950-the-sound-architects