Health & Well-Being
All things wellness affecting BIPOC womxn.
"Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare." - Audre Lorde
Since early 2020, most of us...if not ALL of us...have faced much uncertainty and many challenges mentally, emotionally, and even professionally as we've been confined to social distancing and mask requirements and most importantly....work from home orders. Y'all...we've really been in the house for almost a year and things have and continue to feel very different. After months of new adjustments and normalcy, we are finally provided with vaccination opportunities. But, should we take them? Or nah? This question remains with a lot of people, due to how fast vaccines have been swiftly and mass produced. Additionally, for people of color, the question remains possibly as a result of justified fear and generational trauma from medical wrongdoings in our communities. For this reason, I linked up with Dr. Kimberly Rogers, a primary care internal medicine physician to put some of not just my fears to rest...but all of our own. And to present us with nothing but the facts about the new, swirling COVID vaccines. Welcome to Dialosophy, Dr. Rogers.
Q: Dr. Rogers, thank you so much for agreeing to do this Q & A. I’ve been following you online for a while now and reached out to you because I’m, like a lot of other people, contemplating getting the new COVID-19 vaccine…but I’m nervous. Scared, really. And you’re a trusted healthcare professional, so let’s talk. Before we dive into the vaccine, why don’t you tell us a little bit about yourself and your journey to becoming a physician?
A: Of course! I am a Caribbean immigrant from Anguilla, living in the US for the past 17 years. I completed undergrad, med school and residency in the northeast and have been practicing as a primary care internal medicine physician for the past 6 years. I also am board certified in lifestyle medicine which incorporates evidence-based lifestyle practices such as nutrition, exercise and wellness as an adjunct to traditional medicine practices. So I am definitely an advocate for evidence-based preventive medicine and a public health practices.
Q: Okay now…vaccine time. Let’s start with the pure basics. Lol. Take me back to college biology. What is a vaccine, and how is it supposed to work?
A: So in order to talk about vaccines we need to talk about our immune system. Simply put, our immune system is like an army of soldiers that defends our bodies against enemy germs (viruses, bacteria etc). When we’re exposed to a germ for the first time, our immune system recognizes a “foreign invader”, and begins the process of building its army of immune cells (B cells, T cells, macrophages,; etc.) to fight off the germ. The best part is that our immune system remembers and learns from this experience, so if that particular germ ever comes along again, the army is primed and ready to immediately attack even faster than the first time.
Vaccines basically are an intentional way of priming our immune system by exposing it to some aspect of a particular germ -either a weakened or dead germ, or a small piece of the germ or germ toxin- just enough to trick our immune system into reacting in the same way it would to a real pathogen. Because it “remembers”, if our bodies are later exposed to the REAL germ, our immune system is primed to swiftly attack and defend against invasion.
Specifically in the case of the COVID vaccine, this vaccine actually injects our bodies with messenger RNA (mRNA) which contains instructions to our bodies to make the “spike” protein that is found on the surface of coronavirus. This spike protein triggers the immune system into action. Once we are immunized, if we are exposed to the real coronavirus, our immune system is already prepared and has a better chance of destroying the virus quickly and efficiently. The vaccine does NOT cause us to be infected with coronavirus.
Q: We, the public, know that vaccines typically take YEARS to develop…so, in your professional opinion, can we really “trust the science” with a vaccine that’s been developed so quickly?
A: In full disclosure, I was initially uncomfortable with Operation Warp Speed myself. But then I did my research, and learned that the mRNA technology of the COVID vaccine has actually been around for over 30 years, so scientists have been developing the technology for a long time and were able to use it in the vaccine for the first time. Also, with regard to the process that goes into developing a vaccine and getting it approved, the urgency of the pandemic was so great that it become an “all hands on deck” approach, with teams of scientists all over the world working to create the vaccine and conduct the studies, with large number of participants in the trials. None of the regulatory or operational steps required for vaccine approval were skipped, so that’s reassuring. All these factors together explain how the vaccines were able to be produced so quickly, but without compromising safety or integrity of the process. Knowing this made me feel better about being vaccinated.
Q: Can you break down the research behind the COVID vaccine and it’s efficacy? What do the results tell us, regarding the sample size? Are there any differences between the Moderna and Pfizer vaccines we should be aware of?
A: Both Moderna and Pfizer’s vaccine use the same mRNA technology, so for the purposes of the studies it’s easy to compare them side by side. The trials included 30,400 people for Moderna and 44,000 for Pfizer, and both showed about 95% efficacy in preventing symptomatic illness from covid19. They compared people that received the vaccine against people that received placebo, and at the end of the study looked at how many people contracted COVID. Both vaccine studies showed a significantly lower number of cases of COVID in the group that received the vaccine compared to the group that received placebo. Also, all the vaccinated people that did contract COVID only experienced mild symptoms.
It seems that the side effect profile of both vaccines are similar, their effectiveness is about the same, but there are minor differences like the temperature they’re stored at, and how they are prepared for injection, and the timing between first and second dose. Ultimately, receiving either brand should provide the same level of protection.
Q: So, I was with a group of friends and someone mentioned a picture floating around the net of a few people getting a “droopy” face I guess, after the vaccine (see below). So, to clear things up…can getting this vaccine lead to that, aka Bell’s Palsy?
A: So Bell’s palsy (BP) is a rare, temporary facial paralysis that naturally occurs in 23 cases per 100,000 people a year, and usually resolves completely. The vaccine trials reported 4 cases of BP in the Pfizer trial (out of 44,000 people). There were 3 cases of BP in the Moderna trial (out of 30,4000), and only 2 of those people had received the actual vaccine. According to data analysts, the overall incidence of Bell’s palsy was the same in the trial as in the general population, meaning it could just have been by chance and those people were going to develop BP anyway.
However, they did observe that most of the people in the trial who developed BP had received the real vaccine (6 cases) vs only 1 case from the placebo group…so they are definitely continuing to closely monitor this. And just to provide further context, BP is usually a temporary condition, AND it occurred in a very small number of people. Of course, because we are hypervigilant about this vaccine, any bad reaction is going to end up in the news, even if it only happened to 1 in a million people. At the end of the day, we have to weigh the potential risk vs potential benefit of any vaccine.
Q: I’m curious to know…were pregnant women adequately accounted for or included in the vaccine trials? Is this vaccine safe for expectant mothers? Has there been any adverse effects reported with this vaccine, among pregnant women?
A: Pregnant people were not included in the initial trials, but based on the safety profile of the vaccine, the American College of Obstetrics and Gynecology (ACOG) recommends that the vaccine should not be withheld from pregnant individuals who meet criteria for vaccination. Although there is no explicit data to say the vaccine is safe, there is also no data to show it is NOT safe. And pregnant patients are at higher risk of COVID complications. So, this is definitely a bit of a grey zone, and pregnant patients should really discuss their individual risk/benefit profile with their doctor when considering the vaccine. Personally, I know of multiple pregnant physician colleagues who have opted to receive the vaccine, and I’m sure others have opted against it. There are studies underway to further clarify this.
Q: Lets go a little deeper, and lets just call a spade a spade. I consider myself a public health professional. But STILL. As a person of color, I realize that some of my hesitance with this vaccine comes from the medical distrust that exist in communities of color. What do you say to that, Dr. Rogers? How do we convince communities who are descendants of trauma from the Tuskegee Experiment, forced sterilization, and other wrongful medical practices done to indigenous and people of color in this country…to get this vaccine?
A: It is definitely understandable why our minority communities are more wary of vaccination in general. The distrust of the medical community after multiple atrocities is very real, and very valid. However, we do know that BIPOC populations are disproportionally dying of COVID for various reasons, many of which are rooted in racial disparities. Minorities are more likely to have chronic health conditions, more likely to work jobs that expose them to the virus, and as a result are more likely to have more severe disease, be hospitalized, and to die. Many people would argue that implicit bias also may affect the quality of treatment they receive. So, if anything, BIPOC being vaccinated is the best way to avoid ending up in a situation where they may receive worse care. Prevention is key!
Q: Do you think people living with elderly family members or other vulnerable/exposed populations, should get this vaccine?
A: Definitely. Getting vaccinated in general makes it harder for the virus to infect you, which then makes it harder for you to infect others. Although the COVID vaccine trials didn’t explicitly prove that getting vaccinated reduces transmission to others (because the studies were focused on finding out whether the vaccine prevented COVID disease)...this question is being studied as we speak, and the expectation and hope is that vaccinated people have a lower chance of passing along the virus to others. This would be huge!
Q: So, what happens next AFTER the vaccine? If someone were to get vaccinated, does that mean they can stop wearing masks and/or doing the other safety measures we’ve been told regarding the coronavirus?
A: Unfortunately, that’s not the case. Firstly, it takes weeks after the second dose of the vaccine to become fully immunized, and as mentioned before, we have to first prove that getting vaccinated prevents transmission to other people. The virus is still raging and it will take a large % of the population being immune to COVID (either through immunization or infection) before the virus has nowhere to go, and stop spreading like wildfire. Until then we must continue the same diligent practices of mask wearing, hand washing, disinfecting surfaces and social distancing.
Q: Lol. I’m sure this is a given, but are you getting the vaccine, Dr. Rogers? If so, tell us why?
A: So I actually received my first dose of Moderna last week. Why? Because as a health care worker, I want to do everything possible to reduce my risk of death or serious illness from COVID, I want to protect my patients, my family and my community. Also, setting an example is key in helping folk feel more comfortable with getting vaccinated themselves, especially folk of color like myself.
Q: Wrapping up now, doc! I can speak for me, at the very least, when I say I am so grateful to have gotten this information from you. Last question. What has life been like for you, during this pandemic, as a physician? Can you pull us a little into your world and tell us some of the things you’ve seen and anything else important readers should know about the coronavirus, the vaccine, etc.?
A: On personal level, I’ve been sheltered a lot more than other health care workers during the height of pandemic because it actually coincided with the birth of my child, and since being pregnant is considered high risk...I was mainly treating patients via telehealth. However, it didn’t make me less anxious about the pandemic, and I’ve lost a few patients to COVID for sure. I know multiple colleagues who have been infected and hear the stories every day about our colleagues dying. It’s also been extremely frustrating seeing the blatant disregard for the virus from conspiracy theorists, people who care more about individual liberties than the safety of our communities, because we see it and know it’s real but people are still pretending its fake news. We’ve already lost more people to this virus than deaths from WW2, and the numbers continue to climb. And we continue to focus on the relatively low mortality rate, but forget that there are countless other people who are alive, but suffering from long term health effects from COVID. Damaged lungs, damaged heart, cognitive issues, chronic fatigue and pain…it’s just really important to remember that the vaccine is proven to reduce severe disease, and will help prevent the virus from ravaging our bodies. It gives us the best hope at returning to a normal life sooner rather than later. Let’s continue to be diligent, but open to science. I’d never advocate forcing a vaccine on anyone, rather I believe that once the facts are laid out, people will have the chance to make the most informed option for themselves and their loved ones. Ultimately, we’re in this together.
Meet Dr. Rogers