Progress has been made in addressing equity in vaccine uptake, yet more needs to be done.
“I appreciate the fact that what we’ve done better at is addressing disparities in vaccine uptake,” Dr. Florence Momplaisir, assistant professor of Medicine, Perelman School of Medicine, said as she spoke during a University of Pennsylvania virtual panel discussion.
“Issues related to racial disparities are complex, and they are rooted in practices of structural racism, and it will take a lot of time and persistent, intentional effort to move the needle toward equity, but I say that we can get there.”
“We already see the gap in terms of racial disparities in terms of vaccine uptake to be lowered and they have lowered over time,” she continued.
Momplaisir was one of four medical professionals who participated in a panel discussion on Friday titled “COVID-19 Vaccines: One Year Later.”
“I think that what we’re learned since the beginning of this pandemic is that using multiple-level strategies is key,” she explained. “What I mean by that is that we can’t address the lack of access to COVID-19 vaccines without addressing vaccine hesitancy. This is both valid in the U.S. and globally.”
She said there is a need to increase access to free vaccines particularly in communities that are under-resourced where incidence is high, and provide vaccination at trusted and convenient places like schools, churches, barbershops, salons and pharmacies.
Momplaisir also underscored the importance of continuing to provide access to COVID-19 testing.
“While vaccination is a key pillar to COVID-19 prevention, I do think that testing still has value particularly because a significant number of individuals have not been vaccinated and testing and isolation still remain an important strategy to combating the pandemic,” she explained.
“What I see right now in the current landscape is that testing is either unavailable or costly, and I think we need to do better,” Momplaisir said. “So overall I think we have done better, but I think there’s a lot of work to be done.”
The panelists also addressed the omicron variant in addition to discussing COVID-19 vaccine distribution, uptake and equity.
Dr. Ala Stanford, founder of the Black Doctors COVID-19 Consortium, highlighted the gains made in getting more African American Philadelphians vaccinated.
“Bloomberg reported that we have the highest rate of African Americans vaccinated in the United States,” she said.
“I am raising my hand as a full proponent and taking credit for a lot of that work.”
“We have to be careful because the narrative that African Americans and Black and brown people didn’t want vaccines — that made it hard for me to get vaccines from the city,” Stanford said. “I had to show that people wanted it.”
The Consortium has vaccinated more than 53,000 Philadelphians.
“Even if I didn’t personally vaccinate them, I know a lot of people who have said, ‘Because we listened to what you all were doing, because we saw you, we know it was okay,’ and that matters,” Stanford said.
Stanford also spoke on how health systems can serve the community equitably. She noted that medical providers need to reflect the communities they serve.
“We know that doctors of color only represent five percent but the ones who are there need to be culturally competent,” Stanford stated. “It should actually be part of the hiring process, when new employees come in, that you need to know how comfortable you are in the environment.”
Dr. Paul Offit, director of the Vaccine Education Center and professor of Pediatrics, Division of Infectious Diseases, Children’s Hospital of Philadelphia, offered some insight on vaccine effectiveness in light of the omicron variant.
“I think that we have to define what it is we want from this vaccine,” he said. “All evidence is that we have protection against serious illness for the original variant that came into this country, as well as for the alpha variant, the delta variant, and likely we’ll have that for the omicron variant.”
“If protection from serious illness is what we want, then it is very likely that two doses of an mRNA (messenger RNA) containing vaccine or a Johnson and Johnson vaccine will do just that,” Offit said.
“If on the other hand, we want protection against mild illness or low-moderate illness, which is mediated by naturalizing antibodies present in the circulation at the time of infection, that’s different and that’s going to mean not just a booster dose. I think it will likely mean more than one booster dose in the future and I just think that we need to get the public to understand that,” he continued.
He noted that CHOP experienced an uptick in COVID patients admitted to the intensive care unit last week.
“I can tell you what all those patients had in common, including most who were over five. None of them had been vaccinated,” Offit said. “The problem here is not boosting the vaccinated. It’s getting people to vaccinate. We’re not going to leave this pandemic until that.”
Dr. Nicole Lurie, U.S. director and strategic advisor to the CEO, Coalition for Epidemic Preparedness Initiatives, spoke on increasing vaccine availability for countries around the world.
“I think what we’ve seen is high-income countries continuing to buy up and hoard vaccine, being really, really slow to release their hold on those doses to COVAX, so that they can be distributed elsewhere,” she said.
“When they are released, they are released with short time to exporate. They are released with almost no notice so a country can’t plan, and then we say a country can’t deliver those doses.”
“I would say we’ve got to get vaccines to the rest of the world and we desperately need to accelerate it,” Lurie said.