A Town Hall meeting sponsored by Public Health answered questions from seldom-addressed community members. Participants included (from top left) American Sign Language interpreter Robin Babb, Dr. Andrea Medina, Dr. Henning Ansorg, Lawanda Lyons-Pruitt (bottom left), and Van Do-Reynoso. | Credit: Courtesy

What is in the COVID-19 vaccine, how effective and safe is it, and what documents do you need to get it? These were among the dozen or so fundamental questions asked during a town hall meeting hosted by Santa Barbara County Public Health on February 11. The forum was geared toward the multiple ethnicities in Santa Barbara County — and was simultaneously translated into Mixteco and Spanish — and the questions had been gathered prior to the meeting.

More than 4,000 county residents tuned in to hear the answers from Public Health officials, including Van Do-Reynoso, director of Public Health; Dr. Henning Ansorg, the agency’s health officer; and Paige Batson, deputy director for Community Health. Notably, all spoke simply, directly, and gently, even when delivering painful information such as the inequity in the death rate among Black and brown peoples.

Trust was clearly an issue — trust that the vaccine won’t be harmful, trust that it works, trust that lining up for a vaccine won’t backfire. “We can only move at the speed of trust,” Do-Reynoso said, adding that her department was committed to removing time and location barriers and finding ways to enable everyone to be vaccinated. Though her department had experienced difficulties getting adequate vaccine supplies, which are scarce, she assured viewers that fully 81 percent of the vaccines the county had received was going into arms.

“How do you obtain the vaccine if you have no medical or job-related insurance?” asked Martha Jiménez of the Santa Barbara County Promotores Network. Once a person is eligible to receive it, said Do-Reynoso — referencing the fact that the county was currently only vaccinating people 65 years and older, as well as health-care and senior-home frontline workers — “the vaccine is completely free of charge.”

Dalia Garcia with MICOP (Mixteco Indigena Community Organizing Project) followed up, describing the experience of a colleague in Santa Maria. The Albertsons pharmacy had asked for the last four digits of his Social Security number and for his insurance card. “Fortunately for him, it was not a problem,” Garcia said. “These types of questions scare our community. They don’t allow comfort with or trust in the vaccine.”

“I can see how being asked that could be very threatening,” Do-Reynoso replied, “and could be a barrier for other community members.” She thanked Garcia for the information, saying firmly, “I will address this with that partner to make sure it doesn’t happen again.” On the Tuesday after the Town Hall meeting, however, a story broke that a photo ID was necessary to get the vaccine; a 92-year-old resident whose ID had been stolen had been turned away. (Read the full story here.)

[Update: On February 19, Do-Reynoso stated that the 92-year-old woman did not have an appointment, which is why she was turned away. They only had enough vaccine for people already signed up. Documentation was not necessary for the vaccine, she affirmed. See more here.]

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‘Not an Equal-Opportunity Killer’

The inequities that persisted despite their efforts were addressed by Paige Batson, who spoke of the minority groups who’d suffered COVID-19 in percentages greater than their population in the county. The virus was “not an equal-opportunity killer,” she said: Black, Latinx, and Indigenous people had become ill with the virus and suffered more severe cases than the general population. The cause wasn’t inherent but due to health-care inequities and other disparities, such as crowded housing that didn’t permit effective quarantine, Batson commented. Communities of color were also more affected by chronic maladies such as diabetes and hypertension, she acknowledged, which tended to lead to serious COVID outcomes.

The historic lack of balance in health care was mentioned by Dr. Andrea Medina, who coordinates the COVID-19 Response Task Force for the Latinx and Indigenous populations. During her talk earlier in the discussion, she offered a “deep apology” to her brother and sister Chumash for the lack of attention to their basic needs and equitable medical services. The town hall was their first take on a health-equity approach in the current “time of great loss and pain,” Medina said, for all races and gender identities to see each other, listen to each other, and support each other.

Vital Vaccine Information

“What is in the vaccine?” asked Alex Calangan with the Filipino Seniors Association of Santa Maria. Ansorg explained it was a different vaccine from those up to now, which contain a bit of virus. Both the Moderna and Pfizer vaccines contain instead a small piece of genetic code — a piece of RNA. No viral infection develops, he assured. Ansorg also expected that a third vaccine, from Johnson & Johnson, would be approved soon, and it only required a single shot. The Johnson & Johnson vaccine uses a killed virus with a little piece of genetic code that cannot make you sick, said Ansorg. It’s as if a car drives into a garage that’s the human cell in the body: “It gets the information in there so that the body makes antibodies to fight the virus,” he explained.

“What is the percent efficacy?” Esron Gates with Healing Justice wanted to know: “What’s the percent that we won’t have the virus again?” The efficacy for both available vaccines was high, said Ansorg: 95 percent for Pfizer; 94 percent for Moderna. He noted that people of Latinx ethnicity had a better response during the Moderna testing than other ethnicities and that it was fortunate that both vaccines worked so well.

“How long does immunity last?” asked Paola Ligario, the Indigenous youth organizer with MICOP. Ansorg admitted that with the vaccines so new, they didn’t yet know. The trials had begun a year ago, and they were seeing how good the antibody response was. He thought it could be one year or maybe three years before a booster was needed. He also said regarding long-term effects, that there were so far no signs of significant or long-term negative effects.

Had the vaccine been tested on Black, brown, and Indigenous people, or those with high blood pressure or diabetes? This question came from Lawanda Lyons Pruitt, who leads the county chapter of the NAACP. Ansorg stated both drugs were tested on people of many ethnicities. For Pfizer, the breakdown was 26 percent Latinx, 9.8 percent African American, and 4.4 percent Asian out of trials of 44,000 people. High blood pressure had not been measured, although 21 percent had at least one other condition, high blood pressure among them. Also, 8.4 percent were diabetic, and 35 percent were quite overweight.

In the Moderna trials, 20.5 percent were Latinx, 10.2 percent were African American, 4.6 percent Asian, 0.8 percent American Indian/Alaskan, and 0.2 Hawai’ian/Pacific Islander. The multi-racial box was checked by 2.1 percent of participants, and diabetes by 9.5 percent of them.

Martha Jiménez asked if the vaccine had side effects. Signs did occur that the immune system was being triggered by the vaccine, Ansorg said, such as headache, though for no more than two days, as well as chills and fever. Very rarely, maybe 10 or 11 times in a million, a person has a severe allergic reaction, which was easily treatable, he said. That was why they asked people to stay for 15-20 minutes after the shot to make sure that didn’t happen. However, if you have a reaction, let the vaccine provider know, counseled Batson. If difficulty breathing or another severe reaction occurs, seek medical care, she said. The Centers for Disease Control was collecting data on reactions, and they can be reported at the V-safe smartphone tool.

Other considerations, Ansorg added, were for people with a severe allergy to a vaccine ingredient — polyethylene glycol — a chemical compound used before a colonoscopy and in dental work. If someone had a severe reaction to the first shot, he said, they should avoid the second. As well, pregnant women or patients with a disease like cancer that required immune-suppressing medications would want to talk with their doctor and find out if the benefits of the vaccine outweighed any potential risk.

Dalia Garcia of MICOP also asked how Public Health would ensure equitable access to the vaccines. Working with groups like hers, said Do-Reynoso, and other community groups would help them see that the most vulnerable, including Indigenous and immigrant women, received the vaccines. The vaccine would be allocated to community providers and pharmacies in the communities who had experience with the groups. “The pandemic has brought to the surface all the structural inequalities that exist,” she said. The success her department had in other health efforts would help them create safe, culturally and linguistically appropriate spaces for vaccinations at times and on days that were convenient for the workers among the communities, Do-Reynoso said.

Those groups administering the vaccine included federally qualified health centers, hospitals, and private health providers, added Batson. Information was available at the county’s 2-1-1 information line, she advised, and at Public Health’s Facebook, Instagram, and Twitter, as well as its website, publichealthsbc.org. (The site currently states 2-1-1 wait times are long.) Also, she said the state’s MyTurn vaccination registration site would soon become Public Health’s appointment scheduler and was the place to find out if you can get a vaccination.

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