Dorothy R. Novick is a pediatrician in Philadelphia.
My own headache was a throbbing sort of ache, at the base of the back of my skull. It wasn’t severe as headaches go, but it was hard not to feel a creeping sense of dread. When I was ill with covid-19 just four weeks earlier (yes, you still should be vaccinated if you’ve previously tested positive for the virus), it had started with a similar headache.
I took ibuprofen, lay on the couch and reminded myself why this was different. I pictured the little peg-shaped proteins my body was making. How powerless they were, wandering through my bloodstream all by themselves. How they might stick to the outsides of my cells but could do no damage. How my immune system was chewing them up and spitting them out.
Then I pictured the novel coronavirus. How its shell is coated with these same proteins and its inside is filled with coils of genetic material. How it, too, had stuck to the outsides of my cells, and then injected its coils inside them. How it had reproduced and coursed through my body, searing my lungs and elevating my temperature for 10 full days. How the virus sapped my strength and defeated my spirit.
The difference between those two experiences was enormous. My vaccine reaction was from one small protein revving up my immune system; my illness had been from a large and complex virus destroying my tissues.
People are hesitant toward coronavirus vaccines for a variety of reasons. I hear them often from my patients: “Was it rushed?” “Can we trust it?” “Will it give me covid?” They mostly nod in appreciation when I explain the trials were similar in size and design to others. But then we get to the part about side effects, and I often see them bracing. It is a reaction I recognize from years of people refusing the flu vaccine, from their conviction when they say, “Oh no, it makes me sick.”
It’s not that my patients mind having a headache for a day in exchange for protection from covid-19; they don’t. And it’s not that they doubt the effectiveness of the vaccine; they don’t. What I hear is that people are worried the coronavirus vaccine contains parts of the virus. “Don’t they put the virus inside you?” is a common refrain. “They” being me.
It isn’t enough to quote studies and percentages. When my patients feel ill after vaccines, they fear that fragment of virus. Even a small piece of this virus, they say, could be enough to knock you down. As I listen, I remember that I, too, needed reassurance when my head started throbbing. I remember that feeling ill can seem like a harbinger, especially for those who’ve been sick or lost loved ones. And I remember that many patients from Black, Hispanic and indigenous communities have well-founded reasons to be wary of our health-care system.
Time is of the essence. A new, apparently more contagious strain of the virus is making its way across the globe. Widespread vaccination, if done quickly enough, could interrupt it in its tracks.
As health-care professionals, we have a crucial role to play in increasing vaccine acceptance. Yes, we need to let patients know that up to 28 percent of people take fever or pain medicine after the first dose, and that their symptoms resolve within a few days. But we need to do more. We need to understand that the fear is real, it is visceral, and it doesn’t always respond to statistics. We need to listen, empathize and take time to explain. We need to ask if we’re making sense, if there are questions, if more information would be helpful.
I recently saw a child whose father works inside prisons. The father and I talked about the coronavirus vaccine, and he said he wasn’t sure. He thought he would wait. I listened, said I understood, and then asked if he wanted to hear more. We talked about how the vaccine makes small proteins but none of the evil bits. He watched me draw cells and antibodies and spike proteins and coils of genetic material on the exam table paper. He thanked me. Then he took the diagram home and said he would reconsider.
My colleagues and I kept celebrating after getting vaccinated, even though we had side effects. We believed in our hearts that the vaccine wasn’t “giving us” covid-19. If we have any hope of interrupting this pandemic, we need to ensure everyone else believes this, too. We need to work like our future depends on it. Because it does.