John Yang: Hello everybody. I’m John Yang from the PBS NewsHour. And on behalf of AARP, I want to welcome you all to this important discussion about the coronavirus. Before we begin, I want to tell you that if you want to hear this telephone town hall in Mandarin, and you are on a telephone, press *0 on your telephone keypad now for a simultaneous translation in Mandarin. AARP, as we hope you know, is a nonprofit, nonpartisan, membership organization. It’s been promoting the health and well-being of older Americans for more than 60 years. And for the last year in the face of the global coronavirus pandemic, AARP has been and continues to provide information and resources to help older adults and those caring for them. Today we’re going to discuss the latest on the pandemic, on vaccine safety and access, and what the continued distribution of vaccines means for Asian-Americans, Native Hawaiians and Pacific Islanders.
Today’s panel of experts will address these issues and more, and take your questions. If you’ve participated in one of these town halls before, you know what it’s like; it’s like a radio talk show. You’ll have the opportunity to ask questions live. And once again, if you’re on a phone and you want to hear a simultaneous Mandarin translation, press *0 on your telephone keypad now. And if you are on the phone with us and you want to ask a question of our experts about the coronavirus pandemic, press *3 on your telephone and you’ll be connected with an AARP staff member. They’ll note your name, your question, and place you in a queue to ask that question live on this town hall. If you’re joining us on Facebook or on YouTube, you can post your question in the comments and your question will be read aloud on this town hall.
We have with us today some outstanding leaders and experts in the field from the University of California San Francisco; the Philippine Nurses Association of America; and the U.S. Public Health Service, and the Surgeon General’s Office in the U.S. Department of Health and Human Services [HHS]. We’re also being joined by AARP’s Jean Setzfand, who will help us with your calls and questions and get them to us tonight.
This event is being recorded. You can watch the recording about 24 hours after we end. You can watch it at aarp.org/coronavirus. That’s aarp.org/coronavirus.
Now let’s bring in our guests. We have some very distinguished guests. First, Adelaida Rosario, and I hope I’m getting all these names correctly. Adelaida Rosario holds a Ph.D. She’s a lieutenant in the U.S. Public Health Service and the Surgeon General’s Office in the Department of Health and Human Services. Dr. Rosario, welcome.
Adelaida Rosario: Thank you, sir. How are you?
John Yang: Very well, and I hope you are well, too. Dr. Alka Kanaya is a professor of medicine at the University of California San Francisco. She focuses her work on a range of health issues, including a research program focused on the health of South Asian adults. Dr. Kanaya, thanks for being with us tonight.
Alka Kanaya: Thank you. Pleasure to be here.
John Yang: And Mary Joy Garcia-Dia, she holds a doctorate in nursing practices. She is the president of the Philippine Nurses Association of America, which has more than 5,000 members and works to uphold and foster the positive image and welfare of Filipino American nurses. And if I may add, they are heroes 365 days a year, but particularly in the past year, they have been superheroes. So Dr. Garcia-Dia, thanks for being with us and thanks for all you do.
Mary Joy Garcia-Dia: Thank you so much, John, I really appreciate it.
John Yang: And before we get to your questions for our guests, we think it’s only fair that we get asked a question of you. So we’d like to know, do you live in a multigenerational household? If you’re on the phone, press 1 for yes if you do live in a multigenerational household. Press 2 if you do not live in a multigenerational household. Once again, do you live in a multigenerational household? Press 1 if yes, if you live with multiple generations, and 2 if you do not. We’ll be back with the results of that, and also build on a question depending on how you answer that later on in the town hall.
But right now, let’s get started with our discussion. … So to our guests, I’d like to ask each of you a pretty important question. We have a diverse mix of backgrounds here. We have a diverse mix of expertise here. So I’d like to know from your viewpoint, from each of your viewpoints, what’s the challenge, the biggest challenge or challenges to the Asian American, Native Hawaiian and Pacific Islander [AANHPI] community to getting information about the pandemic and getting the vaccine and the availability of the vaccines, and what are the suggestions or solutions for getting over those hurdles, those challenges? Dr. Rosario, let’s start with you.
Adelaida Rosario: Thank you, John. Well, as you can imagine there are several challenges for our AANHPI community. First, there’s the obvious language barriers. This requires the need for translated materials to understand information about the pandemic, and, of course, the availability of the vaccines. A second challenge is that older adults may not be as accustomed to using today’s computer technology. So that’s kind of required different options or mediums for obtaining information, whether it be print or by phone or in-person communication. And finally, AANHPI community is extremely diverse with multiple subgroups, and therefore there isn’t a one-size-fits-all approach with communications. And we also have a fourth issue, which is misinformation that is just running rampant about not only the pandemic, but about the vaccine. And then the potential that that creates for scams and fraudulent approaches. So one solution is to continue to be very open and listen to our local communities and make a concerted effort to provide factual information about the COVID-19 vaccines. And point everybody to trusted sources of research and rigorous testing that’s been conducted as we know, by the CDC and FDA, and the education about the availability of the COVID-19 vaccines and the efficacy are always going to be important points to stress.
John Yang: You raised a lot of issues there that we’ll get back to, but just quickly, Dr. Rosario … you talk about the need to have materials in different languages. Does the Public Health Service have these materials in various languages?
Adelaida Rosario: They have. The HHS has been working on a number of print materials and virtual materials targeting the major subgroups and the relevant languages so that we can really penetrate the community in their native tongue. And then they’re already moving into a second wave of a whole second sphere of subgroups, which now includes also American Samoans and some of the smaller islands.
John Yang: Great. Thank you very much. Now, Dr. Kanaya, what about you? What do you see as the biggest challenges, and how do we surmount those challenges?
Alka Kanaya: Yes, thank you. … I definitely agree with what Dr. Rosario just said about these challenges with language and technology and misinformation being rampant. I will add a few other thoughts and that is, trust — trust in the vaccine and in the process of making the vaccine and that whether people trust the science behind it and want to get vaccinated as a result. And that may again … I think things that are undermining trust are misinformation for sure, but there’s many ways to approach this problem. And I agree with Dr. Rosario that having as a community help and other people in the community you trust to help you with understanding what needs to be done to schedule the vaccine appointment and all, but the bigger issue that I think we need to think about is getting real information to people from trusted leaders in the community. And that would be, you know, whether it’s a community organization that has trusted leaders, whether it’s the primary care doctor at the local health centers that someone trusts to give them clear information about the pros and cons of vaccine, and really utilizing these people as the trusted voices to help engage our communities in getting these vaccines that are now available for anyone older than age 16.
John Yang: And, with all due respect to Dr. Rosario from the U.S. Public Health Service, a lot of what I’m hearing in talking to people is that in some cases, a trusted source is not necessarily the government. Is that what you’re finding, Dr. Kanaya?
Alka Kanaya: Yeah, there’s been some community forums done in different community groups, in different race, ethnic groups, and, oftentimes the vaccine-hesitant groups, when they interview them — and these may be Latinos, Asians, all different types of groups — the one thing that keeps coming up is lack of trust in larger governmental organizations, and people saying the people who they trust are people who they’ve known for a long time. And that often becomes their primary care doctor, if they’ve had a long-term relationship with somebody, or their community leaders. And that’s where I think having those, whether it be from faith-based organizations or other community-based organizations, these are where we need people to really help step up to really talk about the truth about the vaccines and about why it’s so important that everyone gets vaccinated.
John Yang: Thank you, Dr. Kanaya. Dr. Garcia-Diaz, is there anything, what would you add to what we’ve heard?
Mary Joy Garcia-Dia: I totally agree with those, that trust is really important from a solution perspective. This is where we, as a professional organization, have really worked closely with the American Nurses Association in sharing our own experiences. Why is it important for us to get the vaccine? It’s not (just) because we’re working in the front lines, but also, we want to protect our family and loved ones. As the news … showed in the past that during the height of the pandemic, the Filipino American Nurses Association were impacted by COVID-19. We have the highest rate of that in the nursing workforce, even though we represent 4 percent of the nursing workforce. So it’s really close and personal for us. In addition to that, we know that many of our communities — as our other panel speakers said with regards to the language barrier — we are working with the Asian Pacific Islander American Health Forum in reaching out to our community so we could assist with translations and disseminating the information through webinar sessions, so people can feel comfortable and ask questions without feeling embarrassed. I think town hall discussions such as this, and also just trying to have the personal conversation with our peers, will make people feel why it’s important for them to take the vaccine and really establish that trust.
John Yang: Thanks, Dr. Garcia-Dia. There are a lot of strains that we’ve been talking about here that we’re going to return to, I’m sure. And I also want to remind folks on the phone that if they want to ask us a question, press the * button and then the 3 button. That will connect you to an AARP staffer who will help you get in a queue to ask your question on the town hall. If you’re on Facebook or on YouTube, you can put your questions into the comments section and Jean will read it aloud for the town hall. One … common thread we heard from all the experts to that first question was misinformation, trust, real information about the vaccine. And I think there has been in recent days a lot of concern by the headlines about what is, I think it’s fair to say, a very rare side effect of some of the vaccines — a very rare blood clot side effect that has led to some concern about two vaccines in particular. Earlier today, there was an AARP town hall event with Dr. Kathleen Neuzil, who’s director of the University of Maryland Center for Vaccine Development. And she was asked about the pause in the Johnson & Johnson and AstraZeneca vaccines in the United States and Europe.
Kathleen Neuzil: (from 1 p.m. town hall) You know, I was involved in the clinical trials of both of these vaccines, and just to state that despite the fact that we did enroll 30,000 to 50,000 people in these trials, these are very rare events that are difficult to pick up. I will say that no safety was compromised as part of the trials. Most vaccine-associated side effects do appear within the first few weeks after vaccination, and that is exactly when we’re seeing these rare thromboembolic events. So in fact, it is because they are so rare and not because we didn’t carefully follow participants that we did not pick them up in the clinical trials. These are severe blood clots occurring in unusual places — the cerebral venous sinuses, for example, associated with low platelet counts. And this is a very unusual combination of signs and symptoms. The fact that we could pick up these rare events says a lot about our safety system in both the United States and Europe, and one of the main reasons for the initial pause in the United States is to make recipients of the vaccine and providers aware of this rare side effect, and the fact that we treat it somewhat differently. And so a lot of the reason for the pause was that education about these rare side effects.
John Yang: That answer from Dr. Kathleen Neuzil of the University of Maryland Center for Vaccine Development. But hopefully we’ll break that down.
Dr. Kanaya, I’d like to turn back to you. A lot of concern about the vaccines, a lot of questions about the development of the vaccines, the speed with which the vaccines were developed, about the technology. If someone were to come to you and say, “I really can’t decide whether I’m going to get the vaccine or not,” what would you say?
Alka Kanaya: I actually face this all the time in my own clinic with my patients. I think the biggest reason for people to think about getting vaccinated, and the way I frame this is, it’s about what it means to you and to your family, the people around you. And being vaccinated protects not only you, but protects them as well. And it protects the community. So there’s many reasons that people have to fear the vaccine, but from everything we know about it, and from the studies that now have over six months of follow-up data with the Pfizer vaccine, the vaccine appears to be on the most part, on the hugest amount of data supports safety and efficacy, that it’s working, and it’s working well for up to six months now. And the side effects that occur, occur early and are usually very mild. And these rare, rare side effects that we’ve seen have not been seen in the Pfizer vaccine and the Moderna vaccine. And it’s very important for them to put the fears of side effects and the vaccine science to one side and think about the greater benefits to themselves and to their loved ones around them, and the bigger benefit to us all, to our global community, to be able to have and achieve herd immunity. And that’s hard for people to say that the reason I’m getting vaccinated is because I want the whole world to come back to normal, and it usually takes something a little bit more personal to make people change their mind or to influence and have them move forward. So it’s really about protecting yourself and protecting your family and the people around you.
John Yang: Dr. Rosario, from the public health standpoint, I know that it’s sort of a fine line you have to walk in terms of, on the one hand, warning the public about possible side effects about … these rare events that took place with the Johnson & Johnson and AstraZeneca vaccine. And on the other hand, you want to encourage people to get the vaccine, to protect the public health. How do you balance that in the messaging to people? How do you sort of on the one hand be cautious, but on the other hand, be encouraging?
Adelaida Rosario: Well, I think it’s important to be truthful and honest. So the one thing that is making the news often, the one piece of information that everybody has kind of at the front of their heads — you know, the common piece of conversation, the dinner starter — is kind of all of the negative feedback that you receive that’s out on the news, you know, the smaller numbers that have to do with these rare occurrences and these illnesses. But when you just look at those small numbers in contrast to the millions who have received the vaccine, and who are fully inoculated at this point and are doing fine, and nothing beyond the minor side effects, I mean that is substantial evidence and really encouraging, hopeful evidence, to kind of guide yourself. And that’s always part of our messaging that the benefits so far outweigh these small risks, and the same way that any other vaccine is thought, the COVID vaccine is no different. So this has the same kind of risks that any parent taking their small child to get their series of shots … you’re kind of up against the same numbers. It’s being honest that of course these rare occurrences are happening, not shying away from that, but really celebrating the successes that we’re seeing with the numbers of infections dropping and the successful inoculations at a population level that’s currently occurring, not only in United States but across the world.
John Yang: And Dr. Rosario, I know that that public health is more than just … the symptoms and illness, and there’s sort of a broader impact, particularly as we’ve had in COVID-19. And I’m wondering if you, in your work, have seen the effect on the Asian American, Native Hawaiian and Pacific Islander community, beyond just health, in terms of finances, economics, housing, security and that sort of thing.
Adelaida Rosario: Oh yes, absolutely. I mean we’re seeing long-term unemployment issues rising. Of course, that impacts all spheres of life. It impacts the kids with their education, their access to education; it impacts housing, stability, etc. And then, of course, in addition to this pandemic, there’s this heightened negative attention right now that’s been kind of focused on the Asian American community because of all the stereotyping. And it’s just, it’s terribly unfortunate. It becomes what equals a double pandemic essentially for all of our older Asian American community members, because they’re dealing with all of this awful discrimination in addition, layered to this health crisis. So there’s something to be said on disproportionate mental health impact that now our community is dealing with a courtesy of these two layers — you know, this other layer of impact aside from the actual pandemic.
John Yang: And Dr. Garcia-Dia … along with that idea of sort of the impact beyond just health, there has been a tremendous, we’ve heard the stories of the frontline health care workers like the nurses you represent, the tremendous psychic toll this pandemic has had on them of caring for people who are desperately ill and cannot be with their loved ones — their loved ones can’t be at their bedsides. A lot of people want to help. Members like your membership. What should they do? What can people do to help frontline workers like your nurses?
Mary Joy Garcia-Dia: Thank you so much for asking this question, John. We all know that the level of stress and emotional impact to our health care professionals are very profound. Many of our nurses shared their traumatic experience. Some of the nurses have been infected with COVID-19 and … they are thankful that they were able to make it alive, while others experienced losses within their immediate families. So, for example, individuals like the Justly Project have reached out and fundraised for programs that can provide psychosocial and emotional support through peer-to-peer support. Culturally for Asian American Pacific Islanders [AAPI], and I think more for the Filipinos, there is a stigma associated with seeking mental health. Our organization has conducted an Emotions Behind the Mask Survey to understand what are the challenges that our nurses are experiencing and how can we help unpack these emotions of depression, the moral injury that they feel because they survive versus their other peers or their loved ones, and the frustrations that they continue to feel because the pandemic is not going away. When we kicked off the resilience program, it’s really meant to help them in the long haul. This way they can really refocus and make mindfulness exercises, and a lot of people also practice spirituality. We also sent a survey on what can we do to make them feel appreciated. Surprisingly, amongst the choices of gift cards, one thing that stuck out is the recurring comments that we read — a simple thank you will make us feel better. So this coming May actually, we will be celebrating Nurses Week, and we hope that the audience will express their thank yous to our nurses, to our health care and essential workers, because it will go a long way in reaffirming the reason why we chose to be in the health care profession, to care for our patients and save lives. And we know we can only do our job if everyone will do their share in helping flatten the curve. So really taking the first step to take care of yourself and get your vaccine will help. It will be a huge help. Thank you.
John Yang: Dr. Garcia-Dia … you said that Nurses Week is in May. What week is it? What specific day date?
Mary Joy Garcia-Dia: So historically, John, it’s usually the first to second week of May, but because the American Nurses Association continue to celebrate the Year of the Nurse, we are going to have a Nurse Month Celebration. It’s going to be the whole month of May. We are super excited about that.
John Yang: Excellent. And … I hope everyone keeps that in mind and remembers all of May to be thinking and thanking the nurses. Dr. Garcia-Dia, thank you very much. … Now, before we move forward, I want to bring in Daphne Kwok, who’s vice president for Multicultural Markets — excuse me, she is vice president of Multicultural Markets at AARP, to give us an update on what AARP has been doing on the COVID front. Daphne.
Daphne Kwok: Thank you so much, John, and to our distinguished guests and speakers, we’ve had such a rich conversation already tonight. First of all, I want to say that AARP strongly condemns all racially motivated violence and harassment, and AARP stands with the AAPI community. But as Dr. Rosario just said, for our AAPI elders, they are unfortunately having to combat a double pandemic with the COVID-19 as well as the racism and xenophobia that is happening to our community. And racism is a public health issue. The assaults are causing fear in our community, especially for our older members. The fear is keeping them from their appointments and medical appointments. Most importantly, keeping them from getting their vaccines. And I know that volunteers have been helping out at the local level to …accompany our elders to their appointments, which is so key and critical. This is all part of the public health issue that’s a threat. The entire nation needs to come together to help control COVID spread. So you may be asking, what is AARP doing for AAPI elders? Well, first of all, in May, we will be hosting a Stop Asian Hate forum that will be open to everybody and anybody. We are also working to produce — as we’ve all heard, in-language materials is so key and critical for our elders, and so we are doing that — producing materials to help protect them from becoming a victim while also producing materials for bystanders who may see an incident. Also several of our state AARP offices are engaging with the AAPI community at the local level, and also most importantly, AARP has a tremendous communication channel, whether it’s through these forums or whether it’s through our magazine with 38 million members’ readership, we are able to get information out about the AAPI community. And as we’ve all said … how important it is to shatter the model minority myth, and as well as the perpetual foreigner image, and also really being able to tell and talk about Asian American and Pacific Islander history, the contribution piece in making the United States, back ever since the Civil War. And so for those of you that are AARP members, I hope you get a chance to look at our April/May edition of the Magazine; we actually have a large spread in there of AAPI who are talking about the people that inspired them. It is also on our website as well. So, these are just a few of the examples that we at AARP are doing to really work on behalf of our AAPI elders and their families. Thank you so much.
John Yang: Thank you, Daphne. I just got my copy of AARP The Magazine in the mail today. Haven’t had a chance to look into it, but I certainly will. And thank you, Daphne, for the many important points you made in your remarks. …
And before we take (your) questions, we want to go back to an issue that I think we heard a lot about in the opening round of questions about the challenges facing the community in getting the vaccine, and the availability of the vaccine. We know from not only anecdotal evidence, but we know that there are a lot of people who are having trouble registering for the vaccines where you live, because a lot of this — or most of them, quite frankly — are online, and there are people who don’t have access to a computer or access to the internet, and that can be a challenge. So AARP has come up with an AARP Vaccine Registration Team that can help you if you don’t have a computer, if you don’t have access to the internet. If you’re listening today and you fall into that category — you don’t have a computer, you can’t go online to register for a vaccine — press 1 now. Press 1 on your phone and you’ll be added to the list to receive a phone call from the AARP staff to help you. So once again, if you don’t have a computer, you can’t get online, you don’t have internet access, you can’t sign up for a vaccine online, press 1 now on your telephone, and you’ll be connected with someone — or you’ll be added to a list, I should say — for a call back from the AARP to help you on the phone, in person, get registered, and get an appointment for the vaccine. So we, I urge you to do that. I’ll remind you of that a couple more times before we end this town hall.
And now …I’ve been asking questions, but let’s now get to the smart questions: your questions. Your questions for Dr. Kanaya, Dr. Rosario and Dr. Garcia-Dia. And now let’s bring in AARP Senior Vice President of Programs Jean Setzfand to help with your calls. Jean, are you there?
Jean Setzfand: I’m here, and thanks so much, John. I’m delighted to be here for this important conversation.
John Yang: Thank you, Jean. So have we got some calls? Have we got some questions? Who’s first?
Jean Setzfand: We certainly do. Our first caller is Varate from New York.
John Yang: Varate from New York. How are you and thanks for the question. Go ahead, please.
Varate: Yes, I’m good, thank you. My question is for Dr. Rosario, that after you are vaccinated, how long is the effect to stay? That is my number one question, and secondly, after the vaccination, what kind of proportions (inaudible) regarding going out.
John Yang: Dr. Kanaya, how about … do we know how long the antibodies last — the immunity lasts, and what can you do after getting the vaccine?
Alka Kanaya: Great questions. So from the most recent data, we think the antibody from the Pfizer mRNA vaccine lasts at least six months. So that’s really good news. It lasts at least six months from after the second shot is given. And hopefully it’s longer. We don’t know, but we will find out soon because those people who were in those first trials for Moderna and Pfizer are being followed, and we will find out every three to six months, they’ll be telling us whether it looks like the immunity is still holding or not. And at the same time, these companies are working on booster vaccines already because everyone knows that at some point, we’re going to need boosters. And then the second question she asked was, what we can advise seniors, what they can do, what precautions they should take. At this point, I advise my senior patients and my parents that if they are fully vaccinated, two weeks after their second dose, that they can get together in small groups with other vaccinated friends and family indoors and not wear a mask. And that means small groups — you know, CDC says six people, I think a little bit more is probably OK, as long as everyone has been vaccinated. You can get together with small groups of other vaccinated people. What do you do about unvaccinated people? So when you’re out in the community walking around doing shopping, I would still wear a mask. I would still socially distance from other people because you don’t know if they’ve been vaccinated or not. And, even though you’re not going to be spreading the virus to them, it’s still a good idea for us to continue to mask until we have reached herd immunity, and that means 80 percent or more of the public has been vaccinated. So in public, I would still mask. When you’re indoors, anywhere with other people, and you don’t know if they’re vaccinated or not, still a good idea to mask.
John Yang: And Dr. Kanaya, can I ask, I have one more question. I know that … the vaccine has not been approved for use in young children yet. Can vaccinated grandparents hug their grandchildren?
Alka Kanaya: Absolutely. Absolutely. I think, you know young children have not been shown to have as much problem with the COVID, with the virus. They seem to have less severe disease. If they get sick, they may be able to transmit, but we don’t know how much they transmit, but that grandparent has been vaccinated. So that grandparent is not going to get very sick from a virus. The chances of them catching a virus from their grandchild is extremely, extremely low. So yes, absolutely hug your grandchild. This is time for grandchildren to see their grandparents once the grandparents are vaccinated. Now, should you have the grandchildren inside, indoors, and you’re not masking with the grandparent, there’s some controversy, some infectious disease doctors say, yes, it’s fine because those kids are so, so, so low risk. I think it also depends on the community where you live. If you live in an area where there’s very low transmission of COVID happening — like I live in the San Francisco Bay area, our counts are now in the 1 percent or lower in terms of COVID rate — I think the risk with grandchildren seeing grandparents who were vaccinated would be extremely low, and I would be comfortable with them being indoors with no masks on because the community rate is so low. If you live in an area, like say parts of Michigan that has much higher community transmission rates, then I would say the grandchildren should probably mask in that case just to be on the careful side. But the grandparent doesn’t need to mask as much. OK, so it’s a complicated answer about masking, but absolutely see your grandchildren and now hug them, because you are not going to get sick from them.
John Yang: Complicated, but I think one that grandchildren and grandparents will like, will welcome. Jean, who’s next?
Jean Setzfand: Our next caller is Patel from California.
John Yang: Patel from California. Go ahead.
Patel: I have one question and it is very easy, and that is, I heard a lot that people are not ready to be vaccinated. And sometimes the fear factor is really important for convincing the people to get vaccinated. And the reason is, it’s not like a freedom we have, it’s a responsibility we have to society, and that is very important. And my feeling is that currently there is a very, very bad results going on in Asian countries, especially India. I’m not sure whether … people are aware of it, but what happened to New York last year in March, same thing is happening to India right now, all over the country. And so because people are not vaccinated enough and did not help control on what they are doing. So I think my question, how are we convincing the people to get vaccinated? That’s very important.
John Yang: And Dr. Rosario, as he mentions, are there lessons from abroad — India having a very tough time right now; on the other hand Israel, sort of coming back to life with their vaccination, widespread vaccinations, and now life is returning to normal.
Adelaida Rosario: Correct. He makes an excellent point. And that’s actually for the comment that Dr. Kanaya had made before, which was … altogether valid about the mistrust that exists in the communities, which this gentlemen is referring to as the fear, and the distrust toward the science, or maybe the misunderstanding toward the science; these are the community and population level evidence that everybody can see. That, you know, just taking away the sophistication of science jargon, you can see the differences and the way that it’s impacting the community, the vaccines versus those with a lower vaccine rates. So Israel versus India, as an excellent example. I was reading just today in the New York Times, the case in India and how they have, I mean, a spike, a COVID infection spike that is just unprecedented. So he just makes a wonderful point. I wish everybody shared that sense of responsibility,not only just toward our family, but toward the community at large and the population at large as this gentlemen has, because that’s what it comes down to. I mean, each one, every one person who receives this vaccine has a chain reaction within their family, their friends, their network and their community. And it’s a positive one. They’re protecting themselves, they’re protecting their loved ones, they’re protecting the stranger that they stand 6 feet behind in the store — and they are protected from all that’s going on around. And if they do come in contact with the virus, any severity will be averted because of the effectiveness of this vaccine. So I think it just makes wonderful points. And this is the kind of evidence that — you know, for all of that misinformation that is circulating and all of the distrust that, of course, permeates — these are wonderful factual, concrete examples of the benefit of the vaccine, the lower infection rates that it’s creating, and the unfortunate consequence in other communities for those that aren’t, that don’t have the high vaccine levels.
John Yang: And Dr. Rosario, I think you make a good point that I want to follow up on … that the vaccine is not 100 percent effective. It doesn’t mean that you’re not going to get the coronavirus, COVID-19, at all, but — like the seasonal flu vaccine — it means you’re not going to get a severe case. Is that right?
Adelaida Rosario: That is precisely right. And it’s 99.9 percent, which can round up to 100 percent. But you’re absolutely right. That if you come into contact with the virus, you can get the virus the exact same way as with the influenza vaccine, the flu vaccine. What it does is completely inoculate you and protect you from it being serious, from it having serious consequences, which with COVID as we’ve seen in our older adult community, has been high — very, very critical cases of hospitalizations and deaths. So with the vaccine, it is absolutely those high hospitalization and death rates that are completely eliminated.
John Yang: Thanks. Now let’s go back to the phones — or no, we’re on the phones. Let’s go back to the line. Jean, who do we have next?
Jean Setzfand: Our next caller is Maryanne from New York City.
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John Yang: Maryanne from New York City. Go ahead.
Maryanne: Hello, good evening. I received my first dosage of the Moderna vaccine, which was hard to get — New York City’s really booked up. I received it on Monday afternoon — and the first dosage, I had horrible side effects; chills until 7:30 a.m., I have knee and back arthritis which were exacerbated, I had body aches and a severe headache, and the chills lasted until 7:30 in the morning. That’s finally when I was able to sleep. I wasn’t feeling back to myself until yesterday. That’s three days. Now my concern is this is the Moderna. I’ve heard that the second dosage is worse. Is that going to be the case, because I just wanted to keel over and die from those chills and the body aches. I just, I could barely move. And is it rare to get it? Because I believe I had COVID last year, but my doctor didn’t have any tests last March. They say today that one-fourth of people in New York City had COVID. I think I had it. And would that have something to do with the so-called immune response? Am I going to get worse response after my second dosage? Because the first one was horrible.
John Yang: Dr. Garcia-Dia, do you want to take that — reactions to the shots?
Mary Joy Garcia-Dia: Yeah, absolutely. I know that those are the common reactions that have been reported after the COVID 19 vaccine is given — like pain, redness, swelling at the injection site. And to your case, you have experienced fatigue, muscle or joint pain, headaches, chills, which could sometimes people also have fever. So reactions generally last a short time and, in some cases, will respond to Tylenol or nonsteroidal anti-inflammatory drugs. The body aches and chills you describe are consistent with the reactions that have been reported. And I would advise you to access the COVID tracker tool; I do believe that you could report your symptoms that you are experiencing. This way, more information can be collected, and that’s very important. This way, we can share this with the CDC as well.
John Yang: Given these side effects — and I was in the Moderna clinical trial, and I had side effects — but given the side effects compared with getting COVID, is there a comparison, Dr. Garcia-Dia?
Mary Joy Garcia-Dia: Well, from a professional perspective, I think the symptoms might be the same, but the chances of the mortality rate is better if you have this COVID vaccine. If we could only turn back time and have the vaccine earlier, I am sure that we would have turned the curve of the vaccine — and hopefully with this continuous support and trust that we have, and still with the information that we’re sharing, because just like other medications there will be side effects. Your body will still continue to adopt the immune response system.
John Yang: But I guess what I’m just saying — this is my personal opinion — that given a choice between the relatively mild side effects I had, and getting COVID, I’d rather have the relatively mild side effects. But that’s speaking for myself.
Mary Joy Garcia-Dia: Absolutely. And I myself have a fear, having asthma hypertension. I have my own doubts as a nurse. I also hesitated, but I went to see my doctor, and he explained the positive effects that I would have. In fact, because of my chronic asthma, I have 60 percent lung capacity. And if I get COVID, that means that I would probably reduce my lung capacity to another 20 percent, which will really leave me not be able to walk, even just walking the house. So that in itself made me feel more confident that I should really get the vaccine.
John Yang: Yes, I mean one of the reasons why I sought out and applied for the clinical trials was because I have asthma. I have a mild heart condition. I thought it would be better to have a 50/50 chance of getting the vaccine earlier rather than later. And actually, it brings up a question about clinical trials that we’ll talkabout later. But right now, I do want to return to the question that we asked at the beginning of this town hall. You may remember we asked how many of you live in a multigenerational household, and it looks like 21 percent of those of you who responded said that you do live with multiple generations in a single household — 21 percent. So now we’d like to know if living in a house with multiple generations makes you more or less likely to get the vaccine. So please press 1 on your telephone keypad if living in a house with multiple generations makes you more likely to get the vaccine, and press 2 if living in a household with multiple generations makes you less likely to want to get the vaccine. Once again, does living in a house with multiple generations influence your decision to get the vaccine? Press 1 if it makes you more likely, press 2 if it makes you less likely.
And now let’s get back to our experts. Dr. Kanaya, we heard the question or the caller from New York saying that she was trying to get a specific vaccine, and there are differences in the technologies between the Moderna and Pfizer vaccines, and the Johnson & Johnson and AstraZeneca vaccine. The AstraZeneca vaccine, of course, hasn’t, they have not applied for authorization in the United States. So Dr. Kanaya, could you explain the differences between these vaccines, and also, I’d be interested in your thoughts — should people like the caller from New York essentially try to shop for a vaccine, try to get one over another? And if they’re given a choice when they go to get a vaccine, what would you advise?
Alka Kanaya: Good questions. So the Moderna and Pfizer vaccine use mRNA technology. They’re very similar to each other, and they’re very different from the Johnson & Johnson and AstraZeneca vaccine that use DNA technology. Now, what does this mean in terms of mRNAs, DNA? These are the genetic materials, they’re small pieces of the genetic code of the virus. And when a vaccine is made with DNA, the DNA has to go inside yourself and rev up the protein-making machinery in the cells. And that’s the protein that your body uses to make antibodies again. And so those antibodies will be helpful when, and if you ever, your body gets exposed to the SARS-CoV-19 virus that causes COVID because then the body has antibodies and can protect against getting a serious infection. So the DNA vaccine gives little pieces of DNA of the virus to the cells in the body to get the protein machinery going, whereas the mRNA vaccines, that’s the Moderna and Pfizer, it’s one step ahead of the DNA because those little pieces of mRNA are already going to be moving that protein machinery forward. So, they are related to each other, but just slightly different in terms of the timing of how the proteins are made from the cells. And then you asked a question about whether people should shop for one vaccine over another. At this point I would not, I would take the first vaccine that is offered to you. And if it’s going to be Moderna or Pfizer at this point, because I believe the J&J is still on pause at least through this week, so if you were offered Moderna or Pfizer, take either one. If you want to say, well, are there any small differences in side effects between the Moderna and Pfizer, in the clinical trials it looks like there were some fewer side effects in people who got the Pfizer vaccine compared to the Moderna vaccine. In terms of the local site reaction, there was some fewer percent of people who got site reactions with the Pfizer vaccine compared to the Moderna vaccine. So there’s maybe a tiny bit of a difference in the local site reactions that people get. In terms of the other reactions with feeling body aches and chills, and this usually comes after dose two, that seems to be fairly similar between the Moderna and Pfizer vaccine. But I overall, I wouldn’t shop. I would just take the first one, but if you’re offered either, you have either Moderna or Pfizer in front of you, I would probably take the Pfizer just because of the more possibly somewhat less side effects.
John Yang: Interesting point. And Dr. Kanaya, I’d like to talk to you about clinical trials, about the development of the vaccines. As I said, I sought out an opportunity to apply for a clinical trial. I ended up in the Moderna clinical trial. But in particular, I’d like you to talk about the importance of having people of color in general and Asian American Pacific Islanders and Native Hawaiians in particular involved not only in these clinical trials, but in all clinical trials for new medications and drugs.
Alka Kanaya: I think that that’s a critical point … you know, we need to have better representation of AANHPI groups in all types of studies, whether it’s vaccine studies or Alzheimer’s disease studies or whatever. We don’t have enough participants. We don’t have enough volunteers coming from these communities, and we absolutely need to change that narrative. In the trials that were done with Moderna and Pfizer — I looked this up again today to make sure I have the correct numbers — but Moderna, the main trial had 30,000 participants and 5 percent were Asian American. They don’t tell us about Native Hawaiian and Pacific Islanders in the main study results. I believe there were, there was representation from NHPI groups as well. I don’t have the exact numbers. So about 5 percent of the participants out of 30,000 — that’s about 1,400 people— were Asian American in that trial. In the Pfizer trial that was 38,000 people, and that was not done in the United States, that was done in many other countries around the world. The Moderna trial was done in the U.S. The Pfizer trial included 4 percent Asians as well, which is good. I mean, we’re seeing 4 or 5 percent. It’s good. It’s not great. We could do better and, you know, Asian Americans and NHPI Asians in general represent 60 percent of the global population in the world. And we need to do better about having representation in all sorts of studies.
John Yang: And is there a scientific medical reason you want to have that representation in the trials?
Alka Kanaya: Absolutely, especially in drug trials and in vaccine trials. It’s really important to have representation from diverse groups and communities, because there may be certain biological differences in how we metabolize medications or how our body develops immune responses to vaccines that cannot be seen unless we have adequate numbers of participants in these trials. That being said, at least 4 to 5 percent of Asian Americans were in these trials, and when they looked to see if there was any signal of any difference in efficacy of the vaccine or in side effects, they weren’t able to find one. Now does that mean that the question’s been completely answered — that there’s no differences for Asian Americans versus other groups? Probably not because we’re basing this on 1,400, 1,600 people in these trials. But it at least gives me some comfort knowing that there was some representation in these studies. We can do better.
John Yang: Very good. Dr. Rosario, I’d like to turn to you as someone from the Public Health Service. We’re hearing a lot about — as always happens in these cases — frauds, scams, people selling phony vaccination cards. What can our community, what can the Asian American, Native Hawaiian Pacific Islander community do to fight that sort of thing — frauds and scams, and also misinformation about the vaccine and about COVID?
Adelaida Rosario: Excellent, excellent question. So yeah, for our community and particularly our elders, who tend to be a little bit more vulnerable, and then, of course, our caretakers who are the ones taking care of our older loved ones, we want to make sure that folks are empowered and have resources and have the right information and not get kind of swayed by this misinformation or become a victim of these frauds and scams. So there’s a lot of stuff out there that that can be accessed. First of all, each state has their health department website, and those websites are kept quite up-to-date with information about who are authorized vaccine providers. And then those are the providers that you’d want to obtain a vaccine. As you’ve mentioned, John, [there are] those that call you with these fake vaccination cards and the such. So you want to avoid that by making sure you know who are the authorized providers. You could always check the FDA’s website — ‘cause they always maintain current information about vaccine emergency use, and who has emergency use authorization — if you’re getting a phone call with somebody posing that they now have a brand new emergency use available vaccine. Always consult your trusted health care provider. As Dr. Kanaya was talking about, go to those people in your community that you trust — that are particularly your doctor, your physician — about any of these concerns, and take the concerns that you have about the vaccines and about your health to them as well. So, of course, don’t ever share personal or health information with anybody other than those who are known trusted medical professionals. Please don’t be giving your Social Security or any suchpersonal information over the phone with people calling asking. Always just double check your medical bills and the insurance explanations for benefits. You always want to kind of just keep your eyes out for suspicious claims. And, of course, immediately report any errors to your health insurance provider. And the U.S. Centers for Disease Control and Prevention, the CDC, they always have a list as well of other trusted medical professionals that can be turned to for verification. So we just encourage everybody to become more aware with their most local trusted resources that they could always use to vet and verify when they get approached by these folks trying to run a fraud or a scam.
John Yang: That’s good advice now, and also at any time I think, for all sorts of issues. Thank you very much, Dr. Rosario.
Adelaida Rosario: You’re welcome.
John Yang: Jean, have we got more questions? I hope we have more questions, Jean. Who’s next?
Jean Setzfand: Yep. All right, we have Glenn calling in from Hawaii.
John Yang: Glenn from Hawaii. What’s your question, Glenn?
Jean Setzfand: Hello, Glenn, can you hear us? …All right? I think we probably lost Glenn. We will now go to Jovita from Florida.
John Yang: Jovita from Florida. I hope you’re with us. And what’s your question?
Jovita: Yes, thank you for taking my question. I have a problem because the last flu shot I had about seven years ago, I had like a reaction like the Guillain-Barré syndrome. So I’m reluctant about taking the COVID vaccine. What do you, what can you advise me?
John Yang: Dr. Kanaya, what would be your advice? She had a previous bad reaction to a flu shot. What’s your advice?
Alka Kanaya: The technology used for these vaccines is completely different from a flu shot. A flu shot uses killed parts of a flu virus, and this is, again, DNA and RNA technology, which is so different. There’s no relationship with side effects you may have had with the flu shot and how you will do with this new vaccine. So I wouldn’t be scared because of your prior experience with the flu shot.
John Yang: If the Johnson & Johnson vaccine comes back … would your advice be the same, given the different technology?
Alka Kanaya: Yeah, the Johnson & Johnson vaccine is DNA technology, and it’s different from what we use for the flu shots in the U.S., so I still would say the prior experience that you had with the flu shot does not really apply to how you will do with any of these vaccines now.
John Yang: Great. Thank you very much. Jean, do we have anybody else?
Jean Setzfand: Absolutely. We have a question coming in from YouTube, and this one’s coming from Diane and she’s asking, “Is there a difference between dose one, dose two, and the booster dose three?”
John Yang: Dr. Kanaya, do you want to take that?
Alka Kanaya: Sure. Do you mind repeating that? I didn’t catch the whole question.
Jean Setzfand: Sure, no problem. The question comes from Diane and she’s asking the difference between the doses. Is there a difference between dose one and dose two? And I guess we’re hearing a lot about a booster dose three. Are there any differences between those shots?
Alka Kanaya: Yeah, it’s not yet developed yet. No, the amount of vaccine in terms of the volume of vaccine you get is the same for dose one and for dose two for the Pfizer and the Moderna vaccine. J&J is only a one-dose vaccine. So, yes, in terms of the volume injected is identical for both of these. AstraZeneca had differences in dose one and dose two, but that’s not a vaccine we have here in the U.S.
John Yang: And would, given the variants, given the evolving nature of this virus, will the boosters be any different, or will it essentially be the same?
Alka Kanaya: That’s the hope for these boosters, is we will have smarter boosters that take into account all of these different variants that we have in the world right now so that they will be effective against these variants like the South African variant, the Brazil variant, the Indian variant — there’s many different variants; and variants happen in parts of the world where there’s a lot of transmission of virus. So we’re hopeful that as our communities become more and more vaccinated and we start to reach herd immunity — and that’s usually 80 percent is kind of the goal here, if 80 percent of all Americans get vaccinated, that’s wonderful news because there’ll be less and less transmission of any virus in this country, and we’ll be having less variants, new variants pop up. And we need the whole world to be vaccinated so we can reduce these variants from occurring in other parts of the world as well.
John Yang: Terrific. Jean, do we have any more questions?
Jean Setzfand: Yes, we have a question coming in from Kimberly of Minnesota.
John Yang: Kimberly in Minnesota.
Kimberly: Hi. First, I have a comment and then a question. So my comment is to reassure you about Johnson & Johnson. I went and got mine, but I have no underlying conditions. I got it a couple of weeks ago. I have had no problems whatsoever. And the other thing I want to tell people — I was in their schedule list, but they first tried to schedule me for a city an hour away from where I live, actually where I was born. And I go, I’m not going there. So I walked into the pharmacy, and I introduced myself, and the woman looked at me and she goes, “You’re not old enough.” And I go, “I don’t care. I want to talk to somebody.” And then an older guy came over and he goes, “Walk over here.” And I went to a kiosk and they lined me up for the next week. So to me, it’s persistence in being in person that pays off, because when you’re in a database, people just treat you as a number, you know? So that’s my learning from that. My hard question is, my mother is 88. She still hasn’t had her shot, and she still lives at home. I don’t really want her to live at home, but my brother is the executor of her estate, and he won’t move her out. And he tells me that he doesn’t want her to get the shot because he thinks she’s so frail she’s going to die. What do you do about that?
John Yang: Dr. Garcia-Dia, what’s your advice?
Mary Joy Garcia-Dia: I can relate to that. I also live with my parents-in-law. My father-in-law’s 84 years old, and my mother-in-law is 78 years old. Both of them have really hesitated in getting the vaccines themselves. And we had to have the conversation, difficult conversation. And my advice is really to call the primary care provider and discuss these concerns with them. They know the history, the personal health history of your mother, and he can guide you on weighing the risk and benefits in taking the vaccine. There is no cure for COVID-19, and hundreds of thousands of people have died from it. And the vaccine is really a proven and safe way to help our body fight the infectious disease. And ask your brother to go to the Centers for Disease Control [and Prevention] website and look it up for himself, so this way he can truly understand that this is really our first and best way to protect your mother against COVID-19.
John Yang: Very good. Thank you, Dr. Garcia-Dia. Jean, let’s go back … and see who our next question’s from.
Jean Setzfand: Sounds good. This question is coming on Facebook from Kaiu, and Kaiu’s asking, “How many Asians have been vaccinated in the U.S. — where can we find that information?”
John Yang: Dr. Rosario, was that, I know the CDC has an aggregate number of the number of vaccines and who’s gotten one shot, who’s fully inoculated. Is that sort of information available?
Adelaida Rosario: It is, and what I can say is that this week where we stand is more than 65 percent of people age 65 and older are fully vaccinated. And then 25 [percent] of the general population. However, if we want to look at any specific state, those are available online — CDC’s website has a tracker that is updated daily. And you could always check with your local health department that has local statistics available.
John Yang: And are the numbers broken down by ethnicity and ethnic background?
Adelaida Rosario: On the website, yes, but again, as mentioned early in our conversation, the challenge with our community is the data that we hold for AANHPI doesn’t tend to be disaggregated. So it’s kind of lumped together. We’re not clear on where the statistics stand with each subgroup.
John Yang: Great, thank you very much. Looking at the clock, I think we could keep going for much longer but we do have to bring this to a close. And so I’d like to ask each of you for your closing thoughts, the recommendations, the thoughts you want to leave with our listeners — the most important thing you want to leave with our listeners tonight. Dr. Rosario of the Public Health Service, let’s start with you.
Adelaida Rosario: Yes, sir. What I definitely want to impress upon everybody is how the benefits so far outweigh the risks. It’s an issue of protecting yourself, keeping yourself out of the hospital, being able to go about your day — kind of return to what was your norm with confidence that you won’t end up hospitalized, death won’t be a looming threat. You could interact with your loved ones, your family, your children, your grandkids. And it is a significant, significant step toward returning back to the life that we knew.
John Yang: Very good. Thank you very much. Dr. Kanaya, what would be your closing thoughts?
Alka Kanaya: Well, it’s hard to top that. I would say get vaccinated, get people around you to get vaccinated. Anyone you come into contact with, ask them and help them move that needle toward going and getting activated to get vaccinated, because we need everyone to pitch in here. It’s important that you use your own influence with the people who you know and around you to get them vaccinated, because we’re trying to get the entire world vaccinated. And one more person means one more step closer to getting our life back to normal.
John Yang: And it’s that personal touch, as everyone has said, that’s so important. Dr. Garcia-Dia, what are your closing thoughts?
Mary Joy Garcia-Dia: I would encourage everyone to have an honest conversation and have a listening session with people in the community that you could trust, and share experiences with each other. This is really our shot. We can stop the pandemic on its tracks. Let us be part of that solution and make this opportunity to help in preventing the spread of COVID-19, and really getting the COVID-19 vaccine protects you, your family and our community.
John Yang: Very good. Thank you very much. Thank you very much Mary Joy Garcia-Dia, the Philippine Nurses Association of America; Dr. Alka Kanaya of the University of California San Francisco Medical School; and Adelaida Rosario of the U.S. Public Health Service. Thanks to you all for a most informative discussion tonight. Thanks to everyone out there who asked questions. Thanks to the AARP members, the volunteers, and listeners for participating in this discussion. AARP is a nonprofit, nonpartisan, membership organization. It’s been working to promote the health and well-being for older Americans for more than 60 years. And in the face of the pandemic, it has been providing resources and information to help older adults and those caring for them protect themselves from the virus and prevent its spread to others while taking care of themselves.
All of the resources we’ve talked about, all of the things that we discussed tonight, including a recording of today’s Q&A can be found on the web at aarp.org/coronavirus. The recording of this event will be available on April 23 —tomorrow, in about 24 hours. Again, that web address is aarp.org/coronavirus. If any of you had questions that were not addressed tonight, and I apologize if that’s the case, go to that website. You’ll find the latest updates as well as information created specifically for older adults and family caregivers. And actually, one more time, I want to repeat the information that if you have trouble getting an appointment or registering for a vaccination because you don’t have a computer, because you don’t have access to the internet, press 1 on your telephone. That will get you on a list for a call back from an AARP staffer who can in-person and on the phone help you get that information, register and get an appointment for a vaccine.
As everyone has said tonight, that is what is going to help us get back to normal, get back on track. We hope that you have learned something tonight that can help keep you and your loved ones healthy. There’ll be another conversation about the coronavirus, an AARP tele-town hall meeting May 6 at 1 p.m. That’s May 6 at 1 p.m. And now let me add my personal thanks to Daphne Kwok, Jean Setzfand, Mike Watson from AARP, and especially to Julio in the control room for keeping me straight tonight. I appreciate all the support and the help. That’s it. Thank you all for listening. Have a good day.