A random survey of 66 Urban students showed that 15% have some degree of vaccine hesitancy. Concerns ranged from a lack of knowledge about the contents of the vaccine, how the vaccine works, its effectiveness, side effects, long term effects, and distrust in the government, to whether it is ethical to get the vaccine now rather than waiting for those who are less privileged to get it. I spoke to Mary Murphy, the teacher of Infectious Disease and Urban’s faculty resident COVID-19 expert, about the Urban community’s concerns around the vaccine. The following interview has been edited and condensed for clarity.

How do you weigh the safety the vaccine provides with its potential side effects and long-term effects?

For the vast majority of vaccines, if someone’s going to have a negative reaction –beyond just what you would expect, like, having soreness or feeling not so great for a couple of days–typically, those kinds of reactions happen within a very short time after the vaccination, usually within 6 weeks of the first dose. If there were serious side effects from this vaccine, based on what we’ve observed with all other vaccines, we would have seen those already in the original participants of the trials.
I get what people are saying about this feeling too fast. But really, what got sped up is the approval process. All the data that is usually required was still there. And you’re right, we don’t have that longitudinal data (information about what immunity levels look like after a year or two); that would usually be a part of any kind of application for FDA approval. But that’s because we’re in a crisis. So that’s why the vaccine has been given an Emergency Use Authorization by the FDA. The data thus far really point to this being very safe, not only in terms of not causing negative consequences but in providing really excellent protection from this virus.

How effective is the vaccine? If you can potentially spread it to other people is it worth getting vaccinated?

I fell out of my chair when the Moderna and Pfizer vaccine efficacy numbers came out because people were hoping for them to be 60% or 70% effective and they are 90%+ effective!!! Some of the early data from places that have higher vaccination rates are showing that it looks like the transmission is reduced when you’re vaccinated, but we do not have any definitive data yet. Now, whether that should prevent you from getting a vaccine is a really interesting question. It’s the logic behind it that I would question. We know this vaccine now prevents severe disease and hospitalization and that lack of hospital space is what is in part crushing communities. When we don’t have enough hospital space, that also means we don’t have enough care available for other diseases, heart attacks, strokes, people who need cancer treatment, preventative care. How I look at it: these vaccines are highly effective against severe disease which is placing such a burden on our healthcare system. By being vaccinated, I can protect myself, protect others, and help alleviate this stress.

What has been your experience getting vaccinated?

Oh my god, it was pure joy. I went to the Oakland Coliseum and received the Pfizer vaccine. I have to say, I feel a lot different. I feel the protection. Going to Urban, I can fully concentrate on being with students, teaching and doing my job without feeling worried. There’s a relief, from a personal standpoint. I feel relieved. And I also feel like I’m doing my part, right. I’m doing my part towards working for herd immunity. I really look at it as my responsibility to get vaccinated. As someone who has resources, who has wealth, that is my responsibility. I do believe that is part of being a member of a community. That when it’s my turn, I need to say yes.

What would you say to resourced and/or otherwise privileged students who want to wait to get vaccinated in order to not contribute to an inequitable vaccine rollout?

Get vaccinated when it is your turn. Don’t wait. Follow the rules and get an appointment. You can be involved in health equity work and get jabbed. Kids need to be in school and schools need to be as safe as possible. So, please get vaccinated. And then also be active about finding ways to volunteer. If you really care about making sure the most marginalized and vulnerable people get vaccinated, you can get involved in that work. In fact, that volunteer work might require you to be vaccinated!

How do vaccines work?

Usually, what a vaccine is doing is showing your immune system some signature of the virus that’s going to allow your immune system to say, “Oh hey, I don’t recognize that, I’m going to create an immune response. And then I’m going to create a memory of that immune response.” So, if out in the wild, you actually encounter whatever the pathogen is, your body already knows how to fight it.

Viruses cannot reproduce on their own. They have to get inside your cells to do so. This virus uses what’s called its spike proteins to enter your cells. So, if your immune system can disable those spike proteins, the virus is neutralized and eliminated and you don’t get sick.

People have a lot of questions about the Moderna and the Pfizer vaccines because they are a new technology. Their main ingredient is a nucleic acid called messenger RNA (mRNA). When your body is making a protein, it reads a section of DNA and it copies that section into mRNA. Then the mRNA goes to a ribosome and that ribosome makes the protein. So, this vaccine is giving the cells in your arm the mRNA that codes for the spike protein. This mRNA is NOT the whole virus! You cannot get Covid from a vaccine. That is not possible.

So, the vaccine gets injected into my arm, the cells in my arm take in that mRNA, and the protein-making machines in my cell are like, “oooh mRNA, let’s make that protein.” Then they export that protein to the surface of their cell and suddenly my cells are making these little spike proteins. And my immune system is like, “What the hell is that? That doesn’t belong here.” And then it says “that’s not part of your body, we’re going to mount an immune response.” The result of this immune response is that the vaccine teaches my body how to recognize the spike protein, attack it, and therefore fight and destroy the virus.

What is in the vaccine?

The main ingredient in the Pfizer and Moderna vaccines is the spike protein mRNA. This molecule is super fragile so it has to be encased in a lipid nanoparticle and stored at very low temperatures so it doesn’t degrade. There are other preservatives in the vaccine that help it last and have a better shelf life. When I went and looked at the list of ingredients, it said things like sodium chloride, which is just like table salt, or acetic acid, which is like vinegar. There is nothing in these vaccines that is dangerous. You also receive a very, very small volume – a dose is the equivalent of 0.3-0.5 milliliters — that’s like 6-10 drops of water for comparison!

How does one begin to address vaccine hesitancy in communities of color given this country’s history with medical care?

We have a history of a government that has medically abused people of color. Full stop. Whether that’s in something like the Tuskegee experiment, or in placing environmental pollution near communities of color, there’s so much evidence of our government doing harm against communities of color, the Black community in particular. If you’re part of a community that has been systematically oppressed, violated and had violence committed against you by your government, had your humanity denied, having questions or hesitancy or lack of trust seems logical. I would say to anyone: vaccine hesitancy is healthy. Anytime you’re going to take a medication or treatment or preventative health measure, you should know what you’re taking. You should ask questions. That said, I trust the vaccine science. I trust that it’s safe. So then, for someone who is hesitant, I would say, “Who in your community do you trust? Who do you go to when you have hard questions like this?” This is where public health comes in. In a community with strong public health infrastructure, trained health workers engage with grassroots organizations, volunteer groups, churches, etcetera., so that communities receive accurate health information from people they trust. So, if someone at Urban would trust me to be that source of information, I would gladly do it or help them find someone who feels more comfortable. I also hope that at Urban we can create an environment where people feel safe to ask their questions — that’s really important.