Quinnipiac plays leadership role in COVID-19 vaccine awareness

By the time Americans got together with family and friends on July 4, only 48% of them (some 157 million) were fully vaccinated—missing the mark of 70% that President Biden had hoped for by that date. Hesitancy about getting the vaccine is mostly to blame — there are plenty of doses to meet the demand.

Young adults make up the majority of the unvaccinated, and getting them off the fence is the mission of the Connecticut Public Health College Corps, a partnership between Quinnipiac and the state Department of Public Health. School of Health Sciences Dean Janelle Chiasera, assisted by faculty members and 110 college students from around the state, have collaborated to do this important work.

“We have been learning a lot about how we can decrease vaccine hesitancy in the community and increase vaccination rates in college-aged students,” said Kripa Patel, a junior health science studies major from Guilford, Connecticut. “We’re super excited to take what we’ve learned and make a difference."

With the highly contagious Delta variant on the rise and plaguing the unvaccinated, there is no time to waste.

Lisa Cuchara, professor of biomedical sciences, understands that people may have questions about the COVID vaccine. She’s been studying vaccine hesitancy long before the COVID pandemic. “It is normal to be hesitant about something that has had so much media coverage,” she says.

Statistics show that young people in particular are the primary spreaders of the virus now. “They think they are healthy and don’t urgently need it and just haven’t gotten around to getting it, she says. And some people say they are waiting to see what the long-term effects of the vaccine may be, but the notion of a vaccine having long-term effects has always been a myth, according to Cuchara.

“Some people wrongly compare vaccines to a drug with potential long-term side effects, like Vioxx, but there has never been a vaccine with long-term effects. It goes in, induces an immune response, and then is gone,” she says, adding that any temporary side effects usually show up within a week and that almost all side effects show up within four to six weeks.

“For this reason, the FDA required each of the authorized COVID-19 vaccines to be studied for at least two months after the final dose. Millions of people have received COVID-19 vaccines, and no long-term side effects have been detected,” she says. There have been rare but widely reported side effects, such as blood clots with the Johnson & Johnson vaccine and myocarditis in teens, which also give doubters pause.

Cuchara and a half dozen or so faculty members from the Schools of Health Sciences, Nursing and Medicine took part in four vaccine informational Zoom webinars sponsored by Quinnipiac from December through March. They were open to the public. Watch them here

One of them was attended by Dr. Reginald Eadie, president and CEO of Trinity Health Of New England and co-chair of Connecticut’s COVID-19 Vaccine Advisory Group. At the time, people were eagerly awaiting a vaccine and had many questions for the panelists.

Besides worrying about long-term effects, another factor contributing to hesitancy is a distrust in the government, science and an inclination to put more faith in social media posts than in experts who have spent their life researching viruses and or vaccines, Cuchara notes. Even the name of the effort to facilitate and accelerate the development, manufacture and distribution of the COVID vaccine — Operation Warp Speed — undoubtedly contributed to the hesitancy, she thinks.

“I would have called it Operation Safe Vaccine or Operation Back to Normal,” Cuchara suggests. People don’t realize that all you really need are six weeks’ worth of data to determine a vaccine’s safety, she says, adding that drug companies generally prefer six months of efficacy data to show their vaccine is effective to that time point. “The only part of the process that was expedited were the administrative and preparative parts, not the science, like printing of labels and the manufacture of the vials before the final approval and efficiently recruiting people for the clinical trials,” she adds.

She notes that the message about how the Pfizer and Moderna vaccines create antibodies using messenger RNA did not resonate with people, many of whom erroneously thought they were receiving a small dose of COVID-19 itself or could get COVID from the vaccine. “Not many laypeople had ever heard of mRNA before, despite the fact that all of our cells are making lots of it all the time,” she says.

Contract tracing and testing could and should have been handled better, Cuchara remarks. “From the White House down, testing was so slow that it was difficult to remember who you came into contact with a week ago, so you still went about your daily life, infecting people.”

The professor is frustrated when she hears parents say, “I got vaccinated, I’ve had my kids … but now I’m worried about getting vaccines for my kids.”

“Instead, parents should worry about the long-term effects of their kids getting the virus—we know about those,” Cuchara says. Some long-term effects of the virus include cardiac problems, loss of taste and smell, brain fog, fatigue, headaches, dizziness and shortness of breath. Cuchara thinks some parents figure that if their kids contract COVID, it’s a happenstance of fate versus the parents actively choosing to get their kids inoculated and possibly regretting the decision later.

She also points out that it’s common practice in this country to vaccinate children against rubella (German measles) mainly to protect adults. “Kids don’t die of rubella, but if they were to infect a pregnant woman, she could have congenital rubella syndrome, resulting in mental and physical deficits to her baby. Therefore, we vaccinate everyone.”

Although it’s waned in the last few weeks, more than a few people still choose to wear masks in stores and other public venues. Perhaps some are unvaccinated, but Cuchara reasons that some are afraid to take them off, again because of a trust issue.

“The way the CDC said, ‘Tomorrow, you don’t have to wear a mask,’ that took a while for people to wrap their heads around. We were of the mindset that we were being safe,” she says. And there are folks with compromised immune systems who like the protection of a mask. And still others who don’t miss the common colds they got before mask mandates were issued last year.

Quinnipiac answers the call

Meanwhile, the 18-to-29 age group is being blamed for the continuing spread of the virus nationally and in Europe. The Centers for Disease Control and Prevention analyzed adult vaccination rates by age through May 22, finding 80 percent of adults older than 65 had been immunized compared with just 38.3 percent of 18- to 29-year-olds. It concluded that efforts to improve vaccination coverage are needed, especially among younger adults, to reduce COVID cases, hospitalizations and deaths.

In April, Quinnipiac held a COVID-19 vaccination clinic on campus. More than 500 doses of Pfizer vaccines were administered to students.

For its part, the state of Connecticut reached out to Quinnipiac in June, asking the university to quickly put together a proposal to develop and coordinate a Connecticut Public Health College Corps in partnership with the state Department of Public Health to reduce vaccine hesitancy within the state. Chiasera coordinated the training and deployment of the 150 undergraduate and graduate students who will support the work of community partners already addressing vaccine hesitancy at health clinics, churches, barbershops, soup kitchens, stores and the like. They may even go into neighborhoods to persuade others in their age group to get the vaccine.

They will participate in a week of online training that began July 19. They will learn how to dispel vaccine myths, overcome misconceptions and counter objections raised by the vaccine-hesitant, then carry out their mission through Aug. 20 in 10 cities and towns the CDC has identified as most vulnerable, including Bridgeport, Hartford and New Haven. Each student will earn $550 a week. Their focus will be on their peer age group as well as people of color who may be skeptical of science and government mandates.

Eadie addressed that topic in several televised public service announcements this spring, acknowledging that he understands the hesitancy of communities of color, but he cautions that doing nothing will result in more family and friends dying of COVID at a much higher rate. Some 606,000 Americans have died of COVID since the pandemic began.

“We will teach them how to have discussions about something as politically charged and sensitive as the vaccine and how they can persuade but not push,” Chiasera says.

“It’s a peer-to-peer concept. We want to meet people where they are at, community member to community member, and we think the trust factor will help a lot.”

Quinnipiac has required all students, faculty and staff to be vaccinated before the fall semester. Quinnipiac students comprise about 25% of those accepted into the corps, and members run the gamut from business majors to communications and health sciences majors. “That’s why one week of education is really important to give them fundamental knowledge so they can be successful,” she says.

Chiasera is serving as QU’s liaison with the DPH, and there are three core faculty leaders besides Cuchara who have developed the training curriculum and identified other faculty members who will assist in delivering content: Mary Dunne, assistant teaching professor of strategic communication; Amber Kelly, associate professor of social work, and Laura Willis, associate professor of health and strategic communication.

The dean hopes students in the corps will engage in thoughtful conversations and get to the real root of why some people have yet to be vaccinated and then provide that information to their community partners to help enhance their work.

“Their feelings are valid and they are real. Our role is to help facilitate that discussion and try to get that person who is maybe on the fence to move to the side of the fence to get the vaccine. I believe there is a certain subset of the population who are looking for answers from people in the community, people who will hear them and provide them with information so they can make the best decision for themselves and their families,” Chiasera says.

The media and the message

Although the news media have attempted to provide accurate information during the pandemic, some would lay part of the blame for vaccine hesitancy at the media’s collective feet.

Even as this story was taking shape, experts were raising the specter of the return of mask wearing as they warned and worried about the spread of the Delta variant. The virus is still very much a daily news story.

“Vaccine hesitancy is among the topics covered by the mainstream media, and in the process, they repeat the false narratives that anti-vaxxers are promoting because it’s part of the coverage,” says Rich Hanley, associate professor of journalism.

He said many of the people who have chosen not to get the vaccine have bought into a suite of disinformation narratives. “In many cases they are wearing their anti-vaxx credentials as a badge of honor and independence,” he says.

Although reporters strive for balanced coverage, they have struggled with whether to bring up false information within stories in order to correct it, a technique Hanley calls “the truth sandwich.”

“Paragraph A states a given message is not true, and then to meet the criteria of balance, the message is then reported, followed by another paragraph that re-states the message is not true,” he explains. “That is the way journalists have sort of navigated the requirement for balance while maintaining fidelity to the fact.”

Some readers or viewers will cherry pick that part of the story that aligns with their anti-vaccine position and adopt that position as fact because it’s in the news, so it really is a consequence of fully reporting both sides of a story, he notes.

“By simply repeating it, journalists can give false information credibility, so they are walking on the balance beam there … it sort of undermines who they are as professionals,” he added.

In the case of vaccine stories, Hanley urges journalists to use statistical information high up in their pieces — such as the details about side effects occurring in a fraction of vaccine recipients — to avoid playing into readers’ fears and uncertainties.

Cuchara agreed that many just click on a headline and never finish that story. “The title is clickbait and maybe the article dispels the myths later, but people don’t read that far, they just see the headline or the beginning and they leave more misinformed,” she says.

Hanley thinks the media did a great service to America in its coverage of the pandemic once they got a grasp on its scope and severity.

“There was great debate on whether to cover the White House press conferences because of the, quite frankly, harmful information that was projected, such as the bleach piece,” he said, noting that when events were live, reporters felt they did not have the capacity in the moment to counter disinformation.

Students help with research

The anti-vaccination movement has been around for years and has successfully used social media to convey its message to a much wider group looking for information about COVID-19 vaccines in particular. Without new movies, TV shows and sports to watch, people tended to focus on the virus 24/7, Cuchara says.

She has mentored students who have assisted her with anti-vaccination research since coming to Quinnipiac in 2006 from her post as director of the organ transplant lab at Yale University School of Medicine.

“One of my students just defended her master’s thesis, and she found that those who get news mainly from social media are more likely to believe myths and be hesitant. Emotionally, you may be more likely to believe Facebook, even though you know the right answer might be to trust your doctor,” she said.

Among the students conducting vaccine research with Cuchara was Ethan Reever ’19, who earned a BS in microbiology and immunology. He is employed as a medical technologist at Hartford Hospital and has an abiding interest in vaccines. While working with Cuchara, he was chosen to present a poster titled “Vaccine Misconceptions in the Media: A YouTube Analysis,” at the Microbe 2019 microbiology conference in San Francisco.

The pandemic has motivated more students to work with Cuchara, and she says the work has produced much new data. “We added political questions to our surveys for the first time, asking people who they voted for in 2016 and 2020 and whether they think the pandemic was overblown. It’s mind-blowing to see the difference in answers among people based on whom they voted for,” she remarked. She shared that in the past, they found no correlation between getting a flu shot and voting records, but with COVID, respondents are much more likely to identify as conservative, have voted for Trump, and be Fox News viewers.

“But the virus is non-partisan. It doesn’t care who you voted for,” she says. 

While the push continues to vaccinate as many people as possible, Pfizer is already seeking FDA emergency approval for booster vaccines. “We won’t know if they are needed until any variants break through and vaccinated people begin getting COVID, Cuchara says.

“We are all tired of the virus, thinking about it, worrying about it,” she says. She sees irony in comments by people who refuse the vaccine because they don’t want to be a governmental guinea pig or science experiment.

She views it another way. “Since you don’t know whether you will be the COVID patient with no symptoms, the one with long-hauler COVID, or the one on the ventilator, then you may well be the guinea pig!”

Illustration by Brian Stauffer
Photos by Autumn Driscoll