Weaving Perspective into Propaganda

A recent NJDOH presentation is "Missing Context."

Last week, New Jersey “public health experts” Dr. Meg Fisher, Assemblyman Herb Conaway, MD, Nicole Fields of Saint James Health FQHC and Nayeli Salazar de Noguera of NJDOH's NJCCC had a panel discussion on the “importance of getting your COVID-19 booster shot and how you can help create a safer, healthier New Jersey.”

Our Way Forward: Why a Booster Shot Matters

This was supposed to be a live discussion, but due to technical difficulties it was instead recorded and posted on YouTube and Facebook.

Thanks (or no thanks) to organizations like NACCHO (National Association of City and County Health Officials), the HHS and the CDC, health departments throughout the country often provide similar presentations.

Unfortunately, these pre-packaged talking points and presentations leave little room for open discussion or debate, so I took the liberty of transcribing some of the discussion and inserting hyperlinks to offer other data and/or additional perspective related to some of the assertions that were made.

Meg Fisher: So why aren’t people getting boosters?

Nayeli Salazar:

People believe that they’re fully vaccinated… because they believe they’ve gotten the first and second primary series dose…

Number 2, we have a lot of misinformation related to being fully or naturally immunized after getting COVID. People believe that if they got Covid then they have superior immunity and that’s just not the case. We know that getting boosted after you’ve already recovered from COVID-19 allows you to have extra protection.

And lastly we are hearing that people believe the Covid-19 pandemic is over simply because the mask mandate has been lifted. So I would say those are our top 3 questions and misinformation that we’re hearing on the ground.

Nicole Fields:

We still hear a lot about how the vaccine was developed too quickly and that they don’t necessarily trust it due to how quickly it came out. And then a lot of the misinformation having to do with fertility and that there’s going to be a tracker in the vaccine and things like that. So we’ve continued to stick with our education and make sure we’re putting the proper information out there. And we answer all questions. We don’t think any question is dumb. They can come to any vaccine site and ask any of our providers and they’ll take the time to have the conversation and explain it to them.

Asm Herb Conway:

The challenges are really related to things we just heard. People do get a lot of information from the internet. A lot of that information on the internet is misinformation and really driven by self-interested people who are trying to make a buck…. and they don’t mind telling untruths. And it’s a huge problem when you have so many people using social media as a “trusted” purveyor of information, but there’s a lot of information there that needs to be fought against.

The other thing that we hear is the concern that’s been raised about the vaccine having been sort of rushed into use and what I tell people is that these vaccinations really result from decades of research on the one hand and really involve studies across populations involving different races, different ages… well studied and indeed more studied than many of the medications people typically take today, for blood pressure and other ailments by their doctor. So these vaccines have been well studied and rest on a mountain of research as many of our discoveries, of our scientific advances do. You don’t wake up one day and suddenly you figure out fusion. It’s decades upon decades of work to get these things into place. So education as you mention is the way forward.

And I think interventions by trusted people in the community and particularly the medical community talking about these things will encourage those people who are hesitant. But they have to ask… go to doctors office go to places where there are trusted people can inform them of the truth of vaccination and how important it is.

Meg Fisher: Absolutely. And we know that nurses and doctors are some of those trusted people…. Nayeli, how are you encouraging parents to get their children vaccinated and to get their adolescents boosted?

Nayeli Salazar: (9:38)

Here at the CCC, we run two types of outreach… (virtual and physical)

What that means is we’re talking to different demographics. Typically we’re catering to younger individuals who are in the social media realm by providing infographics, things that are quick to consumption. And then on the ground we actually have the opportunity to have one on one conversations and understand where the hesitancy and miscommunication is coming from. So that’s really when we are meeting parents or elder individuals… sometimes individuals who are new Americans… so we’re able to communicate with them, not only in an intimate way, but also in their native language, which is key for our program…

Nicole Fields: (11:02) 

So we actually find that our largest uninsured population… in the ironbound section of Newark where our health center is located, is also our best vaccinated community in Newark. We saw a lot less vaccine hesitancy in that population and we believe it has to do with the understanding that vaccines help to keep you out of the Emergency room and our uninsured members of the community don’t want to end up in the emergency room. The uninsured members of the community also rely heavily on our federally qualified health centers, so they’re constantly coming in. They’re talking to our providers and they’re listening and asking their questions. So we have not seen that much hesitancy in that population. And I’m pretty confident that they’re also going to be the ones that come in for their boosters.

Meg Fisher: Well, we know that every vaccine has side effects. There’s been a lot of talk…myocarditis… Dr. Conaway, does the vaccine cause that and how do you explain that?

Asm Herb Conway: (12:22)

Well the vaccine can cause - mRNA vaccine in particular - can cause myocarditis, but we see that in a very small percentage…almost vanishingly small percentage.. of people. And we approach it with an understanding that it’s very hard I guess for a lot of reasons for people to assess risk and understand what’s really risky and what’s not risky. We in healthcare deal with risk and risk outcomes all the time and make judgments based on risk. There’s a lot that’s unknown. You can give the same medicine to 10 different people and you might have different reactions, and reactions that hadn’t even come up yet. We understand this… But we move forward because we understand the risk of not doing something are worse than the risk of taking action, either to protect yourself from disease or to have whatever disease process you have treated. And so we look at these various studies on myocarditis as an example.. one recent study… you might find 10 people out of 100,000 vaccinated coming up with a myocarditis condition. The overhwhelming number of those conditions can be mild and you have to explain to people that’s a point, three zeros and then a 1. So that’s 100th of a percent risk associated with myocarditis….

…It is so small of a risk, not that we shouldn’t let people know that there isn’t a risk, but again with everything taken into consideration… the very important known risks with getting the disease, the risk of hospitalization, the risk of death… are orders of magnitude greater than the risk of myocarditis or really any of the other things that have shown up as a possible side effect of vaccination.

And the last thing I say to people is, if you want to consider one grand experiment, we’ve had hundreds of millions of people vaccinated. Hundreds of millions of doses given to people and when you look at the side effects you can say hardly a side effect from that.  And I think that is a success. I don’t know how you want to measure success, but it seems to me the vaccination program around COVID is a miracle… and will be regarded through the ages as absolutely and positively successful.”

Meg Fisher:

We’re trying to prevent something that’s going to do a lot more harm than these wonderful vaccines…

You often hear “My friend was vaccinated and boosted and he still got covid…”

Nayeli Salazar: 15:50

We actually have statistics that show 99% of people that were hospitalized due to Covid-19 were unvaccinated. And when we compare individuals who were fully vaccinated to those who were not vaccinated, we know that those people were 11X more likely to get Covid, 10X more likely to be hospitalized due to Covid and almost 5X as likely to die due to Covid. So those statistics are really meaningful when we’re talking to individuals…

..And we always talk to people about living in multicultural families or multigenerational families. Families that whatever you do, you’re going to bring back to the household and could harm somebody in your house. So we bring those points up. We ask “consider keeping yourself safe, but also your household, your neighborhood, your community safe.”

Meg Fisher:

And sometimes we expect too much from vaccines. And in this case the vaccines do prevent some disease, but they’re not as good at preventing disease as they are at preventing serious disease. So preventing hospitalization and preventing death. And, from my point of view, that’s certainly what we’re trying to do here.

Nicole Fields:

Yes, you absolutely still need a booster even if you already had Covid before.  And it goes back to what Nayeli was saying. It decreases the severity. If you were going to get it again, it will decrease the severity and you need to keep your immune system ready and prepared to fight Covid. Also has to do with the families. You know, where we serve, populations we serve, we have large families living in small situations, small settings, small apartments, to make sure we’re protecting those around us. We’re all going to work again, we’re getting out, and we all want to take these masks off. The mask mandates have been dropped and if we keep getting these boosters we can keep the masks off, but without the boosters we’re gonna end up back in masks.  We’re not going to be able to have the kids in schools take off masks if we don’t keep getting boostered and keep these numbers where they have been and keep increasing them.

Meg Fisher: Can you give the difference between natural immunity and vaccine immunity?

Asm Herb Conway: 18:48

…People believe that natural immunity is better than anything that can be provided by a vaccine. What people forget is that Covid itself causes, you have diseases that might take your life, land you in the hospital… you might spread it to someone in your family who’s vulnerable, your grandparent or someone else who’s undergoing treatments, a co-worker… so getting Covid in itself is problematic on a number of levels.

And when you look up these people on sort of a time study… look up people that have had Covid and watch when they get their second, when they might get Covid again, and you look at their levels of immunity, that immunity from natural Covid wanes. And these same people, if they are vaccinated, will see their level of protection rise. And so for people who are vaccinated, they get a high degree of protection against Covid, high degree of protection against death and hospitalization without ever having Covid in the first place, which I think is a great thing.

We know that just like natural immunity that there is waning immunity from vaccination, which is why we have a booster. I have now had my 2nd booster dose as soon as it was approved. And I know people are going to find this hard to believe – I’m over 50 – I went and got my vaccination this past Saturday and I’m very happy to have done that.  My levels of protection have been boosted because I’ve done that. And that will allow me to get closer to normal and be able to participate in things without the fear of first infecting myself or infecting somebody else.  We all have a responsibility to each other in this society… that all part of the deal that we made to be in a society is that you have to look out for one another. One way that you do that during a pandemic is to get vaccinated.

Meg Fisher: Nayeli, do these boosters help against the variants?

Nayeli Salazar: 21:14

Absolutely. We know that these boosters are evolving – the protection as well as the variant. So we want to make sure that we get boosted and if possible continue to use the mitigation strategies of masking up when you’re in areas that are overcrowded… So between the boosters and the mitigation strategies to washing hands and staying away from large crowds, I think that it’s the best formula to stay protected.

Meg Fisher: Excellent. And we certainly are starting to see lots of variants kind of come and go…It’s not surprising that we may not see the vaccines work quite as well against variants of variants, but we do know that the booster on top of that primary series or natural infection really does protect you well against hospitalization and against death.

Asm Herb Conway:

And I would just add that the studies, that are involved and ongoing, are looking at this question of the effectiveness of this vaccine against Omicron and now Omicron’s cousin, the stealth Omicron… but the preliminary studies are showing that this new variant, which is now dominant across the country, is not able to escape the protection of the vaccine. And I think it’s very important to understand that the vaccines that are available today, that are approved in this country, will work against this new strain of Omicron. So if you haven’t been vaccinated yet, go ahead and get vaccinated. If you haven’t been boosted yet and you’re eligible, go ahead and get boosted as well.

Meg Fisher: Are you still finding hesitancy in your community about the vaccination or the booster and how are you addressing it? Are there certain populations that are still more resistant or hesitant….?

Asm Herb Conway:

…We have conducted focus groups to try to get an understanding of why people are hesitant. A lot of it has to do with the concern about the speedy development of the vaccine and perhaps that steps were skipped with respect to this vaccine. And so we lean forward as we must with understanding of the fact that people have concerns and try to educate them about what the true risks are, understanding how difficult it is for people to appreciate it. But you know we have to try. Our job is to encourage people to participate in their health care, to think about social responsibility as well, but think about what might be missed in your life if you’re unlucky enough to be, to succumb or if you have serious trouble with this vaccine.

There’s a study out here today that suggests that some months after you recover from having Covid you’re at higher risk of developing blood clots in your legs and in your lungs. I mean this is why this idea that you should gain natural immunity and that it’s not such a terrible thing that you should get Covid, you know these are showing, I know there early and there’s a lot more studies that are going to be done here and for decades looking at the impact of this virus, but so far the news isn’t particularly good.

I don’t want Covid…and the next time they tell me to get a vaccine or get boosted, I’m going to be the first in line to receive it.

Meg Fisher: Absolutely. You know a lot of people have this idea, it’s natural, it’s organic, it’s great, but those of us who lived through (hurricane) Sandy here in New Jersey, knows that Mother Nature is not always so benign and not always so great. So if we have something that can prevent something like those natural disasters, we ought to go ahead and use it and protect ourselves as well as we can.

Nicole, if someone comes in to get the booster… which booster to get?

Nicole Fields: 26:36

Most of our population does come in knowing what they want. ... a lot of people do stick with what they originally got, but there are some people that want to switch…

… there are some side effects that they hear of in the news and that gets in their heads, so we can also go after that misinformation and tell them what the actual rates of the side effects are.

One of the big things now that we’re talking to people about…young people are saying “it’s just a cold”…is we’re seeing a lot more long Covid. We’re seeing the diagnosis of long Covid and the long term effects. And nobody knows who’s going to get that. It doesn’t matter your age or who you are, so that is now one of the big things that we’re now educating on. And it could be anything from blood clots to lung problems to heart problems. So we really want to make sure people understand that. And when they’re coming in and saying how hesistant they are in the vaccine, telling them what to research on their own also. So if you’re reading this online, make sure you’re also looking up long Covid and what could happen after you get better, after you start to feel better after your initial cold-like symptoms.

Meg Fisher: I think that’s a great point. We know that if you don’t get Covid, you can’t get Long Covid… Dr. Conaway, is there any evidence that these Covid-19 vaccines affect either male or female fertility?

Asm Herb Conway: 31:42

There’s no evidence that there’s any effect on fertility. These vaccines boost your immune system. It doesn’t really implicate any of your reproductive cells – either your eggs or your sperm. It boosts your immune system by providing a piece of a viral protein against which your body will bring forward an immune response. It doesn’t integrate itself into your cells. I doesn’t affect, negatively or positively, your ovaries or your testes or the reproductive capacity of those organs, so there’s just no evidence of that. It’s unfortunate that that’s out there. But again, people will say anything. And the job, the task is we’ve got to educate our kids about this as well as to look at things with enough skepticism and to ask those who know – health professionals, scientists – there’s plenty of good data out there, too. Go to trusted sources. Go to your health professionals. Go to the CDC and you’ll get the right answers and make the right decisions about your health.

Meg Fisher:

I think it’s important to remember that the American College of Obstetrics and Gynecologists as well as the group on fertility and in-vitro fertilization, all of those groups have actually said “Everyone should get this vaccine.” You should get it if you’re thinking about getting pregnant. You should get it if you are pregnant. You should get it if you’re breastfeeding. You should get the vaccine because there’s no effect on fertility. I kinda like to say if anything it enhances your fertility because it keeps you from being sick. So if anything it’s gonna help you. Certainly there’s no evidence and no biologic reason to think that it would actually affect fertility.

Meg Fisher: Dr. Conaway, what exactly is in the Covid vaccine?

Asm Herb Conway: 36:49

Well, it’s a piece of DNA that codes for part of the Covid viron….

The important thing for people to understand is that there’s no live virus in the vaccine. You’re not getting anything that’s going to cause Covid, which I think is one of the things that’s out there… You might have a sore arm as I had on Saturday after I got my shot. You might feel a little feverish for a day or two…

You are being given this RNA that can go in and create a protein that matches a protein on the virus and the body mounts an immune response to that foreign protein. And that’s what you want. That’s what provides immunity. And if you’re uncomfortable for a day or 24 hours or 2 days, that’s well worth it to get your months and months of protection. And I hope that’s a good answer.

Meg Fisher: 39:40 It’s a great one and it’s absolutely true.

Public (previously submitted) question: They’re asking why we’re using the boosters from the original vaccine when we now have variants and we know that the original vaccine is not quite as protective against the Omicron variant as it was against Delta and Alpha and of course the original SARS-CoV-2. 

Talk about using the booster, which we now know does work, vs. coming up with a brand new vaccine.

Asm Herb Conway: 40:35

First, you’re absolutely right that the boosters work. They raise your level of immunity. They raise your protection and they remain highly effective in preventing death and hospitalization from all of the variants that have been dominant here in our country, from Alpha to Delta to Omicron and now Omicron’s cousin the stealth Omicron. Very highly effective.

Now research is ongoing in this area because there is obvious clear recognition with the 4 variants we’ve dealt with in this country, and many others by the way, that we need to come up with a vaccine that will provide longer protection, because there is a concern that there might be booster fatigue out there. And here the authorities are saying “we want you to get a booster yet again.” I’ll take the shot because I don’t want to get Omicron. But the science is advancing. Moderna has come out with a study to attack some different protein on the viruses under study. I think they’re recruiting people into that study know and we’ll have to wait and see for the results. But a search for a better vaccine that will present a number of proteins…again, not the virus, but a number of proteins on the viruses that circulate so that immune responses can be mounted against them is underway. So just like this current set of vaccines, we want all the studies to be done thoroughly. Just like the current vaccines, we want all races involved in this study. More racial minorities were involved in the studies of the current vaccines than just about any other medicine people currently take. That’s important for people to recognize, particularly people of color who need to get this vaccine. So we have to take the appropriate amount of time to get  large cohort of people…. That we look at any gender issues, age issues that might be involved to make sure we once again deliver a highly effective, highly safe vaccine, that will hopefully provide protection for the longest possible time.

The hope is that you can get your flu shot and your covid vaccine in the fall and you’re protected for a year and you’re good to go. But we’re not there yet. But the studies and the research to provide that to the world is underway.

Meg Fisher: 43:30 Absolutely. And I think that for the near future, the boosters are what we have and we’re studying them to make sure that they work. At some point we may need a different vaccine. I think there’s been changing information throughout this pandemic – that makes people uncomfortable – but I think people should understand that the information is changing. We’re learning more. We’re figuring out how we can do our best job at protecting people and sometimes that means we change the messages over time.