Vaccine

Gilford residents, from left, Jane Dickson, 90, Pat Williams, 85, and Rita Poire, 81 walk for exercise at the Gilford Community Center gym, socially distanced and six feet apart. Another piece of their stay-healthy regimen was getting the COVID vaccine earlier this year. They said they have peers who hesitated. "I try to talk to them and tell them you're better off to take the shot than to take the chance," said Williams, whose daughter, a nurse, urged her to get one. (Roberta Baker/The Laconia Daily Sun photo)

LACONIA — Polarized views of the COVID-19 vaccines abound. Some people believe the shot is essential to protect themselves, their families, co-workers and friends, and to abstain is unpatriotic, a case of ignorance or shortsightedness that could jeopardize public health.

Others remain on the fence, or say they won’t do it. They resent being bullied to get a shot. Vaccination should remain a private and personal choice, they say, and one’s right to travel or mingle freely shouldn’t hang in the balance. Others doubt whether the swiftly-developed vaccines are safe – or effective – at fighting a shifting virus.

“From a political point of view, people who are not getting vaccinated are unpatriotic," Chip Ach posted on The Laconia Daily Sun’s Facebook page. "You are not doing your part as part of society. That’s a shame.” Ach believes naysayers on social media may be guided by hearsay or faulty science.

“I got the shot not just for me, but I have friends and I don’t want to pass it,” said Jane Dixon, 90 of Gilford, who walks with companions at the Gilford Community Center before they go out for breakfast together. “You’re doing everyone a disservice if you don’t get it.”

“My interest since I’ve been a kid has been to question authority,” said Bob Fay, 74, of Lakeport, who got the Johnson & Johnson vaccine because “It was a one-time deal, and seems to be a little more advanced in terms of taking care of future variants. In terms of freedom, it makes me feel a little more like a free man. It allows me access to my family and to travel out of state. I got it done to get it done.”

Beth Silvestri posted on Facebook that she and her husband will steer clear of the COVID vaccine. “It took me until last fall to get a flu shot for the first time at 58. I feel it was manufactured really fast and we don’t really know about any long term affects that could show up later!” Some people have had allergic reactions, she wrote.

“It’s to each his own,” said Claire Lebelle, 71, of Laconia, who was having breakfast at Café Déjà vu with her husband, Donald, a retired inspector for the Food and Drug Administration. “We both got our shots as soon as we could. My sister-in-law, who’s 68, never got a flu shot in her life, and never got the flu,” and has no plans now to be vaccinated against COVID. “You can’t convince people.”

“I feel like I got it for me and the people around me,” said Nick Bailey, 23, of Laconia, who works at Irwin Toyota. “But I have younger siblings who are thinking twice about getting it. They don’t really see the point. They don’t really understand how it would affect them, or people around them.”

When it comes to local perspectives on COVID and getting vaccinated against it, the Lakes Region may be a snapshot of attitudes across America. The diversity of beliefs and mindsets presents a challenge for public health officials here and in other rural areas, especially with information and misinformation dueling for credibility on social media. The challenges of COVID and its mutations pose a hurdle for scientists, too, as parts of the world remain in varying degrees of suspended animation because of the coronavirus, and everyone wants life to return to normal as soon as possible.

One essential ingredients to that is vaccinating 70 percent of the population, enough to create a herd immunity, and stifle rapid contagion, health experts say. And a catalyst to that is education.

Despite mounting evidence that the vaccines boost immunity without compromising health, hesitancy and avoidance linger, even as the number of people vaccinated moves higher in almost every community surveyed.  Among certain groups and individuals, mistrust of government directives and suspicion of profit motives of pharmaceutical companies is lowering trust in the vaccines, according to surveys by the Kaiser Family Foundation. And health officials are grappling with ways to raise confidence – especially when data does not suffice.

So far, roughly 15.5 percent of the population eligible in the Winnipesaukee Public Health Region has been vaccinated, including close to 70 percent of first responders, school employees, people over 65 and nursing home residents and staff, said Tamera Carmichael, director of the Partnership for Public Health in Laconia. The goal is for 70 percent of all eligible residents to get the vaccine so public immunity will grow.

“In order to get back to socializing and feel comfortable that we’re protected and they’re protected, we need to reach that percentage,” Carmichael said. “We want the people to do the research, to explore and make an informed decision. Talk to your doctor and relay your other health conditions. Part of the job of public health is educating the public.”

Fear and emotions can sometimes be the enemy of understanding.

“The data shows that people who are hesitant about the vaccine have strong emotional reasons why,” said Nora Janeway, medical director at Health First Family Care Centers in Laconia and Franklin. “Those feel very real to people. Most of us have different sources of information.  It doesn’t always work to say here’s the data, here are the numbers.”

By the end of April, the Partnership for Public Health plans to have a website with links to the CDC, a facts page and a tool kit for local businesses. Right now it’s too early to predict what regional compliance will be, but Carmichael and others say they are optimistic that evidence and experience will triumph over vaccine reluctance or refusal.

“We sense that there is going to be a big bolus of people who want to do it,” said James Potter, president of the New Hampshire Medical Society. He said the state won’t know until mid-June who has signed up and who hasn’t signed up for a COVID vaccine.

Since December, the Medical Society has partnered with school nurses in seven NH school districts to boost vaccination rates for staff and teachers, counter misinformation and assuage fears in those of child-bearing age. Vaccination became a red flag when concern spread about the potential use of fetal material in the messenger RNA-type vaccines. Scientific evidence shows that vaccines don’t have a chance to cross the placental barrier and adversely affect the newborn, but immunity created in a pregnant woman can pass to her baby, Potter said.

In New Hampshire, the most common concerns about COVID vaccines are related to safety and side effects, and sometimes lack of trust in the political and economic motivations of pharmaceutical corporations and government are also issues, said Potter.

Donald Lebelle of Laconia, who worked for the FDA for 21 years, inspecting and reviewing blood-based medicines including anti-clotting agents for hemophilia, said he has professionally based faith that the COVID vaccines work. “I know what’s done, what it takes (to get FDA approval). It wouldn’t get through if it wasn’t good. If it gets approved it’s not because of government pressure, or congressmen yelling and screaming. The FDA’s role is to protect health, regardless of political pressure. The FDA doesn’t care about cost – safety and efficacy, that’s all. If it’s approved in the U.S., it can be used worldwide,” said Lebelle.

When it comes to disabling fear and rumor, local nurses and doctors are perceived to be the most trustworthy authorities, Potter said.

But raising public confidence in getting vaccinated can be a delicate process. There’s general uncertainty about COVID, and whether it warrants a vaccine, as well as fearmongering from the rumor mill. Regardless of whether the information can be verified, it can instill doubt just to hear it, said Janeway.

Janeway said she steps back and instead of insisting, she asks patients what they think of the COVID vaccine, then describes her own decision-making.

“It’s helpful for providers to speak about it as a person” not just as a scientist who quotes double-blind studies. “I tell people my own experience. I felt concerned when it was first coming out. So many of my co-workers have been vaccinated, and my family members, and I see that they’re OK.”

The human mind is programmed to make connections and these sometimes lead to faulty thinking. After Janeway and her partner got vaccinated, and someone emailed him, ‘Don’t get that vaccine. You’re going to die,’ she said she found her own mind racing, wondering if she was experiencing a delayed reaction. That sort of worry comes with being human, she said, because “the brain looks for reasons for things.”

The vaccine’s potential side effects – feeling achy or tired and run down – are annoying signs that the body is mounting a COVID defense. “The cytokines are all revved up and are pouring out antibodies. I think, great. My system is responding” – instead of feeling that this is harmful. “Yeah, I had my concerns at first. But being able to hug my mother now makes such a difference, and being able to travel again, you kind of have to get it.”  

As her patients see their neighbors and friends and family members getting it, fear deflates and their willingness rises, she said.

As COVID vaccination extends to wider swaths of the local population, Janeway doesn’t hear as much worry from patients, and the barricades of resistance seem to be crumbling, even among holdouts.

On Monday, everyone age 16 or older in NH became eligible. Roughly 1,400 people were vaccinated Tuesday at the vaccination site in the Belknap Mall, in the space that once housed Peeble’s department store, according to the NH National Guard, which is managing that vaccination effort.

Janeway hopes people will increasingly look at the big picture of building immunity: “We used to think that germs are bad things outside you, and you have to keep them out. Now we know that’s not true. Your body’s full of microbes. You have a healthy immune system by exposing it to dirt, germs, lots of foods and vaccines. You get a good immune system by giving it a workout. Kids who grew up on farms are healthier because they’re exposed to all kinds of substances.

“You’re not putting a germ into your body,” Janeway said. Vaccines introduce a signal – “a special baseball cap, glove or necklace that the germ wears, so that when the real thing comes along," your body recognizes the invader and its defense is ready.

Janeway said she and other primary care doctors, public health officials and epidemiologists keep a close eye on emerging data, which includes even small differences in effectiveness reported in trials of various vaccines, which are not statistically or medically significant, and shouldn’t dictate vaccine choice. “Personally, whatever is available, go ahead and get it,” Janeway said.

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