Fewer Merced County residents are getting vaccinated. Here’s how the county is responding
Having overcome issues of low state-allocated COVID-19 vaccines, Merced County is now targeting another barrier to combating the virus: vaccine hesitancy.
Plenty of vaccines are now available for Merced County residents, but the initial race for shots has hit the breaks.
“We’ve noticed a definite slow down,” said Merced County Health Officer Dr. Salvador Sandoval. “I think part of that is effected by the fact that the people who were most interested already received it.”
About a quarter of Merced County residents have been completely vaccinated so far, according the Merced County Department of Public Health. A higher percentage are waiting on a second shot of Pfizer or Moderna.
Statewide, about 38% of residents are vaccinated. The Valley is ranging from 28-31%, Sandoval said, meaning that while Merced County has caught up, it is still occupying the lower end of the spectrum.
In order to reach the threshold touted throughout the pandemic as a benchmark for safety, Merced County must at least triple its current numbers. “Herd immunity” is the percentage of the population immune to an infection so that it is no longer spreads.
The exact immunity percentage needed, and whether the U.S. will even reach it, has been debated. But estimates mainly range from 70% to 90%.
Regardless, healthcare experts say reaching a high percentage of community vaccinations effectively prevents COVID-19-caused hospitalizations, deaths and new mutations.
Calming vaccine fears
Sandoval said he believes a majority of individuals are exercising an abundance of caution and that few are entirely resistant to getting vaccinated.
Vaccinated family, friends and coworkers can help quell fears by sharing their experiences and being candid about anxieties and side effects.
Side effects from COVID-19 vaccines are generally minor and fleeting. None of the rare but severe anaphylactic reactions have occurred in Merced County, but vaccine sites are always prepared for the possibility.
Sandoval acknowledged that hesitancy over a new vaccine is not unmerited. Misinformation, the complexity of explaining intricate scientific concepts and historic mistreatment of people of color by the medical community all contribute to caution being a valid response, he said.
“There’s legitimate concerns that different groups have,” Sandoval said. “All of those can be dealt with when we have the opportunity to address them.”
Local healthcare officials also say overblown and inaccurate portrayals of the Johnson and Johnson vaccine pause has exacerbated fears.
The Johnson and Johnson vaccine has been deemed safe and its rollout resumed with an additional warning about rare blood clotting risk included on labels, per recommendation by the Food and Drug Administration and the Center for Disease Control.
Despite thorough vetting, an inaccurate media narrative sabotaged trust between vaccine-hesitant individuals and the medical community, healthcare officials say.
“There’s a lot of people who aren’t coming back for their second dose,” Dr. Sima Asadi told the Sun-Star. Asadi, a pediatrician with over 20 years of experience, has overseen about 10,000 local COVID-19 vaccinations to date, she said.
Concerns over vaccine hesitancy brought her to Monday’s County Board of Supervisors meeting. Asadi called on local leadership to think carefully about how to incentive residents who are fearful of the COVID-19 vaccine.
“We can’t solve this program if we don’t address society and their fears,” she told the Board.
The importance of getting Valley residents vaccinated was made clear to Asadi during the whooping cough epidemic in 2010. A disproportionate number of the state’s whooping cough cases and infant deaths were in the Valley, she said. Issues leading to high incidence back then are relevant more than 10 years later.
Medical experts speculated at the time that lack of information and inoculations in agricultural regions might be responsible. Merced County is a healthcare desert, meaning the number of providers per capita is low. Members of the county’s undocumented community, estimated to include upwards of 25,000 residents, have also expressed concerns that getting vaccinated could jeopardize immigration status.
COVID-19 vaccines are free to everyone living in the U.S., regardless of immigration or insurance status. But effectively getting this information across to hard-to-reach communities is a challenge made more difficult in a healthcare desert. “I think what the average person is scared of is the unknown,” Asadi said.
Asadi has seen firsthand how the virus can change and end lives. She recalled a 29-year-old patient, formerly healthy, giving birth to her baby at 30 weeks while ill with COVID-19. “We were just praying that we could get this baby out before we got her on a ventilator,” Asadi said.
At the time, no ventilators were available locally and the mother was flown out of state for treatment after giving birth. By effectively preventing hospitalization, approved COVID-19 vaccines can stop those kinds of situations from happening.
“The majority of us have now decided that the risk and unknown of this virus far outweighs the risk and unknown of this vaccine,” she said.
A direct approach to COVID-19 vaccination
Like Asadi, other Merced County healthcare experts and local officials are thinking about how to avoid stalling on the road toward herd immunity numbers.
“As long as we’re under this threshold of the 70-80% herd immunity, we’re still going to be under the thumb of the larger government,” said County Supervisor Scott Silveira, noting the state-mandated restrictions due to the virus. “If you’re looking for a reason to get vaccinated, help us get to that 70-80%.”
Silveira has advocated that changing from large vaccination sites to more targeted, smaller clinics is now a better approach to target less enthusiastic vaccine participants.
Community hubs like outdoor markets, churches and shopping center parking lots offer opportunities to set up clinics that directly reach people and offer them the vaccine, he said. That would also aid in engaging with individuals who aren’t seeing information online.
Indeed, Sandoval said this is the approach County Public Health will be transitioning toward.
Outreach at targeted community locations, including schools, will help educate and assuage resident’s fears — and hopefully get them vaccinated. Plus, the direct approach will overcome barriers some residents have encountered in navigating the vaccine registration process.
The Johnson and Johnson vaccine’s single shot is especially useful with this approach, Sandoval said, since getting hard to reach individuals back for a second dose is especially difficult. However alternative vaccine options — like those made by Moderna and Pfizer — will always be available for those who are still wary, he said.
“I think this is going to be an ongoing discussion, about the issue of hesitancy,” Sandoval said. “It really gets to the issue of trust.”
”Us doctors in general, we’re learning to do a better job in the art of medicine, not just the science of medicine.”
This story was originally published April 30, 2021 at 12:51 PM.
