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A Doctor Battles The Diverse Concerns Of Unvaccinated Americans


As the delta variant continues to fill hospital beds in ICUs across the country, one common sentiment out there is that unvaccinated Americans are to blame, and that as a group, they are a monolith of anti-vaxxers and radicalized anti-science skeptics. And while public health officials agree that the majority of new COVID infections are happening among the unvaccinated, our next guest says our thinking about this group isn't exactly right.

Vermont's Dr. Rhea Boyd has been speaking with underserved communities about the pandemic and vaccines. And this spring, she helped develop a public health campaign in which Black and Latino doctors share messaging like this.


JANICE BLANCHARD: They did testing on a really large group of people. And they found that it was safe, and it was effective.

PAMELA SIMMS-MACKEY: I was confident that I could take the vaccine and protect myself, my patients, my family, my community.

SNELL: The campaign is called THE CONVERSATION: Between Us, About Us. And Dr. Rhea Boyd is here to tell us more about her work. Welcome.

RHEA BOYD: Thank you so much for having me.

SNELL: I wanted to start with this animosity, these ideas about who unvaccinated Americans are. I understand you've spent the past few months speaking with Black and Latino people in particular who have concerns about COVID vaccines. Among vaccinated Americans, what do you think is the biggest misconception about unvaccinated Americans?

BOYD: I think the biggest misconception is that there's a fundamental difference between folks who have chosen to vaccinate and folks who have yet to vaccinate. Instead, what we find is there's actually enormous diversity among both groups. But what has aided folks who have made the choice to vaccinate is that they are more likely to have access to credible information about the vaccines. They're more likely to have access to health care generally, like a regular health care provider or health insurance, which made that choice more accessible to them.

SNELL: Recent polling has shown that a large share of unvaccinated Americans, around half in some polls and more than half in one survey, say that they either probably or definitely won't get the vaccine. Does that match with what you're hearing in your conversations?

BOYD: You know, it doesn't actually. When we talk to folks, we go to their community. And so when we meet folks in these settings, where they're around other folks they know, where the session is led by a pastor or by a neighbor, folks are actually much more open and vulnerable about what's keeping them from vaccination. And instead of hearing that common refrain that people are just adamantly opposed to vaccination, the No. 1 concern we hear time and again is about the side effects of the vaccine and their safety profiles.

And so we commonly hear anecdotes about people who heard of somebody or someone's friend who had a negative outcome that they attribute to the vaccine. And so when we have these conversations, we try to take those anecdotes head on and share some of the science that we have. People actually have concerns about their chronic illnesses, about the risks of the vaccine for them or their children. And they want to have answers before they feel comfortable making that next step.

SNELL: Another element of this is access. You know, the Biden administration was adamant about making sure that people could get the shot easily. But many unvaccinated Americans are living in low-income neighborhoods, places where access to health care and treatment has always been a problem. The vaccine is free, but from what you've heard, is it actually easy for everyone to get the shot? Or is accessibility still an issue?

BOYD: Accessibility is absolutely still an issue. How I've been framing it for people is that availability and accessibility are not the same thing. So even though the Biden administration has really taken on Herculean efforts to make sure that every American lives within five miles of a vaccination and that folks can get vaccinations in common community-based sites, that doesn't mean that everybody can actually access vaccination, right? Five miles sounds pretty close if you have a car or if you live near public transit. But if you live in rural America and you have to walk those five miles, you might think twice about whether or not that's an accessible vaccine to you.

Similarly, we see people have real barriers around not being able to take time away from their child care duties to get vaccinated and around paid sick leave. They worry about their job security if they were to ask for time off should they have some of the common side effects that makes them need to stay home a little longer.

SNELL: You know, there's also been a lot of conflicting messaging about this pandemic. What do you see as the value in sending out doctors who identify racially or socially with the groups you're speaking to?

BOYD: So part of our approach in the conversation was to include providers who look like the communities that we're reaching out to. There's a wealth of data that tells us that communities are more likely to accept messaging from folks who come from their community, who speak their same language. And what we found is that it creates a safe space where we can say, what we're talking about right now is what I talked about with my auntie or my big mama, right? Like, we are already as health care providers having these conversations in our own beloved families. And so we're just extending that circle because frankly, for African Americans in particular, there aren't enough African American physicians for us to even have that conversation one-on-one with everybody. And so as we go across the country and try to gather folks in their communities and groups, we're able to talk to more folks at once who would love to hear this messaging from somebody who they recognized or somebody who they relate to.

SNELL: Before we let you go, what do you think is the most critical thing that leaders and officials can change in their approach to actually sway people to get the shot?

BOYD: You know, this is the million-dollar question, maybe the billion-dollar question at this point. The hard truth is it's going to take multiple things. For some people, they need a personal conversation where they can ask a trusted provider or someone who looks like them something very specific about a piece of misinformation they've heard or about an experience that they've had so that they feel comfortable making the choice for themselves. For other people, they need someone to address - and local government and state and federal government are the right entities to address - the structural barriers that keep them from having adequate access to the vaccine. And then I think for other folks, the federal government has to really take on the disinformation that many people are contending with when they're trying to make this choice.

SNELL: That was Dr. Rhea Boyd. She co-created THE CONVERSATION: Between Us, About Us, a public health campaign that aims to provide credible vaccine information to underserved groups around the country. Dr. Boyd, thanks so much for speaking with us.

BOYD: Thank you again for having me. Transcript provided by NPR, Copyright NPR.