Loretta Rodgers from Chester News: “One of the most consistent reasons that residents may be hesitant to receive the vaccine is due to media reports about breakthrough infections among the people who were already vaccinated. Major media has saturated the message that vaccines save lives. What more would you like to see us do? Maybe more paid advertising might help.”
Dr. Denise Johnson: “We want to make sure that people understand how vaccines work, right? Vaccines are not like a forcefield that can keep the virus from getting to you at all. The virus can get to you, but when the virus gets to you, your body’s antibodies will clear that virus, and so that people who have been vaccinated that do end up getting infected are much less likely to be hospitalized and much less likely to die from it, so the vaccines are working. They’re working as they’re designed. Getting vaccinated does protect you against this virus, even with the Delta that we have.
So, for people who are vaccinated, it’s helpful to speak to other people and tell them about your vaccination. For people that are still hesitant, hearing from someone who is vaccinated can make a difference. So, I would encourage everyone to reach out, and in our advertising and our messaging, to tell people to take the individual responsibility to reach out to other people, just to talk about your vaccination experience. That can help them to make that decision to be vaccinated.”
Ayana Jones from the Philadelphia Tribune: “My question was around the issue of vaccinating children. I know that all the approvals certainly seem like they’ll be coming down the pipeline, and I wanted to know if you could speak to the state’s response, in terms of gearing up and getting ready for the possibility of vaccinating children, and just kind of what parents should know about this process?”
Dr. Denise Johnson: “We are very excited about the possibility of vaccines available for the 5 to 11-year-old group. We’ve been waiting for this for a long time, and we have been in touch with our pediatricians and other physicians, and also from parents who have been waiting for this for a long time, so we are excited, and we have been gearing up. What we have done is the federal government has allowed us to pre-order vaccines for that vaccine group pending approval, so we have been working with our pediatricians. We also have been working with our primary care physicians and other providers to make sure that they are ready to administer vaccines to this group.
We have already received orders from many of those providers, and we have been ready to fulfill those orders, and get them everything that they need so that once the approval comes, we’ll be ready to vaccinate. We expect to vaccinate at pediatrician offices, primary care physicians offices, some children’s hospitals are going to be doing vaccinations, but we also have some vaccination clinics planned in some schools as well, so there’ll be a variety of places all across the state that will offer vaccinations for children.”
Thera Martin from The Scoop and the Philadelphia Sunday Sun: “I wanted to ask about that booster shot. You know, we’re hearing on the news and from medical experts and all that, that after you have your first two shots, be that the Pfizer or Moderna, it’s okay to mix on that booster shot. What can you say to people who are kind of concerned? Is that true? Will it be okay? Will I get messed up if I had the Moderna, and now all of a sudden I’m gonna get Pfizer?
Dr. Denise Johnson: “As you mentioned, booster shots are available, and booster shots have been recommended for certain populations, so not for everyone across the board. We want to remind everyone that the primary course of your vaccine is still working tremendously well. Certain populations may experience a little bit of weaning off their immunity over time, and that’s why boosters are recommended for some, so especially people who are over age 65 or have an underlying medical condition, or because where you work or live puts you at higher risk, so boosters are recommended for them.
The recommendation for boosters is to get the booster of the vaccine that you had before if that’s available. If it’s not available, you can get another booster, another type of vaccine, but some people might elect to get a different vaccine. There have been some studies that show that people who have had the J&J vaccines, once they get a booster they get a boost in their immune system, but if they get a booster of mRNA vaccines like the Pfizer and the Moderna, they may have a higher boost.
Whether or not this makes a clinical difference, I think it’s really hard to tell. We know that when we looked at the effectiveness of the vaccines, the J&J was slightly less than the Pfizer or the Moderna, although not significantly. Some people who have had the J&J might want to get an mRNA vaccine. Some people who had an mRNA before might just want to get the other vaccine, but all of them give great coverage so that you shouldn’t be concerned. If you get a booster of your primary vaccine, that’s great. If you get another one, you may have a little bit more of a boost of your immune system, but clinically, that may not make a difference at all.”
Catherine Hicks from the Philadelphia Sunday Sun, and the President of the Philadelphia NAACP: “Should a person still get a booster shot if they have already contracted COVID and they received their vaccine?”
Dr. Denise Johnson: “For the booster shots, remember that if you got an mRNA, which is the Pfizer and Moderna, you get it six months after your second dose. For the J&J, it’s two months after your dose for the boosters. For people who have already contracted COVID, it’s still recommended to get the vaccine, just because the immunity you get from natural immunity can be variable. Some people who had a severe case of the disease have very little immunity afterward, and some people who had a mild version of the disease have better immunity longer, but it’s very variable and we don’t have really good tests to tell us whether or not you have good immunity, so it’s recommended to get the vaccine because the vaccine consistently improves your immunity and makes you much more protected.
We don’t have a lot of information on boosters or people who have had the vaccine and had natural infections. I think that data is still being collected, so we don’t have any good recommendations based on science to tell you whether you need to have that. Some may argue that having an infection and getting a vaccination, you would have a good level of protection, and not need that booster, but we don’t have enough scientific evidence to say one way or another.”
Karen Warrington from FunTimes Magazine: “My question primarily revolves around what we have learned as a result of the pandemic. It has revealed glaring health disparities in the African-American communities. What has the Pennsylvania Health Department learned as a result of the pandemic regarding these disparities, and what has the state done to address the disparities?”
Dr. Denise Johnson: “Pandemics really can impact everyone severely, but historically underserved people suffer much more during a pandemic. We have seen, especially early on in the pandemic, that our Black and Brown communities contracted COVID at a higher rate, and back then when we didn’t have vaccines and we weren’t sure of the treatment, they suffered more in terms of hospitalizations and death. We also know that many communities don’t have good access to regular healthcare, and so as we rolled out the vaccinations initially, those communities had lower vaccination rates.
As a state, we constantly look at our vaccination rates and look at them by the demographic group as well. When we see areas that are under-vaccinated, we make sure that we increase resources to that community to make sure that we catch up in terms of those rates. We have seen, in some areas where African Americans were less vaccinated, over time, we had higher vaccination rates in those areas because of those efforts.
And those efforts were partnering with local grassroots organizations, houses of worship, other civic groups to do pop-up clinics in those areas, or to make sure the providers that were already in those areas had vaccines to be able to administer, we also partnered to do mobile clinics, especially in the Hispanic community, we’ve worked with Hispanic providers as well to make sure that we are providing information in a language that they can understand, providing information from a trusted messenger that they can relate to, so a lot of outreach like that to make sure that we are getting to the population, especially populations that were more impacted, to make sure that they are getting vaccinated at least to the level of their population, but some would argue that we need to have higher rates in those communities because of the higher impact.”
Catherine Hicks from the Philadelphia Sunday Sun: “With the other illnesses like the flu, etc, should there be a waiting period with seasonal vaccinations and COVID boosters?”
Dr. Denise Johnson: “If you are eligible for the vaccine or booster, you need to get the vaccine right away. Without the vaccine, you can get a severe illness. The flu and COVID are both circulating. You can get the flu and COVID vaccine at the same time. You want to make sure you are protected against both. If you are not yet eligible for the booster, remember not to be worried if it’s not time for you to get a booster.”
P.O.C. from Revive Radio: “My question is geared to the medicinal cannabis community. Back in 2016, Governor Tom Wolf signed into Pennsylvania’s medicinal cannabis legislation, and as of August 2021, more than 633,000 patients and caregivers are registered in Pennsylvania’s medicinal cannabis program, according to the information given by the Pennsylvania Department of Health. Do rising numbers of medicinal cannabis patients and holistic treatment reflect anything when it comes down to vaccine hesitancy?”
Dr. Denise Johnson: “I haven’t seen any data or information that would specifically address that issue, so I really can’t comment. I don’t know how that relates to vaccine hesitancy. I’m not aware of any survey in that particular population that would give us an indication that their rates of hesitancy are any different than the general population.”
Karen Warrington from FunTimes Magazine: “On one hand you talk about the rollout of the vaccine, but that’s quite different than the availability of the vaccine, and what we saw in Philadelphia, was despite the rollout, that many people in the Black community could not figure out where they could go to get the vaccine. Many of us feel if it wasn’t for the work of the Black doctors and the Consortium, the issue wouldn’t have even bubbled up for the media and our local health departments to find out there was a problem What have we learned from the COVID rollout versus the nonavailability of actual locations for people to get the vaccine?
Dr. Denise Johnson: “Pennsylvania is a little particular in that we have two jurisdictions for vaccines, so there is Philadelphia and the rest of the state. So that each area gets an allocation of vaccines, directly from the federal government that’s separate. I know that early on in the pandemic, even before we had vaccines, Dr. Stanford and her group did a tremendous job reaching out to be able to offer testing in her community and then transitioning onto vaccines. She was the first to meet that unmet need with the communities, and since then, those efforts have spread out. The efforts and how they’ve spread out have been using local trusted messengers with the communities to offer faith-based clinics.
So we’ve had clinics in lots of non-traditional areas, even in different businesses, because of the awareness that everyone can’t get to a mass vaccination center. Everyone doesn’t have the transportation to get there. Everyone can’t take the time off work to spend time in that vaccination center.
So those are lessons we have learned from this pandemic. We learned that we need to meet people where they are, we need to know where our patients are, and understand the limitations that they have to get to the places where we think that they should get their vaccines. Right now vaccines are much more available. Anyone can text their ZIP code to get vaxxed and find the 3 closest vaccination sites to you. You can also go to vaccines.gov and get that information as well. Most communities have much better access now but that is because of lessons that we learned during this pandemic.”
Catherine Hicks from the Philadelphia Sunday Sun: “My question again is the question of whether you should wait, because of course, we are still having others, we still get the flu every year, we are still getting colds, all of the regular illnesses that happen throughout the winter are still happening. Should there be a waiting period between the time that you may receive your annual flu shot, or pneumonia before you get your booster shot or vaccine?”
Dr. Denise Johnson: “For the booster shot, if you are eligible for the booster, then you should get it. If you are not eligible for the booster, and you have not gotten your vaccine, you need to get your COVID vaccine right away, because, who knows? While you’re waiting, you can get COVID. Remember that getting COVID naturally, although most times people will do well, we don’t know who that’s gonna be, and you can get severe illness with COVID. We also want to make sure that people know that Flu and COVID are both circulating right now, and so I don’t want you to hold off on the vaccine.
So if you’ve not gotten your COVID vaccine, get it right away, you can get your COVID and flu vaccine at the same time. Get them in both arms. Right now, we’re in the season that there’s COVID and flu, and you want to make sure that you are protected against both. If you’ve not gotten your COVID shot, there’s no need to wait. If you’re not yet eligible for a booster because you don’t fit any one of those categories, remember that the vaccines work well, and they’re working well now, so do not be worried if it’s not time to get a booster if you’ve already been vaccinated.”
Loretta Rodgers from Chester News: “With many reports that medical professionals are being terminated due to their unwillingness to be vaccinated, what can be done to make non-medical personnel feel safe taking the vaccine?”
Dr. Denise Johnson: “With these vaccines, we have safety information like we’ve had for nothing else in the past. So far, we’ve given more than 450 million doses of vaccine here in the United States. Although we have seen some side effects, the serious side effects have been quite rare, and even in the side effect of the inflammation of the heart muscle, the risk for someone to get that inflammation when they get COVID is much much higher than if they get the vaccine. Those inflammations often recover with rest and an anti-inflammatory like Tylenol, so the vaccines, we’ve got lots and lots of data to prove that they’re safe and effective, so people should be reassured by that.
I think that anyone who knows someone who’s been sick with COVID, that’s been devastating. We have lost over 750,000 people already from COVID, and it has been clear that our death rate has gone up. We have had conversations with funeral directors that said that over the winter last year their business had doubled. People were dying from this at a large rate, so we know that these vaccines are safe and effective, and so we highly recommend them. Although we’ve seen that from some healthcare workers, I would bet that anyone speaking with their healthcare provider, most physicians, we’ve all been vaccinated, we were at the front of the line, and we have encouraged all of our relatives to be vaccinated, all of our friends, and we strongly recommend it to those we love because we know that they are safe and effective.”
Ayana Jones from the Philadelphia Tribune: “Can you speak to the issue of concerns around pregnant women becoming vaccinated?”
Dr. Denise Johnson: “I am a trained OBGYN. We know from this pandemic, again that Black and brown people were more impacted, and we know that in pregnancy if you get COVID, the risk is much much higher. COVID and pregnancy mean a higher risk of going to the intensive care unit. Just this past December, the CDC sent out an alert that said in August alone, 22 women died during pregnancy. We have seen stillbirths, and we have also seen premature deliveries in pregnancy in COVID. On the other side, with the COVID vaccine and pregnancy, we have seen no increased side effects, we have seen no increased stillbirths or negative outbursts, we have also seen that if pregnant women are vaccinated, they are making antibodies, and those antibodies to protect the newborn baby. Unfortunately, less than 1/3 of pregnant women have gotten vaccinated, and we know that in the African-American community, that number is probably more in the teens, also in the Hispanic community.
We know that those communities are more impacted, so it is urgent that we have more pregnant women get vaccinated, and we also know that the mechanism of the vaccine, is that when you get the vaccine, it stimulates you to make antibodies, but everything from the vaccine is gone from your system in a short time. Nothing is hanging around there, nothing is incorporated into your DNA, there’s nothing that affects your future fertility. So the American College of OB-GYN’s, the Society for Reproductive Medicine, the Society for Maternal-Fetal Medicine, and many organizations strongly implore people who are pregnant or want to be pregnant to get that COVID vaccine and don’t get COVID.“
Thera Martin from The Scoop and the Philadelphia Sunday Sun: “Is it true that the virus can still be in you for 14 days, and you can enter society after that period?”
Dr. Denise Johnson: “We found that after 14 days there may be some inactive virus that is shedding but it is unlikely that people will be infected from that. However, some still may have a positive test because the cells still may be shedding.”
Karen Warrington from FunTimes Magazine: “Has the medical community, including the CDC, really looked at messaging, and how the rollout of the vaccine was messaged and were there some missed opportunities in terms of messaging when you’re talking to broad populations? I’m wondering what are the lessons learned, and how is whatever is learned being applied? I remember hearing a message about an immunocompromised group, and people were saying ‘Well what was that?’, and it almost seemed like an attack on certain people, if you were obese if you had this, so the messaging, I think, landed on people, rather than people being able to receive the message positively, so I was just interested in whether or not there is some conversation about going forward and messaging.”
Dr. Denise Johnson: “This pandemic has been so new for all of us, we’ve never had anything at all like this. I’ve heard the analogy a couple of times that we were flying the plane while we’re still building it, so we learned a lot of things during this pandemic that changed our tactics and changed what we were doing. All during this time, there have been sequential focus groups and surveys to hear how the messaging has worked and hear where we needed to pivot. A lot of changes have been made.
Some of the big eye-openers are that people want to receive messages from people they trust: people who look like them, people that speak their language, people that live in their communities. Not everyone wants to hear from the government, or not everyone wants to hear from the politicians. As opposed to some other things that we messaged in the past, we certainly learned that there are a lot of nuances.
There has been a lot of work done around many organizations to refine that message and make it more applicable to whatever groups we are trying to message to, so the paa.gov/COVID , where we have our PA Unites Against COVID, we have a lot of messaging there, we’ve got messaging in a dozen different languages, and two different groups as well, I know the Ad Council has done a really good job with some of the messaging, especially with messaging to the African American community, so that is available to use as well, and the CDC and the HHS have done some messaging as well.
Throughout this pandemic, our messaging has changed quite a bit based on what we’ve learned. We’ve learned that hesitant people sometimes have valid questions that they need to have answers to, so they need to be listened to with empathy and openness, to hear what their concerns are, and then have those concerns addressed, and then be allowed to decide to get vaccinated. We’ve learned that people don’t want to be shamed or pressured because of their vaccination status, so we really refined our messaging throughout this pandemic, but certainly, we came into it not knowing how some of these messages were received and need to learn and change as we went on with time.”
Thera Martin from The Scoop and the Philadelphia Sunday Sun: “ What I wanted to ask was about people who do get the virus and come down with COVID. There is an isolation period of about 14 days or so. I’ve heard that you can still test positive for COVID after that two-week isolation period, and I know folks who are being cleared by doctors to go back to work, but yet they are still testing positive. I would think that would be some level of discomfort for families who have more than two people in the household. Is it true that the virus can still be in you after 14 days but you can still re-enter society if you are vaccinated?”
Dr. Denise Johnson: “This is very variable, in terms of how long people are shedding virus. What we found is that after 14 days the vast majority of people are not shedding a significant amount of virus, or virus that is easy to transmit. There may be some inactive virus that is still shedding, and some people do that for a long time, but it is unlikely that other people will be infected from that. We also have very sensitive tests, and so that the tests will be positive if you’ve got florid COVID and you’re shedding a lot of viruses, but if you have small amounts of virus and aren’t able to transmit, you still may have a positive test. After that 14 days, it’s very unlikely that they’re able to spread that to other people but some will still have a positive test.
