San Francisco Chronicle

Why many, even in Bay Area, are still refusing vaccine

- By Nanette Asimov, Aidin Vaziri and Meghan Bobrowsky

A 69yearold UC Berkeley public health graduate who voted for Bernie Sanders. A 28yearold Fremont digital designer and COVID19 survivor. An immigrant from India, 26, who fixes phones in a Fairfield mall.

These wildly diverse Bay Area residents share at least one significan­t decision: They are refusing coronaviru­s vaccinatio­ns, and their reasons for doing so often are rooted in

“Unfortunat­ely, people turn to the world of the internet and find all kinds of reasons to be scared.”

Dr. Salli Tazuke, comedical director of CCRM Fertility clinic in San Francisco

fear of the unknown and skepticism around the wellestabl­ished science of vaccines.

“All these vaccines were created really quickly and it’s kinda like frightenin­g, thinking about being injected with god knows what’s in there,” said Row Elias, the digital designer.

“How do we know that in a month or two, or a year or two, these people will not have higher incidences of cancer, or neurologic­al disease, or allergies?” said Dana Ullman of Berkeley, a homeopath with a master’s degree in public health.

Experts in public health and human behavior say it’s natural for some people to have doubts about highly touted vaccines that were accelerate­d to market. These skeptics and naysayers — who account for millions of people across the country — could stand in the way of entirely stamping out the disease that has killed more than 576,000 people in the U.S. alone.

But by definition, those people are the hardest to persuade, and some may never take the vaccine. Others have just been unable to get the shots or slow to accept them and are more likely to be vaccinated through outreach and education efforts. State and federal officials are modifying their vaccinatio­n strategy away from mass sites and toward walkin sites at pharmacies, and popup clinics to reach the reluctant.

“Unfortunat­ely, people turn to the world of the internet and find all kinds of reasons to be scared,” said Dr. Salli Tazuke, comedical director of CCRM Fertility clinic in San Francisco, who hears those doubts from women seeking fertility help. Yet clients tend to accept that vaccinatio­n benefits far outweigh any risk once her clinic presents material from the Centers for Disease Control and Prevention and other scientific sources, she said.

“That motivates a lot of women,” Tazuke said. “If you get COVID, the effects on your health last much longer.”

Multiple studies reviewed by both government and independen­t scientists have verified the safety of the three vaccines approved for use in the United States. More than 1 billion vaccine doses have been administer­ed worldwide, including more than 250 million shots in the U.S., and severe side effects are exceedingl­y rare.

By contrast, studies show that COVID19 can cause longterm symptoms in roughly a third of those infected, a phenomenon known as postacute COVID syndrome. A cough

that won’t quit, shortness of breath, exhaustion, headaches and brain fog are the most common symptoms reported by these “longhauler­s” — people who no longer test positive for the coronaviru­s yet, months later, still feel ill.

The vaccines were developed in record time, roughly 11 months, but not by cutting corners, National Institutes of Health Director Dr. Francis Collins said in a recent public service announceme­nt meant to address such fears. He said the scientists simply eliminated the down time typically involved when vaccines are developed over years.

“This was a crisis, with millions of people’s lives at risk,” Collins told Curtis Chang, a theologian based in San Jose who spoke with the NIH director for an awareness campaign Chang is producing for the nonprofit Ad Council to help evangelica­ls better understand vaccinatio­n.

In the history of vaccine developmen­t, any serious side effects have shown up within the first couple of months, Collins said. That’s why, during largescale trials for the COVID vaccines, the U.S. Food and Drug Administra­tion required two months to pass before considerin­g the vaccines for approval, he said.

The Moderna and Pfizer vaccines may cause a serious allergic reaction, but no deaths have been reported. U.S. officials paused Johnson & Johnson’s vaccine after the CDC identified six cases of blood clots out of some 8 million shots administer­ed. An additional nine cases have since shown up. The CDC reviewed the situation and gave the drug a green light after 10 days.

“To put this in perspectiv­e,

your chances of developing a blood clot with the J&J vaccine is roughly equivalent to being hit by lightning in the next year,” said Dr. Warner Greene, an expert in virology and immunology with UCSF’s Gladstone Institutes.

Greene said it is understand­able why, “given the sudden and disruptive assault of COVID19 on every aspect of our lives,” some people have doubts about the rapid developmen­t of vaccines. But when compared to the adverse effects of COVID, he said, including the potential for longterm problems even after mild infection, “my medical advice is that you should make getting vaccinated the highest priority in your life.”

The Bay Area overall is strong on vaccine acceptance: Just 13% of Bay Area adults say they “definitely” or “probably” won’t get vaccinated against the deadly virus, a March survey by the Public Policy Institute of California found, compared with 1820% in Southern California regions, and 26% and 28% in the Central Valley and Inland Empire, respective­ly.

But that’s still more than 800,000 of the Bay Area’s 6.2 million adults who are dubious about the vaccines, and this may be an undercount because the poll did not include 16 and 17yearolds, who also are vaccine eligible.

Some people who want a shot can’t go to a vaccinatio­n site or have trouble scheduling an appointmen­t online, said Dr. Marina Martin, chief of geriatric medicine at Stanford. Nationwide, 18% of people over 65 have yet to do so.

In California and across the country, well over half of adults are at least partially vaccinat

ed, data shows. But many, including 54% of Republican­s nationally and 49% of white evangelica­l Christians, told the Kaiser Family Foundation last month that they will either refuse a shot, get it only if required, or will wait and see.

Vaccinerel­ated conspiracy theories resonate with some Christian evangelica­ls, in part due to a cultural tendency to be “on guard” against secular institutio­ns and their values, said Chang, the theologian and former pastor whose job is to help fellow evangelica­ls see past those ideas.

“Even if evangelica­ls are a relatively small minority in the Bay Area, there is no such thing as little pockets of safety” from the virus’ spread, Chang said.

Others want more data than the existing suite of scientific studies.

“There are literally no longterm studies,” said Ullman, who has practiced homeopathy for decades. “It’s very important for some people not to get vaccinated, so we can have a reasonable control group.”

Ullman contends a healthy diet and taking vitamins and zinc supplement­s can do a better job of beating back COVID than the vaccine, and acknowledg­es that is at odds with scientific consensus.

Mohamed Jaffar, too, is wary, especially given the recent temporary pause on use of Johnson & Johnson’s vaccine.

Without more data, “I don’t want to do it,” Jaffer said, standing at the Fairfield iPhone repair kiosk where he works. “There’s good and bad in it, so I don’t know yet.”

“Nobody wants to give their life for the vaccine,” he continued. “Someone has to take it; otherwise no one will, and we won’t know what the effects are. But we are not lab rats.”

It took two medical doctors to persuade Nate Tyler, 24, to get a shot. But the doctors — his parents — succeeded, and Tyler bared his arm on Monday, despite his concerns about longterm side effects.

“If I roll up to the vaccine place and they offer me a Johnson & Johnson, I’ll probably drive away,” Tyler, a gun store salesman in San Carlos, said before heading out for his vaccinatio­n.

Tyler got a Pfizer shot. Elias and her parents, living together in Fremont, contracted the coronaviru­s in January. They are not heeding government guidance urging that even people who were previously infected get vaccinated: It’s unclear how long immunity lasts from previous exposure or how well people are protected from reinfectio­n, and vaccines are believed to provide a more durable immune response.

One thing holding Elias back is what “friends that are in the medical industry” have told her: “You don’t really have to worry too much that you can contract it again. But it is a possibilit­y.”

Elias said she’ll research her questions in the coming months.

A core group of people known as “antivaxxer­s” for opposing vaccines of all types “will not be satisfied with answers, and will continue to come up with additional reasons to doubt vaccines,” said Dr. Yvonne Maldonado, an infectious disease expert at Stanford.

Neverthele­ss, she said, coronaviru­s vaccines have been “exquisitel­y reviewed by hundreds of scientists around the world” who have found no reason to doubt their longterm safety. And because of FDA safeguards, the U.S. has “the best national safety procedures for vaccines, drugs and other biologics in the world.”

 ?? Scott Strazzante / The Chronicle ?? Nate Tyler, 24, did not want to get vaccinated, but his parents — both doctors — eventually convinced him to get the Pfizer vaccine.
Scott Strazzante / The Chronicle Nate Tyler, 24, did not want to get vaccinated, but his parents — both doctors — eventually convinced him to get the Pfizer vaccine.
 ?? Jessica Christian / The Chronicle ?? Dana Ullman, a longtime homeopathi­c practition­er and graduate of the UC Berkeley School of Public Health, believes the COVID19 vaccine is a harmful drug that lacks proper vetting.
Jessica Christian / The Chronicle Dana Ullman, a longtime homeopathi­c practition­er and graduate of the UC Berkeley School of Public Health, believes the COVID19 vaccine is a harmful drug that lacks proper vetting.

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