Dr. Goosby: Vaccine Naysayers Will Become 'Yaysayers'

Sunday, March 28, 2021

This is Part Seven of our Q&A with President Biden COVID Task Force advisor, UCSF's Dr. Eric Goosby.

Synapse: Some of the public, including some healthcare workers, are reluctant to receive the COVID vaccines due to fear/speculation around the quick speed with which they were made. What are your opinions on this? How do you think we can increase public trust in the vaccine, despite its quick rollout speed?

Dr. Goosby: So I guess I start by telling people that the Phase 1, 2, and 3 studies were done quickly. They were done quickly because they were stood up in three to four times the number of sites that we would normally run a vaccine Phase 1, 2, or 3 study in. We also did all Phase 1, 2, and 3 studies by starting them at the same time; we didn’t do one, then do two, then do three. And that’s what saved the time.

The numbers of people participating in these studies are two to three times the number of people in a normal vaccine study. Like, we are 30,000 and 40,000, so 15,000 in placebo, 15,000 in treated for the Pfizer. For the Moderna, it was 40. So you had 20 and 20. Most vaccines are 8! You have 4000 going to treated, 4000 going to placebo.

So in terms of data to see response, to map response, to see variation in response, and to see safety issues that are not 1 in 20, not 1 in 100, but how about the safety abnormalities that are 1 in a 1,000? Or 1 in 5,000? Or 1 in 10,000? We’ll see them up to 15,000 or 20,000. We would not have done that for the others.

We would have to wait for a Phase 4 study that takes the people in the Phase 3 study and continues to follow them, you know, for six months, a year to two years out from when they got the vaccination for those longer, rarer side effects that are one out of a million people in incidence. We’re not going to see those until you have those numbers that you’re surveying.

I’ve been a little surprised at how much the media has gone out of their way to find some healthcare worker who has questions about getting vaccinated.

No healthcare worker who has been standing over COVID bodies in the inpatient side of things has any deliberation about this. And I would daresay that the prevalence is so high now in most areas of the country that everyone has been affected by it.

It’s my feeling that our inability to have patients visited by their families in the hospital, that the death is a black box — the people go in and die, and the family doesn’t really experience it in the same way, especially the extended family — that the permeation of awareness of the morbidity that this virus inflicts on patients is not well-understood by the population.

My feeling is, quite frankly, do everything we can to educate people. Do everything we can to be there for people when they have a second and third welling-up of their doubts. Be attentive to that.

But people are free and will decide what they want to do. And we are there and available. We’re going to eliminate issues of access, we’re going to target groups that have disproportionate morbidity and mortality rates from COVID, but that’ll only go so far as they want it to. And I’m okay with that.

There’s not much else you can do. We’re not going to force it on anybody. So the naysayers will eventually become yay-sayers, is my guess. I think that within the healthcare worker community, eventually everyone will get it.

And those who work with patients are going to have it as a requirement, like the flushot is. You can’t work as a nurse or a doctor in an inpatient or outpatient setting and get JCH approval if you got large percentages of your clinical staff unvaccinated. And they will not give you your license to be a hospital. So there’s all of that pressure that’s going to push it.

My real feeling is that media has chosen to target this as an issue to highlight, and has festered the perception that we are seeing people refusing vaccinations.

The fact that there is a shortage — and that’s the dominant reason people are not getting vaccinated across the country; it’s still going on — makes me think that it’s really the supply problem that’s going to be our big problem.

We’ll let people come onboard as they come onboard.