Debra Furr-Holden is an epidemiologist and C.S. Mott Endowed Professor of Public Health Integration at Michigan State University and associate dean for public health. She also directs the Flint Center for Health Equity Solutions. When it comes to vaccine acceptance, Dr. Furr-Holden thinks we may have done ourselves a disservice with the term Operation Warp Speed.
“What a lot of people heard was corner cutting or skipping steps or quick and dirty,” says Furr-Holden. “There was a very rigorous process in place. There were no steps that were skipped, but I can understand why people may feel that way.”
She says myths and misinformation around the vaccines are a problem, so she encourages us to seek out more than one sole source for information.
“The myths and misinformation are a big problem. We know this. I think people have just enough information to be dangerous to themselves right now because we've all learned a lot about vaccines and viruses and spike proteins, things that we'd never heard about before. There's no one sole source for accurate information. I think the CDC is great. I have many colleagues who work at the CDC. I've told people all during this pandemic the CDC is filled with some of the nation's greatest scientists and clinician scientists and researchers and epidemiologists. They are only one source of information.
“We have great trusted sources of credible information. Included in that are our local health departments. Especially as it relates to vaccines, that's a very, very important resource. Why? Because vaccines are actually being rolled out at the local level. If you want to know what's happening, your local health department is a trusted and credible place to get that information.”
Dr. Furr-Holden stresses the importance of a “medical home,” and when she says equity, she means fairness.
“I always tell people your medical provider is not the person in charge of your health and wellness. You are. But they're a critical player on your health team. If you don't have health coverage, if you fall in that weird spot where you make a little too much to qualify for Medicaid or other supports and not quite enough to be able to afford it out of pocket, please reach out to your local federally qualified health center.
“You might say, ‘Well, I'm an MSU employee. I have health insurance.’ But you may have others in your life who don't have that luxury or that benefit. The federally qualified health centers, the FQHCs, are charged with ensuring that everybody in the community has access to a medical provider.
“On the issue of equity, we have major gaps in our system. We saw huge breakdowns in both distribution and the data infrastructures that are needed for us to answer the question, are we not only getting the vaccine to community fairly and equitably, but are we also getting it into people's arms fairly and equitably?
“I consider the vaccine the dose of hope. And I personally believe hope is something that should be fairly and equitably distributed to all people.
“We all have elderly loved ones, and we've watched people jump the line and get the vaccine ahead of them. We have people in our families with pre-existing health conditions that predispose them to a bad outcome from COVID. So when I say equity, I just mean fairness. Fairness for all people. And I will tell you, our federal partners are fired up and figuring out how we can get that push in place to get our states to really make that a value and something that's at the forefront of how we're getting this vaccine out to people.”
Furr-Holden wants us to be good stewards of the opportunity to be vaccinated and take control of our healthcare.
“You have to stay on your toes, and you have to stay informed. I encourage people to sign up. And if you sign up on multiple lists through your health department or a local pharmacy, when you get your first dose of vaccine, I'm asking people to be a good steward of the opportunity and go back to the second list and cancel that appointment. Don't do it until you get that first dose, but please be a good steward of the opportunity and know that we're also working hard to get the data infrastructure in place so that we don't have so much duplication of effort and so much burden on people and already overburdened organizations to ensure equity in distribution and administration.”
While Dr. Furr-Holden believes in the efficacy of the vaccine, she doesn't tell anyone whether they should or shouldn't get it.
“The choice of whether or not to get the vaccine is yours. I don't tell people to get the vaccine. What I tell people is this. Grapple with it right now. Get all the information and get all of your questions answered. We want to get to herd immunity. The way to get to herd immunity is through prevention. I'm an epidemiologist by training. I love public health; it's the thing that wakes me up and lights me up every day. Herd immunity is not about allowing a significant proportion of our population to get sick. It's about preventing them from getting sick in the first place.
“Be prepared for a game changer every two or three days. Remember, science is not about we've got it all figured out, and this is the truth. At one point they said the world was flat. Thank God somebody ventured beyond that point and we have learned a lot about how our world works. We're learning a lot about how to do the rollout, distribution, and administration of this vaccine. It would not surprise me if we see better systems for ensuring those who need it the most and those who are at risk for the worst outcomes move higher up in the priority chain. So I just ask everybody be patient. That's why it's also so important for people to do that work now so that when your number does come up, you don't lose your place in line.”
Can vaccinated people still be infected by the virus and can they spread it once they've been vaccinated?
“The thing that we know, like we know, we know, we know, is the vaccine is super great at preventing severe illness. So if you were to be exposed and you're vaccinated, it's very good at preventing severe illness. Think about it. This virus is brought into the body through the respiratory tract, through your mouth, through your nose, and possibly even through your eyes. There is a remote possibility that you could be out, you could inhale virus, and you could exhale it. And even though you're vaccinated, you could still pass it on to somebody else. That's a very small possibility, but it's possible.
“Let's just pretend we're in the best case scenario, and you've received your first dose. Depending on which one you got, you got it in the right timeframe window, and you got the second dose. You're three weeks out. So you have the full benefit of the vaccine. There will be some very small percentage of people who will actually still get the virus. And if you get the virus, you still may have the potential to spread the virus. But that likelihood goes way, way, way down relative to if you were not vaccinated. And more importantly, it gives you the tremendous benefit of avoiding these very negative outcomes that we've seen people have. We're learning now that even people who were asymptomatic or had very few symptoms are starting to see these wonky long-term effects that people are dealing with. So it goes back to the point that I make, that you would much rather get the vaccine than the virus. It's an imperfect but important layer of protection. Imperfect, but critically important.”
Furr-Holden was appointed by Governor Gretchen Whitmer to be a member of the Michigan Coronavirus Taskforce on Racial Disparities.
“As a nation and as a global community, we are at our most vulnerable right now. This has taken a toll on everybody, independent of race, economics, gender, and gender identity. The pandemic has made us all very vulnerable, and in some respects, has allowed us to understand, see, process, and digest, and almost be forced to confront the world that we live in. Fundamentally we know that we don't live in a world where opportunity for health and growth and development is realized equally and equitably by all people.
“Privilege is a really funny thing. There are a lot of people who experience privilege who never asked for it. They are champions and believers in a world that works for everyone, in a world that's fair and equitable. And I think a lot of us have now had to confront that that is not actually the society that we live in, either at a national level or at a global level. And some of us knew this and have had different lived experiences that speak to it, but now it's become inescapable. So I really just encourage people to use this opportunity, while we are in this period of modified operations and people are at home and sort of almost forced to digest and consume media and other things that are happening, not to be overwhelmed by it, but to really say, ‘Okay, if I didn't see it or understand it before, I can see it and understand it now,’ and really stand in, ‘What can I do and who can I be as a champion for a world that really works for everybody?’
“For many of us on the front lines of health care, this has always been our mission. That health is something that people experience as a right, and not as a privilege. And in a nation as rich and as capable and innovative as ours, I think we should be global leaders in developing and implementing a world that works for everyone. I do encourage people to stay safe and continue to practice all the protocols. But there is an opportunity before us to really just now confront some of our gaps and having health and health care be something that is a right and not a privilege.”
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