The Vaccines Are Coming. A Divided and Distrustful America Awaits.

A vast majority of people will need to be vaccinated to create a decisive decline in infections. Health officials are scrambling to make that happen.

By Simon Romero and Miriam Jordan

With the federal government poised to authorize distribution of the first Covid-19 vaccine in coming days, Americans are deeply divided about what comes next.Credit...Ted S. Warren/Associated Press

As the Lopez family of Truckee, Calif., gathered to prepare dinner on a recent evening, one subject dominated the conversation: the coronavirus vaccine that will soon be shipped out across the country, giving Americans the first concrete hope that the pandemic will eventually end.

Enrique Lopez, 46, who runs a snow-removal business, explained how he was trying to persuade his skeptical employees that the vaccine was safe. His wife, Brienne, 41, a middle school teacher, said she was desperate for the vaccine after a September bout with Covid-19 sickened her for weeks. Their two daughters just wanted to know if the vaccine would enable them to return to their pre-pandemic lives.

“I know a lot of people are scared. They don’t know what the side effects are going to be,” said Mr. Lopez, who had seen half his work force stricken with the virus. “It’s a risk we have to take. It’s going to make us safer and go back to normal.”

After months of anticipation, the arrival of the first vaccine is near. It lands in a country that is both devastated by the virus and deeply divided over almost everything concerning it.

The Lopez family in Truckee, Calif. Enrique Lopez, 46, who runs a snow-removal business, is trying to persuade his skeptical employees that the vaccine is safe.

The Lopez family in Truckee, Calif. Enrique Lopez, 46, who runs a snow-removal business, is trying to persuade his skeptical employees that the vaccine is safe.Credit...Constantine Papanicolaou for The New York Times

The first Americans will most likely receive shots of the Pfizer-BioNTech vaccine in the coming days, and the government is expected to approve other vaccines as well. Health officials are working to ease public doubts about the safety of the injections, emphasizing that large numbers of Americans — perhaps between 60 to 70 percent — must get vaccinated to produce a decisively sharp decline in transmission rates. So far, there is work to be done.

Stephanie Bennett, a psychiatric nurse in Tulsa, Okla., said she fully understood the importance of the vaccines and expected to be near the front of the line as they were made available. Still, she is torn.

“I do have risks in being a frontline health worker,” Ms. Bennett said. “But just being a mother, I do have this crushing guilt in getting a vaccine that my child would not have access to at the same time.”

Even so, Ms. Bennett said she felt doubly responsible as a nurse and a member of the Kiowa Tribe of Oklahoma to get vaccinated, in part to help ease skepticism among her neighbors.

“There’s a lot of distrust in our community,” Ms. Bennett said. “I want to show people, at least in my family and my community, that this is safe and we’ve got to do this.”

Still, wariness persists, even for some who know the toll the virus can take.

Maria Isabel Ventura, 59, who lives in Blythe, Calif., a rural area near the Arizona border, saw the dangers of the virus up close on Nov. 22. That was the day she rushed her husband, gasping for air, to the emergency room. Her husband, Alfonso Velazquez, a farmworker, spent two weeks being treated for a severe case of Covid-19.

“Why not start with vaccinating the president and the people who developed the vaccine?” asked Ms. Ventura, a Mexican immigrant who makes ends meet by cleaning, waiting tables and cooking. “I am afraid more than anything of this vaccine because we don’t know what reaction we will have to it. Maybe in a few months we’ll know more.”

An Associated Press poll, released this week, found half of all Americans ready to take a vaccine — with a considerable partisan divide. Six in 10 Democrats said they would get vaccinated compared with four in 10 Republicans. 

A recent Gallup survey showed more acceptance, with 63 percent of Americans now saying they would be willing to get a vaccine approved by the Food and Drug Administration, up from 58 percent in October and 50 percent in September.

The authorities are working to dispel doubt about the vaccines’ safety and enduring concerns over unethical examples of medical research in the United States, especially in African-American, Latino and Native American communities that have been hit especially hard by the coronavirus but remain wary because of historical abuses by the medical system.

As virus deaths in the country climb toward 300,000, the toll is influencing how many view the vaccines. Adam Wyatt, the pastor at First Baptist Church in Leakesville, Miss., decided to enroll in Moderna’s vaccine trial after one of his congregants died of the virus in August.

Aesha Mahdi, 42, who lives in Gwinnett County, Ga., was infected with the coronavirus in April and is eager to take a vaccine.Credit...Nicole Craine for The New York Times

Mr. Wyatt views hospital visits as one of his most important obligations as a pastor, and recalls feeling helpless as he gathered with the congregant’s family in a hospital parking lot, barred from entry by pandemic precautions.

But Mr. Wyatt, 38, did not tell many people about his decision afterward to enroll in the trial in Hattiesburg, about an hour’s drive west of his small town. “You hear, ‘This vaccine is the mark of the beast, don’t get this, it’s Bill Gates’s population control, you’ll get the microchips in you,’” he said. “A lot of my folks probably won’t get it.”

Now that the vaccine is on its way, Mr. Wyatt is preparing to speak publicly about his participation in the trial, hoping to ease his community’s concerns. “It’s something I can do,” he said.

Aesha Mahdi, 42, who lives in Gwinnett County, Ga., also knows how the virus can upend lives. She got infected in April and identifies herself as a Covid-19 “long-hauler,” still experiencing symptoms such as a racing heartbeat and shortness of breath going up stairs. Her rheumatoid arthritis has become worse, and sometimes she has trouble walking.

Ms. Mahdi, who is eager to be vaccinated, now works in contact tracing, helping to slow the virus’s spread. She said she was alarmed at how family members have fallen victim to misinformation campaigns that vaccinations are harmful, especially on Facebook and YouTube. “They’re kind of following a disinformation or misinformation train that is leading them down a whole conspiracy theory,” she said.

For others, the first vaccine’s arrival creates moral quandaries. Pat McKeage, 85, of Grand Rapids, Mich., said she understood why older people were expected to get the vaccine before others, citing risk factors and how intensive care units around the country are near or above capacity. Still, Ms. McKeage, a published poet, said it struck her as “obscene” that she could get the vaccine before her long-term caregiver, who is 30.

With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:

“I told her, ‘I have lived my life. You have not,’” she said.

LaMont C. Brown II, a bus driver in Detroit, said the pandemic has exposed just how little his profession is appreciated.Credit...Cydni Elledge for The New York Times

Others who are eager to get the vaccine fret about being low on the priority list. LaMont C. Brown II, a bus driver in Detroit, said the pandemic had exposed just how little his profession was appreciated. While police officers, firefighters and medical workers are treated as heroes, he hears little celebration of drivers who interact with the public, potentially risking their health.

Now he worries that the same dynamic will play out with vaccines.

He has heard that medical workers and other emergency personnel will be first in line. But he has heard nothing about making sure that drivers get vaccinated soon — not from his union, from the city’s Department of Transportation or from city leaders, he said.

“We’re basically second-class citizens,” Mr. Brown, 55, said.

The arrival of a vaccine is also nurturing talk of a return to normalcy, or something resembling it. Tani G. Cantil-Sakauye, California’s chief justice, said she was imagining how the vaccine could change things for the nation’s largest court system, which is grappling with a huge backlog as many crucial proceedings are pushed online.

“If you envision the Supreme Court, every door is open, people are in the hall leaning against doorjambs, talking, chatting, laughing,” Chief Justice Cantil-Sakauye told reporters on a Zoom call this week. “That’s now completely absent, and the place is silent.”

She and her colleagues have debated whether judges and other court officers should be given priority for a vaccine. No one, after all, would deny that the courts were an essential function of society.

But Chief Justice Cantil-Sakauye said she ultimately came to believe that judges could not “stand on title” and be vaccinated before emergency workers and nursing home residents.

“We think that others need to go first,” she said.

Bryan Diaz, 15, of Nuevo, Calif., is also yearning for normalcy. Distance learning has been difficult with his 7-year-old brother, Kevin, vying for his attention, and he misses playing video games and kicking a soccer ball with a friend he has not seen since early in the year.

The Diaz family spends an afternoon in their home out in Nuevo, California. “I feel excited that there’s a vaccine so we can go back to the school,” Bryan Diaz, right, said.

The Diaz family spends an afternoon in their home out in Nuevo, California. “I feel excited that there’s a vaccine so we can go back to the school,” Bryan Diaz, right, said.Credit...Carlos Gonzalez for The New York Times

“I feel excited that there’s a vaccine so we can go back to the school,” he said.

Bryan, whose father is a mechanic and mother is a homemaker, knows several people, including his godfather, who have contracted the virus. But his parents, Mexican immigrants, are suspicious of the vaccine.

“We talked about it, but my parents don’t want us to try it until it’s 100 percent,” he said. “They want to be sure it’s safe.”

David Leavitt, a novelist and professor of English at the University of Florida, said the prospect of a vaccine had given him a feeling he had not previously experienced during the pandemic: “Well, this will end. I never really allowed myself to think about how it will end.”

When it is over, Mr. Leavitt looks forward to traveling once again to Italian book festivals. But then he reflexively reins himself in. After all, Italy thought it had conquered the virus after a brutal spring, and that, Mr. Leavitt says, turned out to be “wishful thinking.” He does not want to fall prey to delusion.

So as he waits to find out his position in the vaccine line, he lives by a motto he attributes to one of his favorite Mel Brooks movies, “The Twelve Chairs”: “Hope for the best. Expect the worst.”

Reporting was contributed by Ellen Barry, John Eligon, Thomas Fuller, Ruth Graham, Anemona Hartocollis, Giulia McDonnell Nieto del Rio and Will Wright.

Answers to Your Vaccine Questions

If I live in the U.S., when can I get the vaccine? 

While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.

When can I return to normal life after being vaccinated? 

Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. 

The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. 

But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. 

So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. 

Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.

If I’ve been vaccinated, do I still need to wear a mask? 

Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. 

That remains a possibility. 

We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. 

Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.

Will it hurt? What are the side effects? 

The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. 

Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. 

But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. 

While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.

Will mRNA vaccines change my genes? 

No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. 

That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. 

The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. 

Once those proteins are made, our cells then shred the mRNA with special enzymes. 

The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell's enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. 

But the mRNA can only last for a few days at most before they are destroyed.

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