- Vaccine confidence, it depends on trust in vaccines as products and trust in the system that produces them.

In the past on this show, we've reported distrust in the Covid-19 vaccine as it correlates to black and brown communities.

But what about vaccines in general?

Let's say, for example, the flu vaccine?

A CDC analysis shows that while people from racial and ethnic minority groups are at higher risk for being hospitalized with the flu, vaccination rates among the same group are lower than rates among non-Hispanic white persons, even though flu vaccines are considered by the scientific community as the best way to prevent the flu and its potentially serious complications.

Flu and Covid-19 vaccine aside, there are a number of vaccines that doctors recommend at all stages of life to prevent certain diseases.

We're going to take a look at vaccines today and their role in disease prevention and also look more closely at some of the reasons why people decide against vaccines as a whole and how that impacts our community.

Welcome to A Su Salud, Cheers to Good Health.

I'm your host, Genesis Ortega.

We're broadcasting from inside the PPL Public Media Center in Bethlehem, Pennsylvania.

My first guest is St Luke's University Health Network expert Dr Eduardo Ceballos.

Doctor, gracias por estar con nosotros.

- Encantado.

- Let's start here.

Vaccines, big topic, equally important for children and adults at all stages.

So the overall question is, why are immunization shots important?

- Because they save lives.

- That is the quick answer and a true one.

I am old enough that I have seen the illnesses that the vaccines are preventing.

The young doctors and the new generations have not seen those illnesses because they have been prevented by the vaccines.

I remember when...

I'm from Peru originally and I remember when you don't, you didn't know when you were going to get polio.

You could...

I remember going and playing with my cousin.

He was two years old and had a little cold, and the next day he couldn't move his legs.

We all had whooping cough, measles, German measles, mumps... We survived, but a lot of people didn't survive.

So now we don't see that.

So the same thing when I started my practice in '75, we used to see babies with Haemophilus influenzae, meningitis, pneumococcal meningitis.

a baby who had a fever, a high fever, we didn't know when they were going to get that problem.

Now, we don't see that because the vaccines are preventing that.

So, the vaccines are very important to prevent illnesses and to prevent diseases, yes.

- Like everything else in life, there will be people who choose to get vaccinated and people who choose to not get vaccinated.

So what do you say to those people who choose not to vaccinate themselves and their children?

- There is...

I will, I will divide it in two groups, people that do not the want vaccines and people that want to have their own schedule.

They want to start later.

To those people, I will say, the schedule that we have is to immunize them at two, four, and six months for the diphtheria, tetanus, whooping cough, polio and Haemophilus influenza and the rotavirus, but they have to have the three vaccines in order to be primarily immunized.

If you start too late, we are missing all the time and children are very vulnerable for that.

When I was an intern at Philadelphia General Hospital, I saw babies dying of whooping cough, little infants having convulsions with whooping cough.

So it was very sad to see that happen with something that could be prevented.

So to those people, I will explain to them why we have to follow this schedule.

The other group is more difficult.

I try to be understanding.

I try to be compassionate.

And I know that they may want the best for their children, but it is a very difficult group to convince.

- Let's take a look at a few myths that some may cling to when it comes to vaccinating children, the first one being some people say that vaccines contain toxic substances.

Is that true?

- No, no.

Uh...

In 1982, there was an NBC program that was the DTP Roulette, which did a lot of damage.

At that time, we were using this wholesale vaccine.

And what happened is that babies had some reactions.

They have tenderness on the leg.

They had high fevers, and some of these babies had convulsions.

That program, it created a lot of mistrust in the vaccines because they made it sound like the vaccines gave the convulsion.

Even though the expert pediatricians went to try to argue that that wasn't true, the damage was done.

And then in 1996, I believe, or '98, Dr Wakefield.

He published an article that was discredited in The Lancet in England, that measles vaccine caused autism.

That was disproven.

But still, people think that that's a possibility and it is not true.

- I've heard that crop up a lot, that vaccines can cause autism.

Why do you think people are saying that?

- If you have Jenny McCarthy telling you that her child had the MMR and got autism or you have another celebrity, probably you will believe those celebrities more than you believe me.

Unfortunately, the anti-vaxxers have very good public relations, and they some of them, not all of them, spread falsehoods that are not true but a lot of people, I guess, choose to believe that that is the Gospel.

They prefer to believe a celebrity than a scientist.

- Well, let's talk about older adults for a second, because vaccines are important at all walks of life.

So should older adults get the pneumonia and shingles vaccine?

- Yes.

I had, I had the pneumococcal vaccine and I have my shingles medicine and yes, to have shingles is not fun.

It's a horrible illness.

It is not just the pain, but it depends where the shingles are going to develop and can be not only painful, but very disabling.

The pneumococcal vaccine.

As you get older, you are more at risk for pneumococcal infections.

So it is a good idea.

- The flu vaccine, you know, it's had a lot of debate in recent years.

There are so many adults that are on the fence.

"Get it, don't get it."

But the bottom line is there's a documented disparity between the vaccination rate for people who are white and the vaccination rate for people who are African-American and Hispanic.

Talk to us about that.

- I read about that.

To be honest, I have not found that in our practice here at St Luke's.

We offer the vaccine to all our patients.

Some opt not to have it.

Some people want to have it.

And they have misconceptions about the vaccine itself.

But no, we, I read, I know what you're saying.

I haven't found that in St Luke's or in our practice.

- And that's OK, you know, when we're talking about as I phase into talking about the Covid-19 vaccine now, it's kind of more or less the same thing, you know, anecdotally and through polling, which doesn't really paint a clear picture but there's talk being said that there's some simmering distrust for the Covid-19 vaccine.

What's the impact of how low vaccination rates in certain areas and among certain groups can affect the rate of progression and the pandemic?

- Those groups will be more affected, obviously, because they won't be as protected as in other areas where the vaccination rate is higher.

There is a distrust in the African-American population, and there is a historical reason, from the Tuskegee trials that they did before.

So there is a reason of a distrust.

Hopefully, the new administration will be able to convince them that the vaccine is safe and it is for the protection of all Americans.

- There's still time to reach those who are still unsure.

But, Doctor, let me ask you, what's the general timeline that we're looking at to get the general community vaccines?

- I can speak only for St Luke's.

We are getting the vaccines.

We are getting immunized.

I don't know about the roll-out in the pharmacies or in other areas where they can get the vaccines.

I am a pediatrician and I'm concerned mainly about the vaccine for the children or my practice, even though they go up to 21 now.

So I couldn't give you a good opinion about where the adult population can get the different, the vaccines or whether they can can get it.

For example, my daughter lives in New Jersey, in Princeton, and she would like to have the vaccine and she's looking everywhere to get the vaccine and she cannot get it.

So but for that type for the Covid, I couldn't tell you.

I got my two shots.

Number one, I'm in health care.

Number two, I'm old.

But I was able to get my two vaccines.

And the same thing, all the providers here at my office had the vaccines, but my daughter, she's younger obviously, and she's still looking for the vaccine.

And she will go anywhere to get the vaccine, but she cannot find it.

- Wow.

You know, what about kids?

How do they fit into this conversation?

As a pediatrician, are you hearing from parents that want to get their kids vaccinated against Covid-19?

- Some do.

Unfortunately, we don't have the vaccine for children.

The trials are going to start and I believe Pfizer has started, and some of the vaccines may be for 16 and older.

But for little kids, we don't have it yet.

Some parents ask, but we have to find... We have to wait for the guidelines.

- We touched on the Covid-19 vaccine, the flu vaccine, but vaccines in general, I want to end on this note and just ask you for your final insight.

Any final thoughts that you have for people who are on the fence about vaccines in general?

- Like I started, vaccines save lives.

Like Dr Paul Offit of Children's Hospital of Philadelphia says, vaccines are victims of their own success.

You don't see those illnesses anymore and because you don't see those illnesses, you think that they are not around, but they are still around.

Once in a while, you may see a case, an isolated case, and all you need is one and have an un-immunized population and you may have an epidemic.

- Doctor, I really appreciate your insight.

Thank you so much for joining us today and your insight.

- Thank you for having me.

- Our pleasure.

Up next, a two-year-old case study revealed that language barriers and cultural misconceptions are another reason that some vaccinations don't take place at all among minority populations.

This proves to be especially true when it comes to the Covid-19 vaccine and the Hispanic and Latino communities.

As part of a nationwide initiative to increase Covid-19 vaccines among minorities, St Luke's University Health Network and the Hispanic Center of the Lehigh Valley teamed up to work towards achieving this goal.

Free Covid-19 vaccines were administered to residents 65 years of age and older at the Hispanic Center of the Lehigh Valley.

I visited the center and met with residents and staff, as well as Victoria Montero, the center's director.

- We are running a Covid-19 vaccine clinic.

We are going to be administering 200 vaccines.

- All done.

- The idea was to create a clinic where it was within the community for the community.

- Do you think that within the local Latino community, events like this will help to alleviate any distrust that exists about the vaccine?

- Yes, and that's the idea behind this, you know, to work in collaboration with the hospitals, with other community agencies that we're working together to provide education, making the process in their language, simplifying the process of the registration, having bilingual staff.

So that way they know that we are here to support them and we're trying to simplify the process so we can get back to being healthy and back together and celebrate with our families.

- I'm part of the nursing school at St Luke's and I was asked to help with the Hispanic Center and it was truly an honor to me since I grew up in Puerto Rico in a really poor section, which we have clinics like that, too.

And when she told me, I said, "Absolutely, I want to give "back to the community," and that's the whole point about it.

- What are you looking forward to today?

- I'm looking just to get as many shots as I can!

- And what's the process today, are you requiring identification, proof of age?

What do people need to do?

- All the information was already pre collected at the time of the registration for the appointments when that was done over the phone.

So today is just basic checking in the demographics to ensure that the person that is coming is the person that we have on our schedule.

And then they'll be ready to get seen today to get their shots today.

- How are you guys handling the booster vaccine?

- So at the time of registration for today's clinic, they are going to be rescheduled for the booster shots.

- This epidemic is like all over the place.

People have been dying.

People get really sick.

And, you know, it's it's good to get the vaccine.

And I'm thankful for the Hispanic Society to give us the opportunity.

- It's in a neighborhood where the community knows the Hispanic Center and, you know, trying to build the trust within our community.

- I'm feeling a little nervous, not because of the shot itself, just the side effects.

But I mean, you know, you get it and hope for the best or not get it and get the virus.

- So many of my friends and family ask me, some of them are afraid like everybody else.

But like I always say, just go online, read, ask your physician.

- I'm glad that I'm in the city.

We're around my Hispanic people, you know, and that they have the opportunity to also get vaccinated.

- It's very, very good to hear how appreciative they are.

Like, very exciting.

I can see their faces, their smile and how appreciated they are.

It just makes the day so bright.

I love it.

- My next guest is Vicky Kistler, the director of the Allentown Health Bureau.

Thanks for joining us today, Vicky.

- Thank you for having me.

- Vicky, let's start here.

According to your website, the Bureau's mission is to prevent disease and injury and to protect the public's health.

So how does the department work towards that goal?

- Our department does a number of services for citizens in Allentown and the surrounding areas in terms of preventing illness by childhood injury prevention programs, senior injury prevention programs, childhood lead abatement and lead testing for our youth.

A number of actual clinical programs where we do vaccination clinics, we do communicable disease treatment, we do some disease investigation work.

And right now we're doing large vaccination clinics for Covid.

- And that's where you're at right now, that's some of the feedback that we're hearing.

You're sitting at a vaccination clinic, - I am.

- Immunizations as a whole play a role in what you do at the Bureau.

Pre-Covid you guys were involved in vaccination clinics for children and adults.

For the time being, they're closed.

But what are some of your other efforts in making immunizations accessible?

Immunizations are a critical part of protecting our society against serious illnesses.

And one of the things we do is we run both childhood and adult immunization clinics throughout the year to protect those folks who perhaps don't have easy access to a primary care physician.

Right now, those clinics are somewhat suspended as we're working through Covid, but we are hoping that our citizens are still visiting their pediatricians and their family doctors to get those vaccines and to stay up to date.

- How integral would you say is accessibility when talking about public health?

- It's extremely important.

Our citizens need access to quality health care and many of them do receive that, but they don't initially receive it when they first come to our community.

And that's what the Health Department's for.

We're there to help them navigate the system, to help them find a primary care home and to help them get their kids enrolled in good quality preventative care.

- What could be some possible public health repercussions if that's even the right word, but the impact of not getting people vaccinated?

- Well, we're talking right now about Covid, that's what you hear you know, everywhere that you turn.

However, we still have childhood illnesses that could easily spread out of control, Measles, mumps, rubella.

Those things are vaccine-preventable.

Meningitis on college campuses, all sorts of illnesses that we really, truly don't need to add to the mix right now.

They can all be prevented by vaccines.

- We hear a lot the word herd immunity.

What does that mean?

- Herd immunity means that people who cannot be vaccinated, maybe they have an allergy or they have a reason that they can't take vaccine, can still be protected if everyone around them receives vaccine.

So the more people who get vaccinated, the more they protect those with low immunity or the inability to get vaccinated.

- The one question on my mind, Vicky, is let's say, for example, every single person in the community gets vaccinated against the disease.

Is it possible to eradicate a disease entirely?

Can vaccines do that?

- It is possible.

You know, smallpox and and some of the polio have been eradicated through the use of vaccines.

Oftentimes, there isn't 100% immunity for a long, long period of time.

But there have been huge successful strides in curtailing major, major illnesses that have caused death and and debilitation in the past through the use of appropriate administration of vaccines.

- Going back to the general vaccine clinics for a second, I'm curious to know what has been some of the feedback from Allentown residents?

- Our childhood immunization clinics are very popular, but we don't want to keep children in them.

And what I mean by that is that we want children truly managed by a pediatrician in a medical home that gets to know that child, not a stopgap immunization clinic.

So although our clinics are useful to catch kids up when school starts or to get kids back on track with their immunization schedule, our real goal is to make sure that every child sees a pediatrician, has a preventative health visit, stays up to date on their shots and whenever they are ill, is seen by a pediatrician who can care for them immediately.

So although our clinics are incredibly popular among folks, especially those folks who don't have insurance, we really want all folks to have access to a good pediatrician for their children.

- Understood, Vicky.

On Covid-19, I understand the Bureau has established a vaccine schedule and call center system solely for city and Lehigh County senior citizens who are at least 65 and don't have access to Internet.

Can you tell us more about that?

Yes, we have what I think is a good system.

It it gets overwhelmed because the supply does not meet the demand with vaccine, but we have a call center for seniors who are 65 and older in Lehigh County.

They can call 610-890-7069 to schedule an appointment.

If we don't have any appointments at the time, they leave their name and their phone number and the call center will call them back to schedule.

We also have an arrangement with LANTA, the transportation system, so that seniors 65 and older can contact LANTA.

That number's 888-253-8333 seven days a week to register with LANTA to get free transportation to and from the vaccination clinic so seniors can call the call center.

Anyone who is 18 years of age or older who qualifies for a vaccine can also visit www.AllentownPAClinics.com And when there are vaccine appointments available, click on the links, the links do get extra appointments every Thursday morning, and schedule by using the computer.

So we encourage folks to do both.

We know that there's a long wait.

We know that it's very frustrating and we ask you to just hang in there until the vaccine becomes more readily available.

- It's a great resource that the Allentown Health Bureau is providing to the community.

Is there an option for Spanish-speaking residents?

- Absolutely.

The call center is staffed with bilingual operators.

The website, paperwork and documentation all has a Google language button to convert it to Spanish.

And we have bilingual staff at every one of our vaccination clinics to help those who speak Spanish.

- Vicky, like we've said before, you're at a vaccination clinic now, but once the vaccine becomes available to the general community, will there be mass vaccination clinics?

And what does something like that look like?

- We are told that our state is in the process of looking at mass vaccination clinics for every county.

Those may be drive through or walk through depending on where they're held.

Some mass vaccination clinics can see over 20,000 people a day.

Right now, our max here is about 1,500 a day.

But those clinics are large clinics.

They're they're located in areas like a Dorney Park or an IronPigs stadium.

And they can be drive through or they can be walk through.

So we are told that the state is looking into that type of a vaccination process.

- Vicky, I know you've been doing this for a year and I'm sure it's probably overwhelming.

So let me, I mean, how are you doing?

How's everything going on your end?

- We started our case investigations almost a year ago this week, and we're happy to say that finally our numbers are falling.

Our case count has not gone up this week, which has been wonderful.

We are still contact tracing right now.

We have 681 people in the contact tracing queue.

So the virus is very much alive and is still very much circulating.

We've been vaccinating since New Year's Eve and we will continue to vaccinate as long as the supply permits and as long as we have folks who are in need.

But we're hanging in there.

It's, we're very grateful to the people who have been kind and understanding that it's a challenging process.

And our hearts go out to all of our residents who have lost someone through this this pandemic.

- I want to ask you, what have been some of your key takeaways in this past year and even with this vaccine distribution that you've been doing since New Year's Eve?

- Our key takeaway is there are many.

But one of them is that it is critically important for folks to be prepared.

I think our society is very much living on a day-to-day, supply-to-supply basis.

So it is my hope that our public health infrastructure will increase and that we will not experience things like shortages of personal protective equipment for health care workers again.

Our other critical takeaways are that people need to help each other.

We have many seniors who are booking appointments online because their neighbor is younger and more computer savvy and is helping them or neighbors helping each other get through this process.

So I think one of the biggest takeaways is that if we're all understanding and we're all patient and we all work together, we can get through this.

- We're just about running out of time, Vicky.

But I want to ask before I let you go, what are some of the ways the Bureau is getting in touch with people who are Spanish-speaking residents?

- Well, basically, again, we use the call center and we use the links by promoting them.

We have also used several of our trusted messengers in the community to help us recruit those persons who speak Spanish and who need vaccine.

So we have several of our police officers, several of our housing authority staff, some of our social workers out in the community helping folks to enlist.

We are also having some conversations with some of our multicultural groups to try to get people to understand the importance of the vaccine, to want the vaccine and then to sign up for an appointment.

- It's been really awesome having you here with us, Vicky.

I'll end on this note as we close out this episode on vaccines.

What is the one thing that you hope our viewers get across about vaccines as a whole?

- That there is a vaccine coming for you.

It may take a little while.

You may have to be patient, but that the more people who accept the vaccine and the more people who make themselves available to the appointments that are out there, the quicker we will put this pandemic behind us.

- Thank you so much, Vicky Kistler, for your time and your insight today.

- Thank you for having me.

Take care.

- I want to thank our St. Luke's University Health Network expert, Dr Eduardo Ceballos and our other guest, Vicky Kistler.

And thank you for tuning in.

We look forward to seeing you again soon.

If there's a medical subject you'd like for us to cover, send me a message on social media.

You can find me on Facebook and Instagram.

Plus, you can tune in to hear more of my reporting on 91.3 FM, WLVR News, your local NPR news source.

I'm Genesis Ortega and from all of us here at Lehigh Valley Public Media, stay safe, be healthy, and cheers to your health.