(film reel clattering) - Good morning, everyone.

Thank you for joining us.

I'm Regina Brown Wilson, the executive director of California Black Media and I am co-sponsoring today's briefing with Ethnic Media Services.

Today, you're gonna be hearing from physicians from around the state who will be sharing information on the updated COVID-19 boosters.

Today you'll hear from Dr. Maggie Park, county public health officer, San Joaquin County Public Health Services, and Dr. Eva Smith, Medical Director of K'ima:w Medical Center on the Hoopa Reservation in California.

I wanna thank you for taking the time to come and speak to ethnic media today to give them the vital information that they need to write about this important topic.

Thank you so much.

We'll go over to Dr. Eva Smith, who is the medical officer with the K'ima:w Medical Center in Hoopa, California.

Dr. Eva Smith will offer the perspective about COVID and boosters on the Hoopa Reservation which she serves, "where" she serves.

She'll also share the messages she feels will resonate about the new updated booster.

Dr. Smith?

- Thanks.

I'm speaking from the Shinnecock Reservation in New York, which is my home community.

I've been a physician for more than 40 years, both in family medicine, addiction medicine and preventive medicine and currently working, and have been for 25 years, working on my husband's reservation in California on the Hoopa Valley Reservation.

So, I kind of look at the whole episode of what we've been living through as a journey.

And, I regularly use this term in our clinic system talking about our journey through COVID land from when we were scared to death in the beginning, didn't know what all this was meaning.

I'm old enough to have been through kind of new medical challenges that have come to us when I didn't know what HIV was gonna mean.

When doctor called me in 1982 and said, "Hey, your patient had a blood transfusion "and we're not sure what this means, but this is what I need you to do."

And, have lived through other kind of conditions like that.

So, I looked at this as yet a new challenge and what can we do to protect our very vulnerable community?

It's a small community in a very rural remote area.

You have to go through twisty, windy roads to get there.

Weather impacts us all the time.

Currently dealing with forest fires, smoke, air quality issues.

And so, when we first got the vaccine, the elders turned out.

I was so impressed.

They lined up.

They wanted it.

They didn't wanna die.

They were watching on TV what had happened in other Native communities with really horrible, horrible death rates.

This was a community that took a lot of leadership in the beginning.

We went into lockdown mode in March of 1920, I'm sorry!

(chuckles) In 2020.

And Jess said, "Nobody can come in from the outside."

They were very, very protective.

And so, we didn't actually have our first COVID case- not death- first case until July of 2020.

Had a little bit of spike, then went down for a little bit.

And, up and down, up and down since then.

As the public health officer I daily, unfortunately, monitor these numbers very carefully and closely.

We've been through several spikes.

We thought we were past one and maybe ahead of the curve of what was happening in our outer counties.

And then, we had another spike that we're fortunately-- think we're now coming down.

There was a lot of hesitancy among younger people.

Again, the elders were impressive.

They turned out.

They lined up.

They wanted it, but the next middle-age group was a little bit more forthright about coming forward.

And then, among the younger group, I think I like the terms that describe the C's: of the "confidence" level; there was "complacency" and there was "convenience".

And, we were really challenged of how do we make this easily accessible?

We are a small tribal clinic trying to deal with a lot of acute and chronic disease issues.

And then, to take that same small understaffed, underfunded clinic system and say, "okay.

Now, you have to evolve this whole preventive approach of how you're gonna get clinics in the community, how you're gonna offer testing, how you're now gonna offer the evolution of different treatments, antivirals that are available that we are now able to offer.

I'm very thankful for that.

But, we're dealing with complacency.

We're dealing with people being tired, tired of having a shot; tired, honestly, of the inconvenience of "yes, I'm gonna be sore for a couple of days.

And, I'm regularly saying I'd rather be mild flu-y kind of symptoms for a day or two than to be sick, sick.

I want to live.

I have children.

I have grandchildren.

I live in a extended family system.

Bi-coastal; both my community here in New York and obviously where my husband's family is.

And, my children are living and being raised.

And, have a responsibility as an elder to be there to take care of my kids and my grandkids.

And so, I'm gonna do what it takes, whether it's getting a flu vaccine or getting a couple of different COVID vaccines.

I've had the initial two primary series, I then got one booster and then the next booster came out.

I was right there in line to get my other booster and we'll be there in line also when this becomes available to our community within the next several days, and do our best to communicate how important it is.

We have limited resources.

And so, to deal with the preventive side and then take care of any additional extra source of what comes to us, that is a challenge.

We had our first hospitalization in several months, just this past week; elder that had been boosted, elder that had lots and lots of vulnerabilities.

But this variant, honestly, I see as making people sicker.

I work regularly COVID clinic, not just from a public health standpoint and not just as medical director.

But, I'm frontline seeing working with who's coming through the door, whose extended family system is connected, know the vulnerabilities of so many patients with diabetes, with weight issues, with rheumatoid conditions, with cardiac conditions.

I mentioned the forest fire smoke.

It's really hard this time of year to tell if it's do you have the sniffles because the smoke is bothering you?

You can't breathe good because you've got asthma that's been triggered by all this forest fire smoke?

Or, do I have COVID?

So, regularly encouraging people: test, test, test!

Come in.

We will test you if you're eligible.

We will offer the treatment immediately, but most critically offer the preventive vaccine.

That's what's made the big difference I think in our having as few deaths as we've had because we continue to support the message of how critical vaccines are.

I truly believe that we are seeing sicker people with the omicron BA.4 and the BA.5 than what we did a couple of months back.

And so, anything that's gonna offer an improvement in condition for the community.

We live in large extended family systems, multi-generational households.

And, there's a real respect for the fact that if you get sick, there's a good chance you're gonna be around somebody that's sick.

I had a young man come into the office the other day who was vaccinated and was expressing his irritation with other people that weren't so anxious to step up and get the vaccine.

He has a daughter that's four years old that's had a liver transplant.

[machinery beeping outside] He has a mother with certain health conditions.

And so he's very, very expressive about we need to make sure people go out there and get their vaccines.

'Cause it's not just about me; it's about we.

It's about our whole community and we as native people taking care of one another, the vaccination is one more tool that we have that we highly encourage people to use.

- Thank you so much Dr. Smith for that.

I know that like we're like two minutes ahead of time, but this gives us an opportunity to, you know, tee this up; this time up for questions in the chat.

And, let me tell you: there have been plenty of them!

And so, I'm actually going through them right now so that I can makes sense of all the ones that we got and get to some of the questions that we didn't get to get to.

But, Dr. Smith, since you just finished, there's a question here for you from Frank Blanquet from FNX TV: (reads chat) "Is there a correlation between elders "and Native youth as it pertains to deciding to move forward "with vaccinations or deciding not to get it?

"Do you think one group sways the other group in either direction?"

- If-- it didn't happen as much as I thought it would, definitely within Native communities.

There is a respect for elders that I was repeatedly saying to folks, "look, the elders lined up.

Why aren't you lining up?

Why aren't you listening to grandma?"

So, there's a disconnect that I don't quite understand.

There's a frustration as a clinician to have a preventive tool available that not everybody's choosing to take and trying to calmly understand that, respect that, and offer the education of this is what we know right now.

We have been through this pandemic, now endemic phase, long enough to understand that yes, there are risks, but we believe in our experiences with the vaccine today that the benefit clearly outweighs the risk.

And, yes-- as one of the other speakers referenced of, "yes, my cousin had it and they're fine.

"And so, you know, I'm not worried about it.

"So, what if I get it?

It's not a big deal."

It is a big deal!

You as an individual may not be so affected, but you live in a community of very vulnerable people all around you.

I just had a sister-in-law that is a dialysis patient that we were so protective.

And, made sure she got all the boosters and had everybody run around the house with a mask on, and unfortunately she just got it.

I believe she is doing as well as she did because she had the prior vaccine in her system because she was able to get medication of the new antivirals to support her and go on to get antibodies and Evusheld, and some of the other tools.

So, the correlation of 'this is what grandma says to do and you need to do it' doesn't necessarily follow in our experience so far with COVID.

- Thank you so much for that.

This is my own editorial.

I think that's what happens whenever you tell somebody to get shots.

So, maybe it works whenever you say 'clean your room' or go do something like that.

Or, 'take out the trash.'

But when you say 'go get shots', they freeze up!

- There is an issue I wanted to reference, though.

So, there were a couple of elders, very respected individuals in the community, very traditional family members that were absolutely positively against the vaccine.

And, they would come and talk to me about it and say, "Yes, I know you think I should get it, Dr. Smith, "but I'm scared.

I'm not gonna get it.

It's too new.

They don't understand it.

And then, unfortunately in that particular family system, there were several members that became extremely ill with lengthy hospitalizations.

Fortunately, they are still alive; some of them dealing with long COVID at this point.

And, those two elder sisters marched into my office one day and said, "I'm ready.

"I'm gonna do it and I'm gonna tell "every single one of my nieces and nephews and grandkids to go get it."

So, we use the power of that family system as well.

When that clock turns and the switch happens, they were the full force people to say, "Let's do it.

Stop messin' around.

"This is a serious, serious illness "and it's not gonna take us down."

- Yes, thank you.

And so now, we're gonna turn to Dr. Maggie Park, who's the county public health officer for the San Joaquin County Public Health Services.

Dr. Park, go ahead.

[electronic clicking sounds] - Thank you so much.

Lovely to be here with you all today.

I wanna say that the rollout of this new booster is actually quite timely as many models are predicting that we're facing another COVID-19 surge this fall or winter, and we need to be ready.

The bivalent vaccines were developed to trigger an immune response to the omicron BA.4 and BA.5 lineages and those are the viruses that are currently still causing the most COVID cases.

BA.5 has been the predominant circulating variant since July and is still and now accounts for about 87% of all newly diagnosed cases of COVID.

With BA.4 pretty much accounting for the rest.

Here in San Joaquin County as in other parts of the state, we saw significant uptick in hospitalizations with the introduction of BA.5.

In California, 72% of all people are now vaccinated with a primary series.

That's nearly 29 million people who have received their first set of shots, usually two doses of Pfizer or two doses of Moderna, and that's great.

But, only 58.8% of Californians who are eligible for a booster have been boosted.

That number is even smaller in my county, San Joaquin, where we have a 48.5% booster rate.

So, those of us in public health and in the medical field have to wonder why so many people were willing to get the first two shots but then not more.

Last year with the introduction of the original boosters, the public health department here in San Joaquin tried to gather information to understand why people were feeling hesitant.

We asked our community business organizations what they were hearing from their clients.

We polled people such as African-American local leaders who we gathered at a town hall meeting and we continue to monitor responses to our social media posts to get a sense of what people in the community are thinking.

So, one thing that I think is going on right now which might be a barrier, is that people think COVID is over, but this virus is not going away just because we want it to!

It's evolving.

It's actually becoming more highly transmissible and getting smarter about evading our immunity, whether that's natural immunity from prior induction or immunity from vaccination.

So, we have to try to stay a step ahead of it.

We've used data science to try to educate the public.

What we do is we show them curves, graphs of our past waves of COVID and our predictions for future waves.

And, our own data scientist has gone out on many town hall meetings and is willing and able to do webinars where he speaks very eloquently and can explain how COVID is not over.

Another thing that we hear a lot is that the vaccines aren't safe.

This is still misinformation that's being perpetuated in our communities, but with all the millions of doses that have been given in the United States and around the world today, we have so much information about them.

And, we do know that they're safe and we know that these newest bivalent vaccines are built on the same technology of their proven predecessors.

In fact when it comes to bivalent vaccines, an earlier version of the bivalent vaccine that contained the BA.1 omicron underwent a clinical trial in humans and showed that people did have either the same amount of side effects or perhaps even less.

Things like redness, swelling, pain at the site of injection.

Another thing that we're still hearing is that shots don't work.

People saying 'my friend is fully vaccinated and boosted, but she still got COVID.'

And, to that I say, 'yes, but is she still alive?'

And, yes, of course she is!

We never promised that the vaccinations would mean you wouldn't get COVID.

We just said that it would reduce the severity of your disease and your chances for requiring hospitalization.

Yes, the chance of getting COVID is also decreased with vaccination and all of this data is closely monitored by CDPH and posted on the state's website.

We've collected a lot of data and we can literally graph the difference that it makes to be vaccinated.

So, definitely what we know is that your chance of getting COVID decreases with vaccines, but the decrease is even greater when it comes to your chance of being hospitalized or dying.

Another thing that we are trying to combat is COVID fatigue.

So, many people who are just tired of thinking about COVID want to move on.

They're tired of considering whether they need to get more shots.

Perhaps they're confused as to whether they should.

Maybe they got some shots to begin with- the two doses, maybe a booster- but they don't wanna keep going because they seem to think that there's just no end to all this vaccination.

And to that I tell people, the majority of folks in the United States get a flu shot every year, and here we are less than three years in the pandemic and we're already tired.

So, hopefully we get to a point where the COVID shot is an annual thing like the flu shot, but in the meantime we need to be patient and need to protect ourselves.

So, you know, lastly I wanna say people just don't think they have the time or the means to get vaccinated.

And to that, I do wanna reiterate something that I've said before.

Don't wait.

We don't wait until we have pain to go to the dentist.

So, why would you wait until you're in the hospital to ask for a vaccine?

We have tried to take the vaccine to people in San Joaquin County to make it convenient to them.

We continually tell them that it's free.

When it came to farmworkers, we reached out to their owners and managers, organized times that we could go to farms and plants and vaccinate people.

We've taken vaccines to homebound people with a small traveling team.

We've taken them to homeless shelters.

We're doing vaccine events at our WIC locations.

We've really promoted them in our Latinx and African-American churches.

And now with boosters, again, we're making them available in the county.

We have a press release out today that's going to tell people that they can get on our website, sjready.org and find when we're vaccinating and where.

We have a mobile van unit and all of our community business organizations know that they can ask for the van on any particular date, and we will be there with the bivalents.

For example, one of our churches is having an event on the 18th and their flyer's already out advertising the fact that they will have bivalents.

In fact, I'll just say that we are also starting to take down the bivalent vaccine into jails.

We go to jails to do syphilis testing and we've started to do some monkeypox vaccines.

So, we just decided we're gonna tack on the bivalents, as well.

So, as much as we can, we're trying to get it out there, and for anyone who's looking it should be available across the state.

And, vaccine availability will be increasing over time.

Thank you.

- Well?

Thank you so much, Dr. Park.

I do wanna make sure I just do another housekeeping.

When we are speaking, we do have interpreters who are translating.

They make sure I'm talking slow enough for them.

They're translating, I believe, in Mandarin, Spanish and Korean.

And so, thank you so much, Dr. Park.

We're gonna take questions.

(reads chat) "A previous flu shot isn't "required for flu shot, so why are people "having to complete a series required "for one to get the new COVID booster?

"Isn't just having the booster without previous COVID shot better than having none at all?"

- Yeah.

So, this is true.

The flu shot we change every year based on what's going on in this other hemisphere and based on predictions.

And, as Dr. Brooks said, it has often three or four variants in it.

And, yes, you don't have to worry about what you receive in the prior years.

But with COVID, the reason why these new bivalents are only available to people who had a primary series with the original monovalents, it's in the word, you know?

Really, it's self-explanatory.

They are "boosters."

So, they're meant to boost an immune system that's already received some vaccination and has some recognition of those spike proteins.

So, the expectation is that you get a primary series first of Moderna or Pfizer, which are higher doses for each of those.

You get two doses of Pfizer, 30 plus 30 micrograms; or Moderna, a hundred plus a hundred.

And then, the booster in the bivalent is less.

It's half of the original half of the new strains.

So really, you wanna get that primary series taken care of first; get your body to have some recognition in its immune response, and then the boosting vaccine is additive to that.

It's a smaller dose.

You need to get the larger doses first.

- And, I don't know if we did this.

I know we're gonna be wrapping up here shortly on the questions, but-- or, this probably is the last question.

Did we even explain, or give the definition of the "bivalent?"

What does it mean?

(chuckles) For anybody who may not know?

- It's basically a vaccine that's a combo.

It's got some of the original strain of the coronavirus and then it's got the BA.4, BA.5 omicron strains in it.

- Okay.

Well, great.

Well, thank you so much.

I-- Any other questions that are-- or, maybe we have one more question because I actually took-- well, actually-?

So, I wanna actually ask this question really, really quick.

But-?

(reads chat) "Many people cannot take paxlovid because of "contradictions with their medications they may be taking or health conditions."

So, maybe that wasn't a question.

Maybe that was a statement.

Was that a statement, Sunita?

Maybe you were using that as a statement versus a question?

Yeah, okay.

So, it was a statement, not a question.

Alright.

Okay, great.

Well, you know what?

I wanna thank everybody for like joining us today.

You know, I also wanna take the time just really quick to segue and thank Sandy Close, the founder of Ethnic Media Services, who does a remarkable job and puts a remarkable amount of time into ensuring that we have these wonderful briefings and bring experts with different perspectives to be able to ask these questions.

So, Sandy?

Kudos and thank you.

And, to all the speakers, we'll do this as a wrap up, kind of; 45 seconds that you may take to answer this.

But you know, final question is, what's the most important message that you would tell your patients this afternoon or anybody you're gonna see at the next church or mobile clinic about the new and updated booster?

- So, I can start.

And you know, the biggest question I always get from people around me is "are you going to get it?"

And, the simple answer is, "yes, I do plan on getting the bivalent."

And, I want to address questions from Nancy and Elena in the chat that I don't think we got to, real quickly, because there is confusion.

And, I do see another person putting in the chat about how there's vaccine overload, so there's a lot of confusion.

And so, the another point I wanna make is, we are no longer really counting your booster doses.

I know that that's been so confusing.

People 50-and-over could get two, and immunocompromised could get three.

And now, everyone could get a third or a fourth and now the 12-year-olds can get it, too.

And so, what the CDC is saying is we're movin' away from all the confusion of saying second booster, third booster.

And, what we're saying is anyone who got their last shot, whether it was a primary series or your first or second booster, is now eligible for this bivalent vaccine as long as they're over 12 and it's been two months from that last shot.

And so, that could be a fifth.

It could be a sixth for some people.

And, I think it's gotten to the point where we're not gonna say "fifth, sixth" shots anymore.

Just wanted to make it clear to people that if you've got a booster in the past, as long as it's been two months from your last one, you can get this one.

The definition of fully vaccinated used to be the first two doses and then we said "up-to-date," if you had the first two doses plus booster.

Now really, we're saying be up-to-date as much as possible.

And, yes, you can get that booster, but it's approved as a single booster dose.

So, no Elena.

You can't keep going every two months and get another bivalent, another bivalent, another bivalent!

It's one single bivalent booster dose that's been approved at this point.

Thank you.

- I wanted to mention that we're about to go inside.

I think our perception is that the current BA.4 and .5 are more contagious than some of the previous variants.

And so, as we move inside from the summer months to everybody being in small closed homes, that the infectious potential is so much greater.

So, the opportunity to get the vaccine now to prevent what we think is coming down the pike and why the timing of this is so critical for something that is safe and that is preventive, is something that we really need to promote.

That summer's over and the rains are gonna come or whatever kind of storm.

Hopefully, we'll get some rain!

But, life is gonna move inside with less outdoor activity and that puts us all at much greater risk.

- And, if you all have nothing else, I wanna thank you all for attending today.

Thank you for your time.

♪ - Thank you!

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