- Just ahead on "Black #*Issues Forum," with flu season upon us and new strains of COVID circulating, many families are considering vaccinations, and once again also weighing longstanding concerns about the side effects.

Our guests today help us break down how to talk with our kids about those vaccinations, and highlight some things to consider before sitting down for our next shot.

Stay with us.

- [Narrator] "Black Issues Forum" is a production of PBS North Carolina, with support from the Z Smith Reynolds Foundation.

Quality public television is made possible through the financial contributions of viewers like you, who invite you to join them in supporting PBS NC.

[upbeat music] ♪ - Welcome to "Black Issues Forum," I'm Kenia Thompson.

There's special attention around COVID vaccines generated in part by a lack of information, and disinformation.

From young children to the elderly, the misconceptions are far and wide, and today we want to help demystify assumptions and separate the facts from the myths.

Later in the show we'll talk with a professional who works in vaccine development and testing to do just that.

But first we'd like to bring on our first guest, who has authored a children's book entitled "Angel Goes to the Doctor to Get a Shot," a book designed to assist children and their families to deal with their fear and apprehension of shots.

We invite to the show the book's author, Reverend Pebbles Lindsay-Lucas.

Welcome to the show, Reverend.

- Good morning and thank you.

- Of course.

So take some time and share with us your inspiration behind writing this book.

It's a beautiful design, beautifully designed piece, and I think it's a great piece for children and and their parents.

- Yes.

So I was inspired to write this book because of our daughter, Angel, who is now a, about to be a college graduate.

- Wow.

- Angel has always had a phobia of getting shots.

I have been with Angel to every doctor's visit, and every visit had becomes just intense more and more.

And I said "There has got to be something that I can do, "because I'm a birth to kindergarten teacher, "to help other students."

So she was my inspiration for writing this book.

- Yeah, no, that's great.

And I think many of our lives' journey fall into that inspiration our children provides for us, so I think that's very on par.

Talk about the types of emotions that children experience during vaccinations, and how do parents identify those, if they're normal, or if they're a problem?

- Yes.

So many of those emotions you can definitely look at them and see 'em, they're visible.

The crying, the anxiety, the apprehension the fear, and even when you're discussing shots with children they start to show you emotions.

Some look afraid, some of them just get scared, and you also see tears.

- [Kenia] Yeah.

- Yes.

- Yeah.

Now, do these emotions have sometimes long-term impacts?

I've even said myself as an adult "I hate shots," right, where did that come from?

And when I actually get the shot it's not that bad.

But what type of long-term impact can that have on children?

- Definitely long-term impacts.

I noticed it in our own daughter, like I said, who it's just overcoming the fear of shots after 21 years.

- Yeah.

- I mean, just driving by a doctor's office and thinking about that needle, or thinking about the pain or just seeing it to be inserted into your arm, it has an effect, and I didn't realize that for years, until I read the book to so many pre-K students and they were actually demonstrating "Ouch, I had a shot," and just explaining.

So I think they do have long-term effects, and it's equally important for parents to sit down and talk with their children about it so that they can help ease the fear.

- Yeah.

So when we talk to our children, in your narrative you talk about using soft language, so I'd love to talk about using soft language to aid in helping children face scary moments.

Maybe there aren't just shock related, medical related, but other scary moments.

- Yeah.

So soft language, when I think about it from a pre-K perspective, just inviting kids to sit down, maybe two to three in a group, where you actually have a sample play needle, one of them can pretend to be the doctor, one can pretend to be the nurse, and they actually just demonstrate what that would be like.

Also YouTube videos can help children understand that process, and perhaps relieve some fear and some anxiety.

And then just education.

- [Kenia] Yeah.

- Parents being available and being there with their children is so important.

- Indeed, indeed.

- Yes.

- So I thought of this question, as children are becoming so much more socially aware, they have access because of social media, and I have the question like what if a child simply refuses to receive a vaccine?

So probably around that 12, 13 years of age they're becoming their own, and they feel like "Well I don't wanna do this "because I know that shots do this," or those myths that we are are conceiving for ourselves, how do you combat that when children are socially aware of what's concerning around vaccines in the media, and they are adamant that that's not what they wanna do?

- Yeah.

As a advocate, from a teacher's point of view education is key.

We have to continue to inform, talk about the importance of shots, and how shots keep us from getting diseases and becoming sick and ill.

So the education piece is just critical.

And kids really need to understand how important that is.

- Yeah.

- Yes.

- Well, Reverend, if those who are looking to utilize your book for their own children are looking to purchase, how can they find your book?

- Yes.

They can go to Amazon, and type in "Angel Goes to the Doctor to Get a Shot," and there it is.

- Wonderful.

Well, Reverend Lindsay-Lucas, thank you so much for sharing your book with us, and we wish you all the best.

- Thank you for having me today.

- Of course.

- Take care.

- Well, let's now shift to what's fact or not when it comes to these vaccines.

A quick disclaimer here that we are not providing medical advice, and any specific questions you have about vaccines and your health should be directed to your medical provider.

With that said, let's bring on our next guest, Vice President of Clinical Development at Dynavax Technologies Corporation, Dr. Ouzama Henry.

Welcome to the show.

- Thank you Kenia.

It's great to be here.

- Of course.

So you just heard the Reverend talk about her book and vaccination with kids and there are a lot of perceptions, right?

A lot of ideas that we have based off of what we've seen, what we've read, what we've heard.

But let's talk about just the basics of vaccines.

How do they work to protect against diseases?

And then we can go from there into a deeper dive.

- Yeah, thanks for that question, Kenia.

I think that's a really important place to start.

So what are vaccines?

Essentially with a vaccine, it's a preparation where you're taking a piece of a bacteria or virus and administering it or giving it to someone, usually in the form of a shot like we just talked about.

But they're also oral and vaccines that you get, you know orally through a pill or that you can inhale through the nose.

But what the vaccine is trying to do when you see a piece of that bacteria or virus it's hoping to trigger your body and your body's immune system to make what usually we were referring to as antibodies to protect or fight that particular virus.

And so what then happens is later on if you happen to be exposed those antibodies are already there.

They're primed, they're ready your body is able to recall them and mount a response that will hopefully help to prevent you from actually getting sick.

- Now, I wanna throw a question in here.

You know, you hear people say, "Every time I get a vaccination, I get sick."

Is there any truth to that?

- There is actually a lot of truth to that.

Vaccines do cause some very common, mild generally, side effects.

And so some of those effects could be that you feel pain or tenderness at the place where the shot was given.

Sometimes you might feel a little bit more tired after the shot.

You may feel that you have gotten a headache or some pain in your muscles.

Again, most of these side effects, they're fairly common, meaning they can happen in more than 10% of the people who get the vaccine, but they are mild and generally don't last more than about 24 to 48 hours.

- Okay, that's good to know.

So let's take it back a little bit.

Let's talk about the history of vaccinations and let's talk about how they've been a large or maybe not contributor to public health.

And so let's talk about the origins of where it started.

- No, for sure, for sure.

So first I have to say, it is very clear that vaccines have made a tremendous impact on public health.

So, you know, when we think about vaccines that are given routinely to children for diseases that most of us have never seen, like diptheria or tetanus or measles, I mean, these are bacteria and or viruses that affected the entire population of kids who were born in any given year.

And sometimes kids would get them multiple times.

So it caused hundreds of thousands of infections and a significant burden where deaths are concerned.

Again for diseases that most of us have never seen.

So a tremendous impact in terms of the history of vaccines.

People talk about vaccines is having saved more life than any other intervention besides clean water.

So, really a long legacy and history of vaccine effectiveness.

Now, where did it come from?

- Yeah.

- So the first vaccines that were developed were actually developed for smallpox.

And this is a disease that impact millions hundreds of millions of people.

It's been a disease that was around for thousands of years.

In the late 1700s, a doctor by the name of Edward Jenner actually thought about the fact that smallpox is probably very closely related to an animal virus called cowpox.

So he actually took fluid from the lesion of a cowpox and injected it into a child.

And that child got sick for a few days, but then recovered.

He then later on infected that same child with lesions from human smallpox.

And lo and behold, that child did not get sick at all because the antibodies they had formed from the cowpox virus actually protected them later on when they got exposed to the human smallpox virus.

Now again, smallpox is a virus that infected hundreds of millions of people, killed that number of people as well.

One in three people died from from it.

But it is a virus that we have completely eradicated.

We haven't seen a case of smallpox in 40 years.

- Oh, wow.

So it is fair to say that some vaccinations can help eradicate certain diseases or at least trickle it down so significantly that it's not impactful anymore?

- That's correct.

When we talk about eradication where we do not see it at all, it doesn't exist, and that's hard to do, but in the case of smallpox, it was done.

We also refer to elimination where it isn't that it doesn't exist, but we have stopped the spread from person to person, so that's referred to as elimination.

- Okay, so in the story you shared just now that was kind of like a test, right?

That doctor was essentially testing.

And so let's talk about how vaccines are developed and tested for safety and efficiency.

So how do we ensure that what we're getting has been tested and is safe?

- No, I think that's a really critically important question and it's what I'm sure your viewers really want to know.

Well, first of all, we do not conduct clinical trials in the same way that they were done in the late 1700s.

We certainly have procedures in place to protect the rights, the welfare, the overall wellbeing, health and safety of trial participants.

But studies, the way we drugs or vaccines are developed is through a series of studies.

Usually across four different phases of development.

In phase one, we're testing whether or not the vaccine is safe in sort of 10, 20, 30 particular individuals.

In phase two, we're looking at is it safe in a larger number of individuals, say a few hundred individuals.

And we're looking to see whether or not the vaccine is making the response that we expect and looking at whether or not it's likely to protect people.

Then in phase three, those are the trials that you hear the results about.

Those are tens of thousands of individuals and we're looking to see if we give a group of people the investigational vaccine or the test vaccine and we give another group of people saline or salt water or placebo.

How is the vaccine actually preventing disease?

And again, that also gives us an opportunity to look at safety in a large number of individuals.

Then finally, there are phase four vaccine studies and those are the studies that we continue to do after a vaccine is used in the general population.

And those are the ones where we're able to see are there any rare but important side effects that the public needs to be informed of?

- Nice, now, I'd love to bring in the contentious COVID vaccine, right?

So when COVID first came out, we saw large numbers of people who were experiencing symptoms, who were diagnosed, and then the vaccine came out, and many people were concerned, right?

We saw people passing away and dying from the disease but they were also afraid to get vaccinated.

So let's talk about the role that vaccinations have played in the COVID-19 spread, and then other infectious diseases that are similar.

- Yeah, so vaccines remain our best protection against COVID and they've had a significant impact on particularly severe disease from COVID that leads to hospitalizations and as well COVID deaths.

This is no time for us to get complacent about COVID vaccination.

We know there's a lot of vaccine fatigue.

People have heard about a first shot, and then a booster shot, and yet another booster shot.

In September of this year, September of 2023, with the return to school with the new COVID vaccine shots not having been out yet, there was actually a surge in cases and hospitalizations and deaths from COVID.

So in that time in September, there were about 1,000 deaths every week in the United States due to COVID.

And in North Carolina, about 600 hospitalizations every week due to COVID.

So again, no time to get complacent about vaccination.

In September of this year, the CDC's advisory committee recommended COVID vaccines for all individuals six months of age and older.

The new vaccines for the 2023-2024 season are designed to protect against the most recent variants that are circulating.

I can't emphasize enough, again, how the fatigue has, you know, been a major part of people just not getting vaccinated.

When we started off, you know, when we think about the first shots, about 70% of the people in the Southeast region including North Carolina, were vaccinated.

Then when we talk about completing the first series, that went down to about 60%.

When we talk about people who got the booster that was recommended about a year ago, that falls off to under 20%.

- Oh, wow.

- We have an opportunity here right now.

Again, the vaccine has been recommended.

It is available.

When you think about getting the vaccine, you need to think about not only protecting yourself but who else might you be protecting?

Who either couldn't get the vaccine or isn't going to make a good response to the vaccine.

So think about those people as well.

- Who are those type of people who can't get the vaccine and why is that a concern for them if other people don't get the vaccine?

- Well, the vaccines are only authorized or approved for people six months of age and older.

So if you are less than six months of age, you are not able to get the vaccine.

There are people who may not make a great response to the vaccine if you already have an immune system that doesn't work well.

And we know the most severe disease is going to be in people who don't have a well-functioning immune system and in older people.

So it's really important to protect those people in our community as well.

- Yeah, now is there gonna be a difference in this next round of vaccines that are coming out for COVID-19 than what we've seen before?

Is it longer lasting?

Is it more effective?

Or is it just another booster?

- Yeah, so this is another booster that is designed to protect against the most recently circulating variants.

So the original vaccines and the vaccines a year ago are no longer being given.

Again, the vaccines that are available now, as of September of this year, are designed to protect against the variants that have been seen most recently.

- Yeah, go ahead.

- Yeah, no, I was thinking about your question about reflecting around the prevention and the impact of COVID vaccination.

And when we think about the impact that this disease has had on communities of color, in the early surge of the pandemic in say the summer of 2020, we really saw deaths in communities of color including Black American, American Indian, Native Alaskans, and Hispanic populations that were three to five times as high as white individuals in the United States.

We also know from data from last summer in 2022, at that time, there were about 600,000 deaths in the US from COVID.

About half of those were preventable deaths, deaths that occurred after vaccine was available, but that people were either unvaccinated or unvaccinated.

- And is that because perhaps within the Black and brown community, we're seeing more hesitancy for those vaccines?

Or is it issue of access?

What do you think that is?

- I think initially, there was more distrust, a lot more hesitancy, and probably in some cases justifiably so.

But I think there was a lot of effort, a lot of work, grassroots efforts to inform people about the importance of the vaccine.

And I think those efforts actually bear fruit in terms of closing the gap in terms of vaccination rates.

When you look at people of color in the United States, however, we do know that the way in which we all work is not necessarily the same, and our household sizes are also not necessarily the same.

So I think the impact on people of color that you saw even once they started to get vaccinated, the differential impact in terms of morbidity and mortality also has to do with whether or not you're someone who can work from home, whether or not you're someone who's taking public transportation, whether or not you're someone who has underlying health conditions that may lead you to be more likely to have severe disease from Covid.

- Yeah.

So let's talk about the future of vaccine development, right?

Including potential advances in vaccine technology and research.

Are there things that are currently underway that are gonna help really refine the effectiveness of vaccinations?

- So I think what we've all witnessed is that in the last couple of years we've seen a brand new technology, which is mRNA Vaccines, allow us to really develop and produce vaccines a lot more rapidly.

I think we'll continue to see that.

I think even beyond that type of vaccine, the COVID Pandemic has taught us how to be more efficient in terms of how we do clinical trials and also to make clinical trials easier for participants actually coming to your home, for example, as opposed to you having to always come into the clinical trial site.

So I think we'll continue to see advances.

We'll continue to see advances where we're combining different vaccines into a single shot to reduce the burden of shots that people have to have.

I think we'll also be able to see new vaccines for completely unmet medical needs.

Viruses like cytomegalovirus, otherwise referred to as CMV, it's a virus that impacts one in 200 newborns.

It causes a form of hearing loss.

Vaccines are currently in development for that virus.

There's a range of other herpes viruses that are currently in development, HIV vaccines in development.

So I'm really looking forward to, as someone who's been a public health champion and infectious disease specialist, I'm really looking forward to the vaccines that will come out that will continue to help us protect individuals.

- Indeed, I'm sure.

So as we wrap up our conversation, this show I think is great because we are debunking some of those myths and hopefully giving folks information that they can feel empowered with.

But beyond this, how do individuals distinguish between reliable vaccine information and vaccine misinformation?

- Yeah, I think that's a great question.

We know there is a considerable amount of misinformation on vaccines.

For me, and what I tell my family members are the best sources are sources like the CDC, the Centers for Disease Control website.

You can find that at cdc.gov.

Also, the Mayo Clinic is a great site.

So that is at mayoclinic.org.

Both of these sites, I think, have information in lay language that most of us can understand.

- Well, Dr. Uzma Henry, thank you so much.

We appreciate the work that you do to ensure the safety within our public.

And obviously, we don't encourage vaccines or not because we don't have that right to do so.

But hopefully people feel a lot more empowered with the information you've provided.

- Absolutely.

Thank you for having me.

- Of course, thank you.

We invite you to engage with us on Instagram using the hashtag #BlackIssuesForum.

You can also find our full episodes on PBSNC.org/BlackIssuesForum and on the PBS video app.

Thank you for watching.

I hope you enjoyed the show.

I'm Kenia Thompson, see you next time.

[ambient electronic music] ♪ [ambient electronic music] ♪ - [Announcer] Black Issues Forum is a production of PBS North Carolina with support from the Z. Smith Reynolds Foundation.

Quality public television is made possible through the financial contributions of viewers like you who invite you to join them in supporting PBS NC.