The following is an extended version of the story that recently appeared in our print edition.

 

Like many New Yorkers, Dilletta Pina, a 70-year-old retiree from Norwood, worries about the highly infectious COVID-19 Delta variant. To stay safe, Pina never leaves her house without a mask, diligently washes her hands, and practices social distancing. But, like some of her fellow Bronxites, there is one step she’s not yet ready to take, and that’s getting the COVID-19 vaccine.

 

According to the New York City Department of Health and Mental Hygiene, compared to other boroughs, as reported, the Bronx continues to have the lowest percentage of fully vaccinated adults at 43 percent as of July 10, while Manhattan has the highest, at 64 percent.

 

While citywide infection, hospitalization, and death rates have all dropped significantly since COVID-19 vaccines became available, the Delta variant, a highly infectious mutation of the COVID-19 virus, has some health experts worried that another deadly spike in cases could occur, especially in Bronx communities with low vaccination rates, and among the vaccine-hesitant, like Pina.

 

“We don’t know the long-term effects of these vaccines yet,” Pina told the Norwood News. “They were developed so fast. It’s scary.” According to the College of Physicians of Philadelphia, in some cases, it can take up to 15 years to develop and approve a vaccine. However, because of the immediate need to end the pandemic and the unprecedented global research and cooperation that was undertaken to achieve this, the entire vaccine development process was prioritized and accelerated. This included making billions of dollars in funding immediately available, freeing up scientists to prioritize vaccine research, testing, clinical trials, obtaining emergency use authorization, manufacturing and distribution.

 

The Centers for Disease Control (CDC) said COVID-19 vaccines are overwhelmingly safe and effective, with minimal life-altering side effects. Regarding the Johnson & Johnson (Jansen) vaccine, as of June 28, 2021, 12.3 million doses had been administered in the United States. Of that total, there were 38 (0.0003 percent) confirmed reports of people who later developed blood clots. According to a fact-sheet made available to the public by the Food & Drug Administration (F.D.A.) after a federal investigation into the issue, such clots can occur in people who have low platelets. The fact-sheet provided more information about this type of scenario, as well as more information about that vaccine itself.

 

Additionally, the CDC said the chances of dying from a COVID-19 vaccine are rare. Of the over 324 million doses administered in the United States between Dec. 14, 2020, and June 28, 2021, the Vaccine Adverse Event Reporting System (VAERS), a national warning system that logs and detects possible safety issues with vaccines approved by the Food and Drug Administration (FDA), received 5,718 (0.0018 percent) reports of death among people who got a COVID-19 vaccine.

 

Many had underlying health problems. In fact, a CDC report published in September 2020 found there were underlying conditions in patients in 94 percent of COVID-19 deaths examined. By contrast, as of July 4, the total number of COVID-19 cases in the United States was 33,685,075, and the number of deaths totaled 604,752 or 1.79 percent.

 

However, it’s not necessarily the vaccines that make people unwilling to roll up their sleeves, but rather what they represent. For some people in historically marginalized, low-income communities who have an inherent mistrust of government-mandated programs, it triggers the legacy of the Tuskegee experiment.

 

In the 1930s, 600 Black sharecroppers in Macon County, Alabama, were denied life-saving treatments for syphilis through a program spearheaded by the United States Public Health Service.

 

More recently, skepticism about the COVID-19 vaccines grew when a nurse alleged that six Mexican women were involuntarily sterilized while being held at an Immigration and Customs Enforcement center (ICE) in Georgia. However, unlike these examples of medical misconduct, where individuals were denied their rights and were unlawfully mislead, citizens of the United States are not required to take a COVID-19 vaccine. It is a choice.

 

For Pina, however, she likens the situation to being treated like a guinea pig, making the vaccine a harder sell. Compounding her skepticism is the fact that other long-known health issues that have plagued lower-income communities in the Bronx, such as asthma, hypertension, and diabetes, have not, in her opinion, received the same level of attention as she is seeing with the COVID vaccines.

 

“In our communities, we never get this much attention for our medical needs. We’ve had high rates of asthma in the Bronx for years, and nobody’s addressing that with this much intensity,” said Pina. “Every other commercial on TV is about the vaccine. They’re pounding us every day about getting the vaccine. But if the government is really concerned about poor communities of color, why aren’t they investing money in people with diabetes and asthma, and giving them free insulin and asthma medications? How is it that now they have all this money for the vaccine?”

 

Indeed, there have been focused efforts over the years to reduce the high asthma rates in the Bronx, as reported, and more than once, but those efforts probably garnered a lot less attention since asthma is not contagious, whereas COVID-19 is. The latter therefore has the potential to disproportionately overburden intensive care units in hospitals as it can affect the whole population.

 

Sandra Albrecht, a professor of epidemiology at Columbia University’s Mailman School of Public Health, says arguments like Pina’s are valid. “You have the City and health officials wanting everyone to get vaccinated so we can bring case rates down and reopen.

 

But from the community’s point of view, I can see why they would balk at that because they feel like they’re taking the vaccine so that the City can reopen and the economy can come back,” Albrecht said. “These economic wins don’t always translate to wins for these communities. For historically marginalized people, it can feel like they’re doing the City a favor by getting vaccinated, and getting nothing in return.”

 

The return is, of course, increased protection from COVID-19 for everyone, through herd immunity, lower cases and a return to normalcy. In addition, Albrecht says while Pina’s arguments deserve consideration, they don’t change the fact that science and research have shown that people with underlying conditions such as diabetes and asthma have a much higher risk of dying from COVID-19 than those who do not have these conditions. Therefore, indirectly, these long-known health conditions are being addressed.

 

“I know that’s not always been seen as a big enough of a motivator, but I think if people can understand that [that] is a big reason why they should get vaccinated, so that they don’t succumb to COVID, and they don’t have to deal with the hospitalization associated with COVID, then they’ll be more willing to do it,” Albrecht said.

As previously reported by Norwood News, the Bronx was once the pandemic’s epicenter, often leading the City in infection rates, hospitalizations, and deaths from COVID-19. In early March 2020, almost one percent of Bronxites had been hospitalized with the coronavirus.

 

That was double Manhattan’s COVID-19 hospitalization rate which, at the time, was the lowest of all five boroughs at 0.5 percent. Additionally, according to March 2020 data provided by the City’s health department, the Bronx also had the highest rate of deaths at 0.3 percent, compared to Manhattan at 0.15 percent.

 

The Bronx’s current low vaccination rates, coupled with widespread vaccine-hesitancy and the looming threat of the Delta variant, has Bronxites like Michelle Avila, chair of Bronx Community Board 7’s (CB7) health committee, fearing for the borough’s future, as reported.

 

“I am very concerned,” Avila told the Norwood News in an email. “While vaccination is an individual’s choice, we are in this public health crisis together. So long as these factors remain, our communities remain vulnerable to an outbreak. No one wants to go back to that situation. The pandemic upended people’s health, livelihood, and way of life. The only way we return to normal is to continue to increase vaccination rates and protect those that can’t be vaccinated at this time.”

Once you're fully #vaccinated:
✅All activities become safer
✅Generally, you no longer need to wear a face covering or stay 6 feet apart from other people
✅You no longer need to quarantine after exposure to someone with COVID-19
Learn more: https://t.co/BHibl5jeSz pic.twitter.com/VUfYlDdquq

— nychealthy (@nycHealthy) July 12, 2021

 

Jason Autar, chief operating officer at Bronx Rising Initiative, an organization dedicated to addressing COVID-19 related health care disparities in the Bronx, also believes that increasing vaccination rates is critical to avoiding another wave of cases. To get more people vaccinated, his organization has created pop-up vaccination sites and has even gone door-to-door, throughout the pandemic, to help seniors and essential workers register for vaccine appointments. However, for Autar, getting people vaccinated is a short-term win. He said what really matters is building and earning the communities trust beyond the pandemic.

 

“You really have to meet people where they are, and it’s not a one-time thing,” he said. “It’s showing up constantly, and demonstrating that we are part of the community, and we look like the community, and we speak the languages. It’s so important not to paint entire swaths of a community with broad strokes.”

 

Additionally, Autar hopes that as people see their family members, friends, and neighbors being vaccinated, without experiencing adverse reactions, that proof will trickle down and motivate the vaccine-hesitant to get vaccinated. “You have to take a multifaceted approach with this,” Autar said. “It can’t be one size fits all.”

 

Autar is also concerned that now that the City has reopened, Bronxites will let their guard down and may not take the usual safety measures like hand-washing and mask-wearing as seriously as they did during the height of the pandemic. He said this is also more worrisome in a borough that has the lowest vaccination rate.

How do we know the #COVID19 vaccines are safe? Because they were shown to be safe through clinical trials, which involved testing the vaccine on tens of thousands of volunteers. These trials were closely monitored by the @US_FDA and outside experts: https://t.co/4zgWbbigan pic.twitter.com/A0vd2AZQQX

— nychealthy (@nycHealthy) July 12, 2021

As for Pina, she’s beginning to feel the impact of not being vaccinated outside of her immediate community, “The Late Show with Stephen Colbert is a show I would love to see, and I wanted to get tickets,” she said. “It turns out that now he’s got the shows in person, but if you’re not vaccinated, you’re not getting in. So that’s it. I won’t be able to do it now.”

 

However, not being able to see Colbert live still isn’t enough of a push for Pina to want to get vaccinated, and at this point, she doesn’t know what would be. “I don’t have anything specifically that I could say, well, if this particular thing happens, then I’ll take it,” she said. “I’m still hesitant about it. That’s not to say, in the future or maybe even next year, I’ll get it. But I guess right this minute, I don’t know.”

 

On Monday, July 12, DOH tweeted that the reason it is known that COVID-19 vaccines are safe is because they were shown to be safe during clinical trials, which involved testing the vaccine on tens of thousands of volunteers. “These trials were closely monitored by @US_FDA and outside experts: on.nyc.gov/vaccinefacts.” For the latest information on vaccine facts, go here.

 

Meanwhile, on Monday, The New York Times and other outlets reported that the Johnson & Johnson (Janssen & Janssen) vaccine received another set-back following the decision by the F.D.A. to attach a warning of a rare nerve syndrome to the Johnson & Johnson vaccine. It followed findings of the syndrome among some people who had received the vaccine, and despite the fact that the syndrome has also been found in people who have not had the vaccine. Federal regulators concluded that the risk of developing the syndrome was low, and that the benefits of the vaccine still strongly outweigh the risk of developing the syndrome. The F.D.A. fact sheet has been updated accordingly.

 

*Síle Moloney contributed to this story.