tv COVID-19 Vaccine Hesitancy Discussion with Bipartisan Policy Center CSPAN April 7, 2021 5:48pm-7:20pm EDT
eight eastern are anytime on c-span.org. emet good morning. my name is -- i'm the chief medical adviser at the bipartisan policy center in i want to welcome you to today's event entitled building vaccine confidence during covid-19 the role of the medical neighborhood we are thrilled to be part during with the d.c. mr ask
group and organization that focuses on appropriate use of medication to improve outcomes and health care costs. today's event occurs against the backdrop of covid-19 insignificant optimism now that the vaccines remarkable achievements to help end this pandemic. as of today 167 million doses of covid-19 vaccine have an administered. this has resulted in nearly one in five americans being fully vaccinated and over 55% of seniors being fully vaccinated. today's event also occurs against the backdrop of a precaution. we have a ways to go with respect to the vaccination campaign. there is her doing variants that are more transmissible and potentially more virulent and we are seeing americans with less cautious behavior. additional challenge which may grow is the building vaccine confidence and some populations
that have been less willing to take up the vaccine. ethnic minorities white [roll call] americans and young americans in on friday in the "associated press" poll showed that 25% of the american public say they probably or definitely will not get the vaccine because of concerns about side effects and they are usually underpaid today we talk about how to further vaccine confidence through multi-factorial approach through distrust of the medical committee and the feeling by many that they don't need the vaccine to hear from experts from a variety of fields including doctor john burke doctor karen dunley and we will hear from the ceo -- and shall be announcing the launch of the task force on building vaccine confidence in the medical neighborhood led by doctor regimen. this will be followed by discussion underrated by susan
dennison. with a terrific panel of experts lisa fitzpatrick and howard taft. please utilize the chat function to ask questions today's events and will try to get in as many questions aswi possible. thank you and at this time i'd like to introduce former senate majority leader and dcc senior fellow who will provide -- >> thank you and thanks to the staff of the bipartisan policy center and our partners. today we have come together to discuss the timely topic covid-19 has taken too many american lives. hope that our economy and interrupt their socialma connections and has overwhelmed our health care system. mask and social distancing continue to be fundamental to our toolkit to reduce their risk for being exposed to the virus and now we have a game-changing tool that will accelerate our
efforts and the pandemic, vaccines. the three fda authorized vaccines are safe and effective. vaccines are the miraculous final piece in the puzzle to help us to return to work, rick to return to play and to engage in everything in p between. vaccines will save lives. we have seen an encouraging uptake and vaccinations as vaccines become available to more americans at no cost. but we are only at the beginning of the road. we have the moral. up to work as hard as we possibly can and as quickly as we can to reach herd immunity. to get there we must continue to build confidence in covid-19 vaccine. and here's how we do it read first increased trust.
vaccines efficacy is nothing new and is a doctor in a position i have witnessed some type of hesitancy on vaccines with my patients for over 40 years. but v what is new is many americans have concerns specifically about the covid-19 vaccine. their concerns typically typically center on that vaccine development and the processes. throughout the pandemic public trust in the scientific committee has unfortunately increased. compounding that some americans express skepticism because covid-19 vaccines received fda approval faster than many other vaccines in the past when it comes emergency youth -- use authorizations from over many americans feel the vaccine approval processes than politically motivated rather than driven by science and in fact recent polls just the mark showed the largest single divide amongt, americans in their suppt
for vaccination now falls along political lines. the truth is it does not discriminate based on political affiliation. building trust and confidence in vaccine we can entreat -- increase trust a leading with the facts and the facts are the three fda approved vaccines that the agency's rigorous scientific standards for safety, for quality and effectiveness. those are the facts. we must remove the political undertones of these conversations in order to improve trust and in p order to increase the uptake of vaccines and to reduce formidable death. all americans who can get the vaccine should regardless of political affiliation, regardless of political affiliation get those vaccines. number two, we must leverage
public and private partnerships. these partnering connections are integral to successfully building confidence in covid-19 vaccines. the covid-19 pandemic is a public health threat that is too great for any one company, it any one institution any one government department to solvest alone. like all of the covid-19 response efforts building trust and vaccines requires inclusive all hands on deck approach. we need to make a decision to get vaccinated as easy as possible for americans could we have to meet people where they are, employers and this is his and faith-based organizations play hugely important parts in getting peopley vaccinated. they are the ones, those faith-based organizations those employers thoseti businesses are deeply embedded in communities
all across america to public-private partnerships also help us use all resources to get gettable and to help take active measures to encourage employees and community members to get vaccinated. one example faith-based organizations could partner with state health officials to serve as vaccination sites or provide transportation to those vaccination sites that employers might offer employees paid time off for thef time involved in going to get that vaccine. vaccination you say is not just a win for public health but we know businesses will be affected too. vaccination plays a large role in giving us the herd immunity and fully reopening the economy. finally we must incorporate the medical neighborhood in our strategy to build vaccine confidence.
we think of hospitals and we think of health care professionals and we think of all the other health care services in the communities are all important in building trust in the covid-19 vaccines. as a doctor i know first-hand the amount of trust americans put in the medical neighborhood to neighborhood around in the ecosystem around them each and every day to care for themselves to care for their children and their lovedre ones. there is no more important time than now to tap into that trust ando to the confidence in covid-19 vaccines as well as vaccines of the future. you know we have a great panel of experts today that will go into greater detail about the role of these medical -- and building vaccine confidence and i'm excited for the conversation. thank you all for joining us today.
>> thank you senator. at this time i'd like to welcome the founder of institute for health care improvement doctor don berwok to make additional oakum in remarks. friends. i'm a pediatrician by training a president emeritus and senior fellow at the incident for health care improvement in boston massachusetts and former minister at her of the centers for services during the obama administration per day field this work for a long time decades improving the quality of health care around the world and now improving the quality of health. it is hard to covid pandemic certainly is a call to arms for reasserting in learning and the improvement at the core. the concepts of the thing vaccine confidence through work
with medical neighborhood is alsoth core to improvement overall. there really are two ways to make things better to oversimplify. one is unfortunately too much the tradition too much habit and hthat is command, control incentive expert patient trying to force her push people into new ways of being to change processes are insisting on change. iton is simple and it's wrong. burning is a shared enterprise not involving control and not involving demand. involves curiosity comment and the idea that as we say in health care improvement all teach, all learned.
in the covid pandemic we are learning this very fast. in clinical care around the world knowledge is speeding from place to place at a pace i have never seen before. sense of humility and curiosity in dealing with this dreadful tragedy local tragedy is helping us become more curious to do better in the two crisis of confidence. can you trust the experts and through many errors and public policyts we have been forced a t of these fears and hesitancy especially communities that are quite used to being left out or left behind. people do it make sense to them and if trust is science trust and expertise in trust and the allegations of professionals then we are in trouble.
how do you build trust? that is the problem today. the confidence in the bipartisan center and colleagues are trying to address. it's done through corporation. there is no other way. the idea that we can somehow browbeat or convince people to do things that they don't believe to be in their interest is the exact opposite. it's crucial to address fears honestly with enormous respect and to engage in dialogue and constant listening so we can walk in the shoes of the people that we are in dialogue with. in the pandemic with respect to vaccine concerns that's trust in science trucks -- trust and expertise trust and accumulated experience in trying to reach out to reverse the attacks of
thisct pandemic. i think that happens best in communities and neighborhoods. the terminology is entering health care more and more and faith-based approaches to addressing the problems of improvement and we will have to think that when the covid pandemic two. localities neighborhoods collectives of people they care about where they live care buddy gibbering getting together to understand what the problems are. there is no top-down solution. i think in this journey toward dialogue and curiosity and authentic conversation and authentic listening a dialogue toward trust plays a central role. we need trust. people when they speak in communities because of their relationships with the community
has started out with a trust and i think primary care is in a position not just of physicians that all people involved in first contact in the community potentially the very kinds of trusted voices that are needed to help people become comfortable with what needs to be done in order to stop this pandemic. some will never agree. some will never find the sources of trust they need and that's okay. we just need enough people in dialogue and an authentic search for better to change the characteristics of the community as a whole. i think to build trust at the neighborhood level is exactly right and this is about more than vaccines. about more than covid trades about an overall approach to
improving health and well-being and our communities as a whole. the sources of health and well-being our social determinants of health and those enhance the communities we deal with. just as with vaccine hesitancy when he did talk more about understanding the nature of concerns in the sources of trust in those communities to when work on the other determinants of health be a good security or transportation or housing security or criminal justice reform or environmental improvements or equity itself we need to do it exactly the same when localities in places in communities with shared voices and a sense of real respect to the dialogue that can a lead uso it i thank you for the chance to share these thoughts with the assad delight about the effort underway and where that effort needs to be. thank you.
>> thank you don for those remarks particularly the focus on the role of efficacy. now we are very lucky to hear from the centers for disease control and prevention playing a leading role across the nation when it comes to building vaccine confidence. please will come the director of the cdc's national center oncd birth defects and developmental disabilities and former deputy implement manager the cdc's covid-19 fun. he sirs as ceo of the american academy of pediatrics and commission of health for the commonwealth of virginia. smith thank you very much for having me and thank you to everyone on the call of the bipartisan policy center and the institute for hosting this very important call. as you just heard i have a lot of roles but one of the most important things and don't just book about it is -- and is a
pediatrician i've spent countless hours talking to parents about what to do for with her child in listing two partners about what they are concerns were and how we collectively answer them. we've been having discussions with pediatricians about vaccinations and importance of vaccinations for many years and i couldn't read more than it always needs to be a conversation that we join together from listening and learning. i'm excited to talk with you today about the important topic. we know that strong confidence in the vaccine in the committee needs to work with getting people backs say which leads to fewer cases and deaths. we appreciate the initiative focusing on trinity and trust in relationships and as i say there's nothing more port and put them going to share more about the details of the available vaccines or current distribution and administration
vaccine safety and an overview of the cdc's competence framework andn other resources that help address vaccine efficacy. overview of programs that include access to vaccines identifying the vaccine uptake and building vaccine confidence among health care workers and their patients and ultimately receive what we here at the cdc doing partnership with all of you possesses been said back say is a critical tool in bringing this pandemic to an end. as we know multiple vaccines have been developed in clinical trials. we talked about the three currently available the pfizer biotech -- pfizer biontech moderna three doses, 28 days apart in the johnson & johnson for people 18 and up.
all of these have been effective in preventing serious illness hospitalization and death from covid-19 and they think as you heard as of april 4 over 207 million vaccine doses have been distributed in the united states with over 155 million being it ministered and that includes 99 people initiating vaccines and 51 million -- have been vaccinated. that's great but we have a long way to go. we continue to work with states to understand what blogs and figure out how to overcome challenges and distribution and administrationon to ensure we ae getting vaccines a and arms as quickly and safely as possible. we at the cdc now packs an confidence is built on the foundation of vaccine safety. covid-19 vaccines are safe and effective and were evaluating tens of thousands of her disappearance through clinical trials and maffia the a's
workers standards for safety effectiveness and manufacturing quality in support of emergency use authorization. many monitoring systems watch for possible side effects and the adverse effects of me now to been seen inff clinical trials predict we see an unexpected adverse event expert study at further to the south whether it's a true safety concern. experts decide whether changes are needed in our vaccine recommendations. this monitoring is critical to help insure the benefits continue to outweigh the risk for people who receive vaccines. here the cdc and the fda we have a number of tools. the bsafe is a program health checker for people who ever see the covid-19 vaccine. we now have over 8 million enrolled. over 80,000 of them just have the self-identify themselves
reaching out to mothers and babies through pregnancy registry. reso have t the vaccine event tt is workable with the fda for this national system set in place for many years from health care professionals vaccine manufactures in the public of events that happen after vaccination. there are reports of adverse events that are unexpected and appeared to happen more often or have an unusual pattern to these are followed up a specific studies to date we haven't had significant safety -- related covid vaccine. let's talk about vaccine confidence for a minute. most people in nine states are planning to get vaccinated with covid vaccine and as you've heard the numbers continue go up but we do know many people want more information about the vaccine including a process for developing and operating testing
and information about its safety and effectiveness. they have also had experiences that affect their confidence in the health care system. competence in the vaccine leads to more people getting vaccinated which leads to fewer illnesses hospitalizations and deaths. many factors include vaccine decision decision-making. social political individual and group -- factors however the conference and the vaccine to vaccinate her in the system. i think we are talking about the vaccinators and the committee based system that can make it significantit difference. our strategy is told on teamwork. build trust and power health care personnel indicate communities and individuals. in order to build trust willnn continue to share clear and
accurate messages about covid-19 vaccines and take visible action to build trust in the vaccine. thee vaccinators and the vaccine system through these are some of the tactics of that the cdc will use to reinforce trust. we are transparent about the for authorizing approving recommendations forr monitoring the safety just a bidding allocating and administering the covid vaccine including how the data is handled providing updates on the benefits safety side effects and effectiveness and clearly communicating what is not yet known accurately addressing in mitigating the spread of misinformation by social media platforms and messengers empowering promoting confidence in their decision to get vaccinated and to recommend vaccinating their patients through these are some of the
tactics we use in health care personnel engaging national professional associations health systems and health care personnel to ensure clear understanding of vaccine developmentt approval process nw vaccine technologies and better vaccinations ensuring that those health care systems and medical practices are equipped to build confidence in the covid-19 vaccination and strengthening the capacity of health care professionals to have empathetic conversations address myths and questionss provide tailored information and motivation about techniques when needed to read as a pediatrician i know technique can have a significant impact on aim conversation with patients and families. engaging committeesti and individuals in a sustainable equitable and inclusive way with twodu wake medication to listen build trust and build
collaboration. these are the tactics we engage in with these individuals and empower vaccine recipients to share their personal stories within their circles. working with health departments and national partners to engage the community around vaccine confidence and services delivery strategy including adaptation of vaccine provider sites and each command he collaborate with faith-based and community leaders to taylor and share messages and material -- this is where weri are focused building trust and helping people make decisions for those who trust them. it's not an advertising marketing for committee patients campaign. it's to help teacher framework for health departments health careme providers immunization partners and community partners and leaders in their promotion of the covid vaccine.
our confidence that vaccine leads to fewer illnesses hospitalizations and deaths hos, illnesses and deaths. we have resources to assist and share information about vaccination. we have an informational guide to build confidence in covid-19 vaccines with strategies for immunization coordinators to build vaccine confidence within their health system or clinic. we have a number of the tools including communications and confidence checklists, covid-19 confidence conversation starter, vaccine confidence strategy, and building confidence in vaccines among patients, tips for health care providers. these includes toolkits, slides, information that helps providers, print offs they can give to their patients. more information can be found on the cdc covid-19 vaccine with confidence website.
i want to very quickly go over a few highlights of some work we have been able to do with our local and state partners. we have an agreement with multiple districts to support vaccinations. 10% of the funding received by these districts must be allocated for high risks and underserved operation -- including -- in order to engage minority communities and build trust and improve vaccine uptake we are working with diversity champions to meet these communities where they are. we have developed a comprehensive flow gram of 20 national organizations to support federal and local community-based organizations to improve covid-19 and vaccination coverage among racial and athletic groups. -- we have a retail pharmacy program with 21 pharmacy chains and independent pharmacy networks to administer vaccines in communities across the united states.
almost 90% of people in our country live within five miles of a community pharmacy. pharmacies have a unique reach and ability to fight access to covid-19 vaccines and provide -- this presents one component of the vaccine -- on march 29, the biden administration announced a plan to more than double the number of pharmacies offering covid-19 vaccines, and that by april 19 90% of adults in the u.s. would be eligible for vaccination, and 90% will have a vaccination within five miles of where they live. what we are talking about is so important, we need to bring the vaccine to communities, but we need to have communities and individuals want to be able to get the vaccination. we have programs with health centers working with federally qualified health centers, local vaccination unit are being supported, over 500 mobile sites and partnerships with jurisdictions around the country
are committed to providing available resources to support our state and tribal partners in our effort to provide a vaccine to everyone. i am now working through multiple different hhs agencies to help promote people who are homebound and disabilities also have access in a culturally upappropriate way to vaccinatios within their community. we talk about amenity communities within communities within communities works best at the local level as john for rick said in a make since we have to make sure we consider all of those communities within communities than we think about the groups that may need help in how we make sure he reach out to them. a word to any questions and it will turn it back over to you. thank you. >> thank you so much for those
remarks. we do have a couple of questions if you don't mind. the first question comes from the viewer from youtube or can you please comment on recommendations for a patient who is experiencing severe side effects from the covid vaccine and should that individual receive a different vaccine? >> i assume they are talking about their first vaccine and the first thing i would do is talk to my health care provider and to make sure that i understandwh with the those side effects are symptoms were related to the vaccine or -- that provider can talk to an expert about vaccines efficacy and you cann walk through whethr it was related to the vaccine are not and if that person is at risk for than what their recommendations would he. but i think it's very important
because as we know people have different types of allergies and you can alsos have symptoms of another health problem related to the vaccine. we never want to take that lightly and we want to make sure they have an opportunity to talk to their health care provider. >> thank you. another question is comment also from youtube. the approval causes many to be hesitant thinking the vaccine hasn't followed articles. how do we collectively address this issue? >> is a very important issue and i think walking through with people that this is notin new technology that this is technology that -- and yes the process itself does not cut corners by focusing research science and bring everyone together on this very important
issue. i think of it as i'm old enough to remember my first flu shot and this was i think this generation's flu shot to make sure this vaccine was created as safely and as possible but have complete confidence that there were no corners cut and also importantly is the day the vaccine is approved we talk about we don't stop monitoring. every day they are there working with the pharmaceutical companies to monitor the safety to make sure we have get not just short-term but also long-term outcomes and lastly i'm very happy that i come from a family of health care providers are ever one in my family has been vaccinated and we have had all three. some have had pfizer pfizer and sematech moderna and some of them had j&j and i can't wait or
my grandson in when the vaccine is available forai children for them to getci vaccinated. on the arsenal professional level -- grade and one final question from the audience. if you could just summarize scientifichi advice for women of childbearing age and pregnant women with respect to the safety of the covid-19 vaccine. >> working with the oncology and obstetrics -- pregnant women offered the opportunity to be vaccinated and they do that in conjunction with their provider their physician about whether the vaccine is right for them. we are gathering more information previously said we have 80,000 women who ever see the vaccine and we we are a registry in the coming weeks. there will be information published about the safety of the vaccine and i just saw an
article about the. fact that antibodies are created and troop breastmilk are transferred from the placenta to the baby so rejecting not only the mother from covid infection but also protecting that infant around the time of birth. it is again, have a very dear friend who is 8.5 weeks pregnant including -- who got her vaccine last week. important to protect them. and thank you so much for joining us today. it's very much appreciated areas in i thank thank you. senate of this, that introduced katie. katie is the co-founder and executive director of the institute and has had a long collaboration and multis take hold or health care garments but thank you for your leadership and welcome. >> inc. you. appreciate her partnership with the bipartisan policy center as well. i'm excited to share from the
institute launching a new national task force of building confidence in the medical neighborhood. our goal is to identify -- to build that confidence in local communities. this work is supported by a grant by johnson & johnson and weeg will work collaboratively d communicate c effectively about vaccinations during the current pandemic with the local committee religious organizations collaborating with local state and federal agencies and clinic being to ensure -- a safe committeeun response. we at the institute believe in the medical neighborhood is fundamental to implementing
confidence. today is part of our partnership with the bipartisan policy center are first listening session for the task force and i delighted that we have the institute to introduce to you our task force. doctor bensimon executive director of the american public health association and doctor paula abramovich with the american society for health system pharmacists. susan denver from the center for health policy at fisk university to facilitate this evening i will serve as task officer. i'm also delighted to introduce to you a member of the tas' force. on behalf of the -- the board of directors thanks all of you for serving.
the american nurses association and coat greiner primary care philanthropist paul innovator in recent of the institute got kinley from the american academy of family physicians connie -- the alliance of community health. susan keller mike american college of clinical pharmacists there'll geralyn moyer the american college of physicians deborah knapp is nestled partnership with women and families the bipartisan policy center and american society of health system pharmacists marcus association of state and territorial health officials the national quality forum deb
robson walgreens -- the national association of community health centers richard stone might thompson the national alliance of health care clinicians careen howard university tony from the university of central -- and susan winkler. thank you for participating in serving on this very important task force. and today we are releasing a report from the michigan institute background resources to build confidence. this report offers tools for the national task force in crafting overcoming barriers and building thatbu confidence in communities
today and in the future. it can be found on the task force web site at gt mr.org. thank you to all of you appeared at look forward to hearing the upcoming panel to build confidence in the teen vaccine specifically about vaccines more broadly. thank you. >> thank you katie. and now we will move to our panel discussion which will be moderated -- moderated -- the senior policy fellow at the robert j. b center for health policy at duke university and is headed to distinguish career in health policy and health services. thank you susan for being with us today and i will turn it over to you. >> thank you so much for that very kind introduction and to all of her opening speakers for their very important remarks this morning.
before introducedin this panel t me just briefly recap what we have are the herd. first we heard from you 167 million people in our country have now been vaccinated as of today with 61 million of those fully vaccinated and as we know the nation reached a record or a million vaccinations a day over this past weekend. we have new variant of sars covid too many abandoning mitigation measures like wearing masks and social distancing so we are far from out of the woods when it comes to this pandemic rate most people in the west as we heard do want to be vaccinated by thee quarter peope are saying they won't he vaccinated. and from the senator as we heard with vaccines being a game-changing tool of this pandemic that got to accelerate our efforts to get more people
vaccinated. we have a moral imperative to get as many people as possible vaccinated to reach herd immunity and break that chain of transmission of the stars covid to virus. we heard the pandemic has been a call to arms for our country in so many ways about the need to improve health and health care in america by tackling health word is which is in communities and really vaccination now as part of an overall approach to improve the health and well-being of communities as a whole. it is the right place to begin to build the drive to maintain and increase confidence in vaccines. .. the importance of having the conversations with people, with parents about the importance of vaccines.
we heard about all the all of thecd tools the cdc has created now to enhance confidence. to vaccinate with confidence framework. the covid vaccine be safe health checker that people can check after the fact, after they have been vaccinated. the pregnancy registry that she mentioned. along with many other tools and toolkits available through cdc to build confidence. we also heard from the report to get the medications right institute justti released showing that vaccine hesitancy has been a long-standing feature of our country and indeed many societies around the world. but there are also very well known ways of addressing it. we know that black populations have well-founded historical grounds for distrusting much of the medical and scientific
establishment and of course that distrust has increased generally in recent years. people do what makes sense to them. and now we face the very important point of building their trust, correcting misapprehends an. illuminating myths and taking other steps to build confidence. that means as john birbeckop said particularly engaging people in that trusted a medical neighborhood. the primary care doctors, the pharmacist, the nurses and others who already have a lot of trust from the patients they serve. and it is time to tap into that trust. to build that confidence. take advantage of all of the other entities that can come together, public and private partnerships, employers, businesses, basic based organizations and others to
turn that trust to the goals now very importantly of building heard immunity our i population. so with that as a summary of what we've already heard, let's turn now to our distinguished panel. let me introduce them now. i do it to remind the audience that they arehe open for questions. so please use that live chat feature on youtuber facebook, or go to twitter and use # bc live to tweet us your questions. our panelists include who is the chief medical officer of cvs caremark. and cbs as we know has played a vitally important role in vaccine rollout paid cvs ultimately to white papers addressing hesitancy and confidence it will be happy to address. we are also delighted to have lisa fitzpatrick who is a
physician, a founder of great pine health which is an organization that creates health promoting content for underserved and under resourced communities. in build trust through delivery of credible community focus health information and content. also very happy to be joined by bruce gallen a physician also president of global immunization at the vaccine institute in washington d.c. for the institute seeks to make vaccines more accessible to enable innovation and expand immunization across the globe. also served as a deputy assistant secretary for health. and the director of the national vaccine program office previous to his current position. and finally, howard have to is a physician as well. he is executive director of the maryland primary care program at the maryland i'm sorry the american department of health.
his career has been dedicated to solving complex medical care delivery challenges in implementing programs to serve diverse populations in maryland and across the nation. we have asked all of youne panels today to give particular observation to the distinguish task force talked about. again headed by paula. as they work to draft recommendations to harness the capabilities of medical neighborhoods across the country to build a vaccine confidence and get us to the goals we described. so let me turn first to you. drawing on your experience on those white papers i mentioned about hesitancy, what do you think are the key points of the task force needs to keep in mind as it drafts its recommendations to build vaccine confidence?
suspect thank you susan thank you for the institute for the opportunity. what i want to sit over my introductory comment is talked about health capabilities are vaccine efforts. what we have learned and how we are actually using that information to build confidence and coded vaccination. maas we have three business units, aetna, cvs pharmacy aetna. across theur nationwide footprint we have nearly 10,000 retail locations. as the doctor mentioned cvs health like other pharmacy includes close proximity to the rest of america with 85% of americans that are within 10 miles of a cvs pharmacy. we have up to 50000 trusted immunized or sour pharmacist and pharmacy technicians who are trained. we will talk about training is part of building confidence into that vaccination process. we have significant expertise and experience in providing a number of a vaccination services
during the covid pandemic we provided 50 million blue vaccines recently announced that we have surpassed 10 million covid vaccinations be provided for the country. using these capabilities provide 20 -- 25 million covid vaccinations for the country on a monthly basis. cvs health has been participating in the national effort through to federal programs for the long-term care pharmacy partnership program where we are now completing that program reported with 45000 skilled nursing facilities and long-term care facilities and provided nearly 5 million vaccinations. through the federal pharmacy partnership where pharmacist and pharmacies that are in the community are providing. community based access very brcool talk more about that program briefly. but let's get to the topic of building confidence.
what are the drivers of confidence? we have conducted a number of white papers with some interesting insights on what drives confidence. and there's really three strategies making sure that it is easy to get the vaccine locally with an explicit focus on equity. making sure we have trusted clinicians and protocols and making sure we amplify the messages around safety and efficacy using multiple communication modality.t' let's talk about her white papers research. we conducted a number of national surveys from november onward essentially monthly for we had surveys across the country thousands of individuals marrying the demographics of america about their intent and their reasoning around getting a covid-19 vaccine. early on we saw a very large movable middle. that 45% say they would either get the vaccine were not interested in the vaccine. but 55% who were in the middle that were just either waiting
to see what would actually happen and would make a decision later on. what we have seen also is that varied by race and ethnicity with greater hesitancy among black americans and hispanic americans than other americans. however as the pandemic has progressed in vaccination has progressed but we have seen is the hesitancy has decreased in the most recent months. and when we asked what will help you in making a decision, clinicians matter. hearing the messages around vaccines from trusted clinicians in the incredibly important. we ask those who are willing to get, the vaccine they say a return to normalcy is really important. they want toma get back to a normal life. the second peace that the risen recently as a interesting one. it's what i'm calling a network effect. it's not someone else has received a vaccine that was
safe, there's not much issues around it. that has led people to say i know people have gotten the vaccine. so i can get a vaccine as well. for those who are hesitant continues to be around safety and efficacy they want to hear from clinicians about the efficacy per they want to hear from their community trusted clinician. as we think about in the next minute or so and then i will wrap up, we are committed to making sure through the cvs pharmacy retail chains in the federal pharmacy partnership to make sure the vaccine is available locally. we have turned on stores and based on social vulnerability index in thehe understanding of communities to make sure we are providing under representative minority. we then a partner off with community-based organizations that note the community to amplify messages about availability and how to do theo scheduling.
that has led to nearly 34% of the individuals who are coming to our stores are underrepresented minorities were getting the vaccine. oversee that nationally hovering around 20%. the conscious about store location amplify the messages has been critically important.in the vaccine availability expands will continue to provide vaccinations outside of our retail locations with off-site transportation support with partnerships with organization. we have filled out a training program to ensure clinicians are knowledgeable about the questions that patients would have when they come in paid we have a greeter up front of the store to answer questions about the process as they go through the process for digital link scheduling is connected to educational efforts to ensure people have questions answered before they
even go through the process of getting the vaccine. so again, having trusted clinicians, making this accessible in community and amplifying messages around efficacy are critically important as building vaccine confidence in neighborhoods. connect thank you so much. that is really remarkable success as you have said. 34% underrepresented minorities vaccinated through cvs pharmacies versus the national averageio of 19%. i really remarkableak achievement. that takes me, lisa fitzpatrick to you. having heard that success story and recognizing your own extremely important work in finding the messagesfi that resonate with blacks in particular and those in vulnerable communities especially, what do you think are the most important takeaways for the task force in terms of started moving out
of that movable middle that was reference. for the efficacy of the vaccine. what messages do you think are most important that will resonate with those communities? >> good morning everyone. thank you so much for including me on this panel. think this is a vital conversation. i'd like to tell you a little bit about what we have been doing. i think back when it takes. who is given the information you need to get the vaccine continuum. have not been a fan of the word hesitancy because it's not the experience i've been seeing per there are people i
won't the vaccine but my experience has been in a trusted way and i've heard it many, many times already this morning. very fine healthy part of bit about it. we have actually been in the community. we offered a o combination of tech taxes, tech messaging and e-mail so people can contact us to ask questions. we also hold virtual selections we have a tribeon ofr doctors who have been on rotation answering the community questions during the ask the doctor session sprayed there s were also out on the streets. we collaborate with social service providers that is a group i have not heard much
about today. really, really critical group with the goal of improving vaccine access. because they are already inus the community providing social services built trust in the community. it's really important to workp in partnership with them. and so wee have been doing that on the ground with them when they are providing services we hear from people we've talked a lot already today about what the concerns are. the pass concerns are is the vaccine safe and why do we have a vaccine so a quickly? an initially one of the concerns was around being in the community's words a guinea pig. once we talk about the number of people i talked to them
about my experience in a research trial. we don't have those concerns as much anymore about being a guinea pig. we still hear a lot of concerns about safety and the side effects. and why the vaccine is so quickly. the intervention and the two categories. many attach abatement whether it's virtually or in the community, we hear this information and misunderstanding. the reason the messaging is important is because people want to hear that should not come as a surprise because we are all the same way. i people i trust with certain information in the community is no different. we talk about the black community we often hear we
should collaborate with churches. we should collaborate withte athletes. the truth is we are not monolithic very much a multifaceted approach. the church especially is a powerful influencer in the black community a lot of people we're interacting with in this removable middle not been influenced by the church lifted think about who the other influences are. we also talk at how people get their information. they get their information from word of mouth a lot of time. that is why our company is called grapevine health. we recognize a lot of health information is being transmitted on the grapevine. but we are not there to correct the misinformation. it's a perfect opportunity to learn and listen to understand
where the misinformation is coming from. so think with respect to messages in addition to t the churches and influential partners like athletes and visible people we also -- need to include healthcare providers. i'll just tell you a quick story that caught me offguard. one of these ask the doctor sessions, someone said to meet my doctor said to me not get the vaccine so why should i believe you over my doctor? my doctor knows me and i trust my doctor. so that told me we are also need to implement training and access to information for some providers. because the provider community is also notpr monolithic. so even though we think of providers as trusted messengers it is not a foregone conclusion that all providers will understand the research or even has been
trained in academic settings where they may have participated in research or referred patients into research trials. think with take all these things for granted. and the public sees us as science messengers. sometimes, some of us need a little more help and support. this is an area i would love the committee to think about. how can we provide the resources to the care providers in particular if they are on the frontline and their trusted messenger to ensure they have the information they need. and then finally, i'll find some messaging. this is a bread-and-butter of what i focus on. ensuring people understand what we are saying. and we have been asking people both virtually and in person if they understand words like
antibody in unity, efficacy, they do not understand what we are saying. so i think it's really important it is essential that we find better ways to communicate this information using metaphors, using examples, relatable examples that help people understand what we are saying and finding messaging. the other playful interaction i have is that they know the difference between cdc. i have not found anyone yet who can tell me the difference. in fact most people think dr. t anthony fauci she is ahead of the cdc. so this is an example. offering this as an example for why we need to think about how we are communicating health information. because we take it for granted. we are very close to the information. i would love to see some attention in the report
focused on how we communicate in plain language. it is possible to be scientifically credible it also speak and plain language so people understand what we are saying. because otherwise we are just leaving them behind. and the final thing i will say for turning this back to you, i think it's really critical for us to deploy vaccines into communities. the reason this is important is because we talk a lot about equity now. and ensuring people havees access. even if we provide, i think these interventions are incredible.th i think we can lead to many more people with these interventions. we have a last mile problem now. and so to get those people who are still in the movable mental and it's taking a little more time, energy, and
intervention to move them to vaccine acceptance. we have to take the vaccine to them. i think if we think about that, all of these ideas we are hearing today i think collectively will get us to where we need too go. so thanks for much for having me here. >> thank you so much lisa. and bruce, just to pick up on some of the point lisa made, she talks about her organization grapevine and the fact it was named after the great by the notion of how people communicate and your role in your prior rule at the national vaccine center do this great by dwell in the grapevine has a lot of participants on it saying different things. as lisa said, sometimes that information is wrong and needs to be corrected. what do you think are the most important steps now that need
to beig taken to get the right messages out through the right messengers and move the people who now really are going to need to be moved towards a position of vaccine confidence? stomach this has been such a rich discussion. another task force is taking great notes on all the things they can go forward. actually, as i think about that this is another opportunity to think about what we are doing now. this focus on local on place, on the medical neighborhood is critically important. we should not just do it for covid. we should take advantage of this and build it out so we have this not only for other vaccines, not only for c children and adults but for other things. this is where it's going to matter. at the heart of this is where people can get trusted t information's going to improve their health. that's were trying to do here were doing in very narrow way around the covid vaccine. bless not lose this opportunity to think about this chance to build up this
part of the system which we all recognize as critical. local matters most its host trusted voices that matter most and people are going to turn to those trusted voices. but lisa describes in the grapevine is right pretty think of it more technical term the information supply chain. and everybody inan that chain needs to know what is happening. an agent of the answers a need to know how the system works. in some ways the issues are the same globally as they are within the united states. the big differences supply. we will not dwell on that now that's a separate issue. when it comes down to the community level, all countries at think about equity in advancing the health of their community because down to the community level where people money at trusted information to make the right decisions for themselves for think we should also take the time in the same way that lisa talked about not using hesitancy. i think we should be careful about the use of that word.
a lot of things get swept into that we need to make clear whether issues of access versus issues of people's reluctance to actually step up to the vaccination clinic when supplies are available and it.rwise they can get we need to make sure those are handled. but part of that access is not only the vaccine and the opportunity for vaccination the information. they may not have places to go get trusted information proven each take a hard look at that. that something the task force should do drill into how to make sure people with theti trusted information have the right information. sometimes they may have itha wrong and sometimes may have been contaminated by devious efforts of disinformation to feel some of this. i think we need to make sure the end of this are people going to seek information get it and get it from trusted sources those sources have the right answer but not to point
people to wear those need to be. set this up at the beginning is meeting people where they are. which is not just a geographical statement but as a philosophical statement. talked about moving to vaccine in some of these centers of the geographies that are most affected. that's acc place to get vaccines where they are lisa text me going further out into the communities to make sure the transportation is not an issue in vaccines can be available. meeting them where they are is also what they think of this? one of think of the whole process were think of the system? one of think of vaccines in general and the ability to address those questions. in my role at hhs for 15 years, when i looked at from this perspective of a national vaccine program office was the overall system. everything from the surveillance the cdc and the states to try to figure out the problems are to the whole
research and development enterprise grade how vaccinesrp are approved how they are recommended, how they are used in measuring the overall impact. i think that's another overlay of confidence. it is a complex system. think they need to understand all the elements of the system how they work and the degree of transparency. i think that is central to trust it and that transparency is really very important. i will give one example i know have a chance to talk some more's the fda process. i was a former member of the vaccine advisory committee. the advisory committee process the nights is is very unique in its transparency it has to have conversation now with zoom and youtube everyone can watch. everyone can see independent experts kicking theng tires, looking at the data asking tough questions. that's what goes into making decisions. there are similar places along
the chain for transparency all the way through into how the vaccine works heather monitored for safety, karen mentioned that before continues to be evaluated when they are used,po all that is critically important that some people look at when the make and the right decisions for themselves. i will stop there and say the taskforces got plenty to do i encourage them to think through notno only how they're going to continue to work on this problem butm house when to translate into a better sense of medical neighborhoods across the country. back great thank you so much bruce. and now howard, to you. capturing some the things we've heard from your fellow panel participants here, moving people along with the vaccine acceptance contain ammo which we a lot of people have already moved. the ones who may be left in a
month or so going to be ones who've t the already moved out of that movable middle and the role in particular of primary care clinicians as the trusted messengers. they have the trust of patients and others in the community. let's talk a bit from your perspective about recommendations to the task force around primary care in particular. not all doctors were informed as they should be. gives that what needs to be done make sure their well-informed and well-equipped on the continuum lisa just describe its back thank you it's a pleasure in
addressing some of those issues. you wouldn't believe the majority of primary care providers are well informed and hope to seek the information they need. the minority of individuals in any particular profession who do not adhere to the highest standards. i don't think that is typical for primary care. let's approach this from the perspective of what this pandemic has really done which is shining a very bright light with health disparity. with this pandemic communities of color have been disproportionately impacted in terms of covid-19 in terms of increased cases disproportionately debts, but
at the same time they've not had the same kind of access to testing or even the antibiotics that are available. it just shines a very bright light on things we need to address. i think things that can be addressed at least in part in the medical neighborhood and primary care providers. the disparities are not biological in basis. it's things that to do with both health equity and social underpinnings for health equity transportation nutrition, economics, the things that are barriers for people on being able to get the access they need for many of the things that would be helpful to reduce f disparity. but also the flipside of that has been addressed before also is this issue of acceptance. which is much more personal
issue. it's impacted by all the social determinants but comes down to where people are in terms of their stages of change. that is something that is to be dealt with most intimately and either the grapevine or with a trusted provider. i think and doctor fist said it's reaching people where they are physically but also where they play, pray, work, all those things that go into our lives goes to the understanding of an individual that's an intimate time of conversation. think that's one off the places can really lean in because they develop with their patients these longitudinal relationships they go for years and understand the aspects of people's lives might not bepl available from data from a longitudinal
relationship. in an empathetic way. b it comes on to primary care part of the medical neighborhood. but the foundational part of the medical neighborhood to supplement hospitals and the great work of pharmacies in the long reach they have.e it's on a more intimate level. people who are most trusted in terms of medical information are clearly the physicians and primary care providers. that's where people prefer to go for their vaccinations typically a care office is a comfortable places with a gone in many cases for vaccines, they know the people there is easy access. they are widely distributed
perhaps even more widely distributed across the country. the extraordinary powers and access. they already have the built infrastructure someone can go who usually gives in my vaccines customer this the place i'm comfortable with.io they know how to build the new mass vaccination site. they are not -- make their aptly essential now address the two thirds of theio population who are just very comfortable with i need to get a vaccine and going to go to the quickest easiest place i can go too. i'll have that issue of equity in the don't have those barriers just sign me up. still have got a third of the population or a quarter. they need to have more intimate relationship with who
is vaccinated and the reasons why they are vaccinated. it's the primary care has the ability said of being a push what you do with large mass vaccination site you push people into that they were going to open up the registration process and will push you into the queue. primary care providers if you know they've not been vaccinated as it primary care program you run together with the state department. and the center for medicare and termination while the primary care sites including it's got a broad reach. were able to provide all of those primary care practices
and other congregant practices across the state. it tells every one of them does not pick the payer, in terms of their status whether immunized which vaccine they've had. they allows the providers who've not been immunized particularly with the sensitivity to the hardest to reach most vulnerable for a variety of reasons. sometimes that's racial sometimes it's ethnic. it's remarkable to see in the early days of the provide providers to pull people and based on their knowledge. people come in very easily and there also very insightful. this is waiting for you to be able to give me my vaccine. the results are they provide a very equitable product.
we look at the data people are vaccinated that's exactly the neighborhood the hurdle of nutley being acceptable but trusted. there also being accessible and equitable the sameta time. so it's not the only way to do vaccinations. clearly all the things he talks about before critically important. it goes back to being part of the medical neighborhood and being able to reach people exactly where they are to the tune of 20 million people or so in this country everyone needs to be reach in their own unique way. >> great, thank you, all of you. we have some questions that came in from the audience. we have limited times of goingqu to try to work my way through as many as possible.
and direct those questions to one of t you at a time if that's all right with you so we can get to many of these questions. or to start the question of lisa which is that you got a lot of work to do to communicate around along the grapevine, how do we make sure people like you have the resources to communicate those messages? and again not just organization such as yours but you mentioned very importantly social services organization as well as more medical entities in the medical neighborhood. how do we make sure they have the resources to address this issue? >> that is an incredible question i appreciate whoever asked the w question. i think this is about intention and will. we have a lot of resources and what's needed are financial. a lot of the organizations we have worked with that provide
food, housing, transportation or employee skill development support, these organizationso often struggle to make ends meet. so i think by intention dedicating resources for these organizations. and then lowering, reducing the barrier for them to access the resources and support. i think about the foundation and the funding organizations -- i do not want to be politically incorrect here. i think there is a miss match between the mission of a lot of these organizations the folks who hold the purse strings. in order to facilitate their involvement, their engagement trying to reach you really
have to help a system and gaining access to the financial resources. so that great, thank you so much lisa. and bruce, i went to go to youo next for a question. we have a really unusual circumstance right now which is that a number of healthcare workers in long-term care workers remain hesitant aboutno the vaccine are not moved e enough along in the continuum shall we say to vaccine acceptance. this seems to be different from what we have seen in the past but isn't that different? and how do we address it? so back thanks that is really important question. i think to me part of what this boils down to is it healthcare workers are affected. not everyone who's working to help industry has the same level of education the same access to information more from the communities than the
fact they wear a white coat during the day. think they need to acknowledge that in the regime. they tell us where these gaps are and to try again just because someone can help your does not mean they are brought into the whole thing. they have to have a clear understanding for them like anybody else. what is the issue? and how can we know if you understand that? it is been laid out a number l of times in healthcare. you see part of that argument as well. it falls down to having a candid conversation with a person on what their concerns might be. and the degree you can address those and have them make a best informed decision. >> great, thank you so much bruce. want to go to next with a question which came in from an audience member watching it on youtube. the process of getting a
vaccine still remains a barrier even if they've gotten past hesitancy towards acceptance. he talked about a number of things at cvs are doing to make that process easier. including working with lift to address the very important transportation component. what else should the task force recommended on that score for increasing the accessibility of vaccines through the medical neighborhood. to build confidence? >> there are a couple of issues. one is the supply has been constrained until recently. as the supply continues to accelerate that will allow for more locations. we believe pharmacies will be one of the many channels. the important challenge expanding a number of pharmacies such as hospitals,
community-basedon organizations that are able to provide vaccinations. but once you open up that site it is really important to amplify the awareness of that site. being available in that community and potentially even thinking about how to advance notified community make sure people are away the stores open in the office has the availability. and then i would say the other complexity that is been making it difficult for covid-19 vaccination has been the eligibility. thety eligibility has been difficult. it changes state-by-state and week by week, and month by month i think were getting to the other end of that. that opened up and really
three short weeks. they've really opened up. so increase location simplicity and we've seen that at the time. not the only ones but the ones i wanted to highlight to you.. >> rights, thank you so much. now let's take what think be our final question, doctor we will address this one to you.e we are now undergoing trials of the use of covered vaccine in children. but we need to anticipate parental concerns about vaccination of children. so thinking aboutfo that future and the adults were going to have to be communicated with about the safety of vaccines and efficacy of vaccines for children. how should we think aboute getting ready to undertake that part of the process?
potentially as soon later this year. these comprehensive as you can this is going to be but we had to do in the beginning of this pandemic being able to develop confidence to develop vaccine confidence with adults. it isn't another entire level of concern when you're talking y about your child. i am very encouraged although i'm not a pediatrician, i know the doctor is for instance, i have many, many colleagues and coworkers who are pediatricians. they have been communicating about vaccine safety and efficacy for many, many
years. probably more than anyone has. there is a hard-core group of vaccines, naysayers, doubters, still a small number will deny efficacy. we have seen over the years the outcomes for those in the infectious diseases scattered across the country because of those. i think will re- duplicate our efforts and pediatricians and states together in the nation will lean into give parents comfort. but it will have to be based on the same kind of scientific data the same kind transparency we have seen with every other aspect of this vaccine rollout. spain's - we want to thank all of you doctors for a terrific
discussion. we have heard so many additional perspectives from all of you this morning. starting with the notion that we have seen the movable middle and we have moved a lot of people from the movable metal to along that continuum that lisa described to vaccine acceptance. we heard very important observations that help people get there. their desire to see us all return to normal. there desire to be assured the vaccines are safe and effective pretext for importantly about the role of trusted messengers and making sure those messengers have thehe right messages and are well resourced in order to get those messages out. and very importantly about building out the components of the medical neighborhood including breaking and social service providerss and others who are able to get those messages out to people along these very important
grapevines that exist around our country. so thanks again to all of you. and thanks a particularly tort opening speakers, also to karen bromley from the cdc important to our task force members we hope this is been a very important informative session for all of you. we look forward to working with all of you as reformulate the very important recommendation till come out of this effort to continue to move the nation toward vaccine acceptance. not just for covid vaccine as we heard from bruce gallen, but for many vaccines to comfortably know unfortunately this will probably not be our last pandemic. we better figure out a way to get messages across effectively and importantly to populations. i cannot think of a better set the people to help us do that than those who have been with us today. thank you all very much great thanks to you who have joined us through youtuber various
modalities. and we wish you all a very good day. and a very, very successful experience as we as a nation begin to emerge from the pandemic. thanks again. yvette goes to c-span.org/coronavirus for the federal response to the coronavirus pandemic. if you miss our live coverage easy to find the latest briefings and find the response use interactive gallery of maps to file the cases in the u.s. and worldwide. go to c-span.org/coronavirus. >> cspan2 is your unfiltered view of government. created by america's cable television companies. today per brought to by these television companies who provide cspan2 to viewers as a public service. >> this week on c-span we are featuring the host of podcasts and joining us on this