I thought it might be interesting to compare strategies, to show my audience a well-established framework.
Traveling
Someone asked about how a disease, that originated in China, wind up in America: "Travelers"
Think about what happens during a pandemic ... borders, train stations, and airports close.
If we look at the Aedes mosquitoes and how they made it to the America: a couple who owned an import-export company brought them from China to El Monte.
I learned in graduate school that the US has quarantine stations along the perimeter of the US [airports, train stations, and ports]. If that doesn't make you feel safe. We have them, also, globally in case someone is found to be sick with a communicable disease, you're not coming into our country. A lot of people dis the CDC, lol, trust our public health agencies are amazing.
Want to read more? [https://www.sciencedirect.com/topics/nursing-and-health-professions/quarantine-station]
Smallpox History- 6th Century—Increased trade with China and Korea brings smallpox to Japan.
- 7th Century—Arab expansion spreads smallpox into northern Africa, Spain, and Portugal.
- 11th Century—Crusades further spread smallpox in Europe.
- 15th Century—Portugal occupies part of western Africa, bringing smallpox.
- 16th Century—European settlers and the African slave trade import smallpox into:
- The Caribbean
- Central and South America
- 17th Century—European settlers bring smallpox to North America.
- 18th Century—Explorers from Great Britain bring smallpox to Australia.
- https://laist.com/news/entertainment/los-angeles-smallpox-epidemics-1800-can-teach-us-about-covid-19-plague-history
Early Control Efforts
Smallpox was a terrible disease. On average, 3 out of every 10 people who got it died. People who survived usually had scars, which were sometimes severe.
One of the first methods for controlling smallpox was variolation, a process named after the virus that causes smallpox (variola virus). During variolation, people who had never had smallpox were exposed to material from smallpox sores (pustules) by scratching the material into their arm or inhaling it through the nose. After variolation, people usually developed the symptoms associated with smallpox, such as fever and a rash. However, fewer people died from variolation than if they had acquired smallpox naturally.
The basis for vaccination began in 1796 when the English doctor Edward Jenner noticed that milkmaids who had gotten cowpox were protected from smallpox. Jenner also knew about variolation and guessed that exposure to cowpox could be used to protect against smallpox. To test his theory, Dr. Jenner took material from a cowpox sore on milkmaid Sarah Nelmes’ hand and inoculated it into the arm of James Phipps, the 9-year-old son of Jenner’s gardener. Months later, Jenner exposed Phipps several times to variola virus, but Phipps never developed smallpox. More experiments followed, and, in 1801, Jenner published his treatise “On the Origin of the Vaccine Inoculation.” In this work, he summarized his discoveries and expressed hope that “the annihilation of the smallpox, the most dreadful scourge of the human species, must be the final result of this practice.”
Vaccination became widely accepted and gradually replaced the practice of variolation. At some point in the 1800s, the virus used to make the smallpox vaccine changed from cowpox to vaccinia virus.
[https://www.cdc.gov/smallpox/history/history.html]
Global Smallpox Eradication Program
In 1959, the World Health Organization (WHO) started a plan to rid the world of smallpox. Unfortunately, this global eradication campaign suffered from a lack of funds, personnel, and commitment from countries, and a shortage of vaccine donations. Despite their best efforts, smallpox was still widespread in 1966, causing regular outbreaks across South America, Africa, and Asia.
The Intensified Eradication Program began in 1967 with a promise of renewed efforts. Laboratories in many countries where smallpox occurred regularly were able to produce more, higher-quality freeze-dried vaccine. Other factors that played an important role in the success of the intensified efforts included the development of the bifurcated needle, the establishment of a case surveillance system, and mass vaccination campaigns.
By the time the Intensified Eradication Program began in 1967, smallpox was already eliminated in North America (1952) and Europe (1953). Cases were still occurring in South America, Asia, and Africa (smallpox was never widespread in Australia). The Program made steady progress toward ridding the world of this disease, and by 1971 smallpox was eradicated from South America, followed by Asia (1975), and finally Africa (1977).
When did smallpox vaccine become mandatory?
A 1905 decision provided a powerful and controversial precedent for the flexing of government authority. In 1901 a deadly smallpox epidemic tore through the Northeast, prompting the Boston and Cambridge boards of health to order the vaccination of all residents. Aug 2, 2021
So, you can recognize the similarities in getting people to get vaccinated. Smallpox, Cholera, & the Plagues don't play & people got vaccinated. There are funding problems, non-believers, conspiracy theories, fear of government control, time need to isolate the disease and find the etiology; it's all part of the process. What you've seen with Covid-19 is par for the course.
We are very fortunate today, because we radio, TV, social media ... so many ways to get the word out; to educate and bring people on board for vaccinations.
Vaccine inequity is "just one part of a larger picture of inequity," Colgrove says. "People have been unvaccinated for the same set of reasons that they have always been deprived of other material goods."
For every vaccine, there's been a campaign against it
"Anti-vaccination movements are as old as vaccines themselves," Bhattacharya says.
What drives people to oppose a vaccine? You have to look at what is happening in a country or community culturally and politically and that is where you'll find your answers. It is usually a combination of factors that create doubts about how safe and effective a vaccine is, Bhattacharya says.
But what really gets people riled up, Colgrove says, is when governments mandate vaccinations. "What gets people marching in the stress, forming orgs, creating pamphlets is when governments start to require it. If you don't want the vaccine, but you don't feel like anyone is forcing you to get it, then you just don't get it. Anti-vaccination movements really arose in the mid-19th century when governments started to require it."
There have always been trust issues
A vaccine campaign must address the issues of trust between those giving the vaccines and those receiving it, Bhattacharya says. You can't run it just with logistics. The vaccine campaigns that don't take trust into account end up struggling while the process drags on to get a disease under control.
In the case of polio, Bhattacharya says, it was difficult to convince communities to get the vaccine in places where governments hadn't acted in the communities' interest on other issues.
"It was about [the government] convincing people that the polio vaccination was about their best interests in a context where governments had done little for their general welfare. This was the context in which polio vaccination drives were resisted in northern India, for example," Bhattacharya says. People have said it was superstition about the vaccine that prevented Indians from getting the vaccine, but it was actually about "a fundamental lack of trust."
It's all about the advertising
To get the word out and make a convincing argument about the vaccine, it's all about marketing and messaging. Advertising techniques were first used in the 1920s for diphtheria immunizations, Colgrove says. (Think images of smiling babies with warnings in red ink that diphtheria kills.)
The way a vaccine is given is also critical. The first oral vaccine in the 1960s for polio replaced the hypodermic needle. It certainly made it much easier to sell to those who might be hesitant or fearful of needles, Colgrove says.
"Needle phobia is a big deal, and orally administered vaccines are more acceptable to many people. Also you don't have to worry about the injection equipment [which was helpful for mass vaccinations]," Colgrove says. "In fact one of the reasons the global polio eradication ended up being so successful was they used the oral vaccine as opposed to the injected vaccine." The oral vaccine also did a better job of protecting against the virus.
Politicians love their mottos and the vaccination effort is no different. In the U.S., government officials called it Operation Warp Speed and now the "We Can Do This" campaign. In Germany, it's "Vaccinate, Vaccinate, Vaccinate." In Israel, it's "Getting Back to Life."
So, how much of vaccine production and distribution is about political power and money?
Bhattacharya says pretty much all of it. "Pandemic responses, including the vaccination programs that underpin them, are always political," he says. "Those who claim that they know the means of accentuating 'global solidarity' are no less political; they just have different political goals."
And the money? Most vaccines wouldn't exist if Big Pharma didn't make a profit off them, Colgrove says.
One of the criticisms is that we have vaccines for diseases that burden rich countries but not for those that plague poor countries — such as malaria and dengue fever. "If those diseases were a problem in Europe and the U.S., we would probably have vaccines for them now."
That's the contradiction of the pharma industry, Colgrove says. "On the one hand they produce these drugs for the benefit of everyone, but their mission is to make profits for their shareholders."
What will the world say about the COVID-19 vaccination effort in 100 years?
People will not remember the details, Colgrove says. Take, for example, the polio vaccine rollout, he says. If you ask people today, they would say it was a huge success, but they forget it was total chaos for a while.
"There were a lot of problems with the initial distribution during the period when the demand exceeded the supply. The polio vaccine was developed by a nonprofit foundation. The U.S. government had very little involvement because the Eisenhower administration saw involvement as the opening for socialized medicine.
"There was also lots of confusion and uncertainty about who should get the vaccine first and supplies were limited. There were stories of rich people pulling strings to get their kids vaccinated first."
When it came to the COVID-19 vaccine, the Centers for Disease Control and Prevention knew there were limited supplies so it was able to prioritize certain populations such as health care workers and older people, Colgrove says. "But I think the way people will remember the COVID rollout will depend on what happens in the coming months and years."
No one can deny the incredible feat of making vaccines in a year. But Bhattacharya points to another legacy.
Bhattacharya says it's unfortunate, but this vaccination effort will be all about profits, not humanity — the world was let down when it comes to equity and access to the vaccine.
[https://www.npr.org/sections/goatsandsoda/2021/05/14/991201743/photos-vaccine-history-repeats-itself-sometimes]
The 1947 Smallpox Vaccination Campaign in New York City, Revisited
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323221/]
Get Vaxxed, Move On With Your Life
If it's highly unlikely you'll get COVID-19 or spread the virus, there isn't much more to it than that.
t's time to stop waffling about this: if you're vaccinated, you can move on with your life. Enough with the obsession over breakthrough cases. COVID-19 is never going away. Never. It will become endemic, like the flu or the common cold or any manner of other diseases we lived our lives knowing we could get before March 2020. We still left the house, went to work, got on crowded subways, ate at restaurants, went to concerts. Maybe now we'll do some of that in masks. If you're vaccinated, the odds are overwhelming that if you are exposed to the novel coronavirus, you will not be hospitalized or die. The situation in many American hospitals right now is dire, and our collective treatment of healthcare workers at the moment is shameful, but it is almost exclusively the unvaccinated fueling this problem.
And, as Craig Spencer, an ER doctor and Director of Global Health in Emergency Medicine at New York Presbyterian/Columbia University, laid out in an article in The Atlantic on Thursday, you are in no way as likely to spread the virus when you're vaccinated compared to an unvaccinated person.
To spread the coronavirus, you have to have the coronavirus. And vaccinated people are far less likely to have the coronavirus—period...
Despite concern about waning immunity, vaccines provide the best protection against infection. And if someone isn’t infected, they can’t spread the coronavirus. It’s truly that simple. Additionally, for those instances of a vaccinated person getting a breakthrough case, yes, they can be as infectious as an unvaccinated person. But they are likely contagious for a shorter period of time when compared with the unvaccinated, and they may harbor less infectious virus overall.
...Among the unvaccinated, the virus travels unhindered on a highway with multiple off-ramps and refueling stations. In the vaccinated, it gets lost in a maze of dead-end streets and cul-de-sacs. Every so often, it pieces together an escape route, but in most scenarios, it finds itself cut off, and its journey ends. It can go no further.
By all means, get yourself a booster shot if that'll give you some peace of mind. If you remain at higher risk, you may want to continue avoiding places where you're likely to find indoor crowds. At places like supermarkets, which anyone, including higher-risk citizens, will need to frequent, it doesn't hurt any of us to wear a mask. If you're going to interact with a high-risk person, you should take all the precautions you feel are necessary—getting tested before, meeting outside, wearing a mask. We need to get kids vaccinated, even if it is very rare for them to have severe outcomes. But by and large, the way forward is clear: get vaccinated, then choose your own adventure. Life goes on. Get back to yours.
This also seems like better messaging for the vaccination drive than, "you can maybe still get the virus, and your life might not change that much..." Even, "protect yourself and others" isn't the best message for many Americans. "Get vaxxed and people will leave you alone" might be the ticket. We don't have time for equivocation about what the vaccines do, doubt and inconsistency that does not reflect the reality. If you're vaccinated, you're less likely to get COVID, less likely to have a severe case, and less likely to spread it—all by wide margins. Billions of people are fully vaccinated without any adverse consequences. We're doing fine!
Consider all of the above The Carrot, though we ought to also just straight-up pay people to get the shot like New York City has begun to do. The Stick is, so far, the large-employer mandate the Biden administration has instituted and some state-level mandates that go beyond that. Personally, I would go with restricting bars, restaurants, theaters, stadiums, concert halls—anywhere that large groups of people congregate on a voluntary basis—to those who provide proof of vaccination. You want to enjoy some of the best things in life? Get vaxxed and move on with yours.
[https://www.esquire.com/news-politics/a37721242/vaccinated-far-less-likely-to-spread-covid-19/?source=nl&utm_source=nl_esq&utm_medium=email&date=092421&utm_campaign=nl25135710&utm_term=AAA%20--%20High%20Minus%20Dormant%20and%2090%20Day%20Non%20Openers]
COVID-19 Public Education Campaign
[https://wecandothis.hhs.gov/]
We're All In. Together we can stop the spread of COVID-19
On January 30th, 2020, the World Health Organization announced that the COVID-19 outbreak was a Public Health Emergency of International Concern and on March 11th WHO described the COVID-19 situation as a pandemic. As of March 30th, 2020, it has been reported in all countries except the Region of Antarctica. This means that Trinidad and Tobago have not been exempt as we have had over 100 positive cases and 8 deaths.
In light of this, The Pan American Health Organization World Health Organization (PAHO/WHO) has embarked on a communications campaign that seeks to raise COVID-19 awareness and response. This campaign is aligned with the Government of Trinidad and Tobago’s effort to prevent, contain, and mitigate the impact of COVID-19 in Trinidad and Tobago. [https://www.paho.org/en/campaigns/were-all-together-we-can-stop-spread-covid-19]
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