ARI SHAPIRO, HOST:
How do you distribute a coronavirus vaccine to millions of Americans who may be suspicious of authority or on the fringes of society, especially when those people are among those most at-risk risk of COVID-19? Dr. Julie Morita has been thinking and writing about these problems for months as Chicago's former health commissioner. And now she'll have an opportunity to shape these policies on a national level as part of President-elect Biden's COVID response team.
Dr. Morita, welcome to ALL THINGS CONSIDERED.
JULIE MORITA: Thanks for having me, Ari.
SHAPIRO: Well, let's start with this question of how you build confidence in a vaccine when there is so much suspicion and disinformation circulating. What do you think needs to be done right now, even before a vaccine is widely available to the public?
MORITA: So I think it's really important for people to have a sense of what's happening and what's been done so far, so very clear and concise and consistent messaging about the vaccine development process, the manufacturing process, the approval processes, just so that people have a sense that we're not doing this blindly, that the vaccine development that's happened with the COVID vaccine has been fast, but it's built on decades and decades of experience in making vaccines and distributing vaccines as well.
SHAPIRO: When you were Chicago's chief medical officer, you were involved in distribution of the H1N1 vaccine around the city. What did that experience teach you about how to address hesitation, especially in marginalized communities? And are there lessons there that you think the incoming Biden administration can apply nationally?
MORITA: Yeah, I think we learned a lot of lessons through the H1N1 pandemic in 2009. We were working frantically to get vaccine providers lined up to actually make the vaccine available. And we also hosted vaccine clinics in communities that are typically underserved or where their physician access is a little bit more challenging. And what we found was that these mass-immunization clinics that we hosted in some of our communities of color - the turnout for the vaccines was lower. And so at that point, we started reaching out to community organizations, faith-based organizations, to have them help us understand what was going on in the communities. Why weren't they turning out for the vaccine? Why weren't they getting vaccinated? And it...
SHAPIRO: So working through the organizations that are already in touch with members of that community.
MORITA: Right. So we were - we had organizations that we were already partnering with. We reached out to them and asked them to engage with us again. And it worked to some extent. But with that, we didn't get the success that we were hoping for. And so building on that experience in non-pandemic times, the health department and our partners worked to establish relationships on an ongoing time between pandemics so that we would actually have these relationships and could really rely on the information from those community groups to inform our planning for future pandemics. The current health department is actually tapping into and relying on those relationships now to really help to get the information to the communities and understand what their questions and their concerns are.
SHAPIRO: Interesting. But let me ask - there are real questions about vaccine safety. I mean, yesterday the CDC Immunization Advisory Committee recommended to give the first round of vaccines to health care workers and residents of long-term care facilities, but there has not been a lot of research into the effectiveness of the vaccine and the safety of the vaccine in the nursing home population. How can experts be sure that it is safe for them?
MORITA: So the information is being evaluated - will be evaluated by FDA to look at the safety and the efficacy to understand who the study populations included. The information that I've seen so far suggests that the vaccines are safe and effective in a wide range of age groups, a wide range of races and ethnicity. And so when that information is fully evaluated by the FDA's advisory committee next week, we'll have additional information to really inform the recommendations. What CDC - or the ACIP did yesterday was really make recommendations in anticipation of these results. But they can be refined based on what the FDA and their advisory committee actually determine.
SHAPIRO: Now, the CDC's reputation has taken a hit during this pandemic. Guidance on testing and school reopenings has sometimes been influenced by political pressure. So how do you think a new administration can restore confidence in the agency?
MORITA: So I think one of the things - when I think about the vaccine situation currently, the key thing to keep in mind is that the ACIP is not - it's an independent group of physicians, scientists, public health officials who come together and really review the data, review the facts, review the evidence and then make a...
SHAPIRO: That's the advisory committee, yeah.
MORITA: That's the advisory committee. And they make recommendations to CDC, and then CDC then makes recommendations. And by and large, those recommendations that the ACIP makes the CDC usually makes as well. And so we'd be looking for - after the recommendations are made ACIP, what does CDC actually say? Is there alignment, is their agreement with what ICIP is saying as well?
SHAPIRO: Now as you know, distribution of the vaccine is going to be handled by the states. And a couple of weeks ago, I spoke with the head of Maine's Center for Disease Control and Prevention, Dr. Nirav Shah. And he told me his state does not have enough money to build the infrastructure required to make sure everybody who needs it gets the vaccine. Here's what he said.
NIRAV SHAH: We at the state level are ready to receive the baton, to have that baton passed to us to begin the vaccination process. But without proper funding, it'll be like putting up tent poles without having the tent.
SHAPIRO: And he said this is true of many other states, too. So, Dr. Morita, do you think the federal government is ready to provide the money that is going to be necessary?
MORITA: I think it's important to provide the adequate resources to public health. What I've seen in the past in public health emergencies during my 10, 20 years at the Chicago Department of Public Health was that there would be large boluses of funding that would come to public health agencies at the state and local level during a crisis and then shortly after the crisis, but then the funding would actually go away. And so public health infrastructure really has suffered over time. And there is a need. There's a strong immunization system that's in place, but it has to be enhanced and it has to be strengthened so that actually people can actually get the vaccine in an equitable fashion.
SHAPIRO: That's Dr. Julie Morita. She is executive vice president of the Robert Wood Johnson Foundation, which is a funder of NPR. Today she was speaking with us in her personal capacity as a volunteer for the Biden transition team's COVID-19 board.
Dr. Morita, thanks for your time.
MORITA: Thank you.
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