COVID-19 Vaccine: Remedy for Mistrust
(Flaviovivoriosalles/Wikipedia Commons)
On Friday, April 9th, my mother received her second dose of the Pfizer COVID-19 vaccine. The following Monday she started feeling a pain in her right leg which she related to a flare-up of her right knee. By Thursday, she said that her leg now felt warm and was red; that she was experiencing significant calf pain. When she mentioned calf pain, all my nursing red flags went up. I asked her to head to the emergency department, but she waited until the next day.
The morning of Friday, April 16th, she called and said she was heading into the emergency department because she could not stand the pain anymore. A few hours later she called me to confirm that she in fact had a blood clot. Her voice, cracking with uncertainty and fear.
Given everything going on with the Johnson & Johnson vaccine, I cannot help but wonder why an otherwise healthy sixty-eight-year-old adult, with a very active lifestyle, and nothing listed under medical problems except glaucoma and an aching knee, would suddenly develop a blood clot.
In these COVID times of treatments and vaccines, I keep hearing Frankie Ruíz’s salsa in my head, blasting out of a gold 1984 Chevy Impala, “Amargura, señores, que a veces me da / la cura resulta mas mala que la enfermedad.”
In a year, COVID has claimed over 3 million lives worldwide, over half million of those deaths in the US. We’re learning about the long-term effects of surviving COVID and its impact on multiple systems of the body including the cardiovascular, respiratory, and nervous systems. We’ve learned that the disease has disproportionately affected the Latinx community. A CDC weekly report states that, “Hispanic and Latino people were 3.1 times more likely than non-Hispanic white people to be hospitalized and 2.3 times more likely to die from COVID-19 infection.” The overall picture of COVID v. Latinx Community has COVID winning by a segregated landslide.
I am a Latinx, community nurse* at a federally qualified health center in Connecticut, who has witnessed this pandemic from a different lens. While hospital nurses have been tending the sickest patients, the community nurse has been working hard to keep additional patients out of the hospital. We are helping patients manage their diabetes, hypertension, and asthma. We are in the frontlines in underserved communities across the state providing continued primary care as well as education about COVID testing and vaccines. We have been providing medical and emotional support in places where we saw people lose multiple family members in less than a month.
The history between the medical system and the Latinx community (in fact, all communities of color) has been horrific and has rightfully fostered wariness. From the exposure of prisoners in Guatemala to sex-workers with STDs to the sterilization and birth control method testing of Puerto Rican women, these are just some of the horrendous events that our community has experienced at the hands of medical personnel.
For forty years Puerto Rican women were being sterilized to reduce the overpopulation of poor people on the island. These women didn’t even understand the procedures that were being performed on them. As they were going into labor, they were being asked to sign paperwork that stated they understood the procedure. Between the language barrier and active labor, they could not possibly be expected to be in full consciousness to make an informed decision. When these women woke up from anesthesia, they learned that they could no longer bear children. An entire generation lost trust in the medical system with plenty of reasons to do so.
To some, these events (50-70 years ago) may seem far in the distance but we just need to look at the most recent actions of ICE Detention centers, where again, they began to sterilize women that called for a full ongoing investigation. We are still reliving the atrocities our grandmothers endured, and history repeats itself in the wombs of our daughters.
In a more local context, St. Alban’s Nursing Home community in Queens, NY, a nursing home medical staff gave Veteran’s unproven medication cocktails even though “public health officials had cautioned against the use of these [medications],” particularly outside of hospital settings. But it wasn’t until one of the residents had passed away and their relative received the final bill that she became aware of the medication cocktail listed. She shares that she was always informed of any medication changes. She states, “If they’d told me anything...I would have told him, you cannot give that to my father. He’s 93 years old,” Parson said. “There’s no way in hell I would have let them give my father that medication.” There should be no question as to why we side-eye your foggy white lens when we ask for transparency and it is masked in political jargon that is downplayed, leaving people grieving without a sense of closure.
While in most instances, vaccine hesitancy is a direct result of historical and present-day actions, evidence has also shown that the distribution of vaccinations has met its challenges with limited information, locations for vaccination, and doses made available. In Los Angeles, vaccines reserved for communities that were significantly impacted by COVID, were made available to some who gained access to codes that allowed them to schedule appointments in neighborhoods they never tread. A similar instance in NYC’s, Washington Heights neighborhood in January 2021, where local news source “THE CITY, found the site doling out scarce doses to suburbanites,” prompting the agency operating that vaccination clinic to “limit all new appointments to NYC residents only.” Even when systems attempt to create equity, the folks who have access to resources can gain access into spaces reserved for others. Stories are surfacing about places where these instances are also happening. We are learning that access is scarce-to-none, and that navigating the system for sign-up is daunting. This is not a new thing. These systems were never built to support all people, and blaming it on the pandemic is a scapegoat.
As a community nurse, I am responsible to all patients, particularly those who can not advocate for themselves. I reach real deep to find that place that remains hopeful. But hope can be so fleeting these days. And as our communities grapple between gaining confidence in getting vaccinated and navigating access, we learn about the Johnson & Johnson vaccine and our communities say a collective, “¿Ves lo que te dije?”
Under recommendation from the CDC and the FDA, the Johnson & Johnson vaccine was on hold to further analyze six very rare cases of blood clotting. There are many who still support the use of the vaccine, stating that it is “only” seven cases out of seven million but pause at this point. A total of seven people have been affected. These are not objects. With humans, one is enough to consider looking further into matters.
I find it even more difficult and quite disheartening that in the days that followed the J&J vaccine pause to see that in fact, Johnson & Johnson had asked Pfizer and Moderna for assistance in looking further into this and they declined citing a few excuses including that they didn’t want to be “tarnished by association.” This is where my job becomes increasingly difficult, because at the end of the day all the pharmaceuticals are focused on profit. They see each other as competitors versus collaborative partners in trying to protect people.
As I continue to vaccinate people, I am met with questions: “Have you had the vaccine yet? Did you have a reaction? Do you trust it?” I’m always honest. I tell them that I am cautiously optimistic but still skeptical, mostly because stock market folks are drooling and watching.
Daily I am reminded that our fear shows up even when we have resolved to do the thing that scares us. Before I give the injection, some patients do the sign of the cross, and say “en el nombre de Dios y la Virgen,” others take a breath and say a prayer that this vaccine won’t kill them, that they will be protected from the virus and the vaccine. One woman cried after I gave her the shot. Her husband died from COVID just four months ago. She was grateful to have been able to receive the vaccine, but sad that it didn’t get to her husband on time.
I pray, but my prayer is different. I pray that pharmaceutical companies be turned into non-profits so that “the bottom dollar” and “image” are not used to excuse the possibility of helping another company defeat this pandemic and other diseases together. I pray for a complete overhaul of systems that for too long, have injected poison into our bodies and lies into our communities.
*Author’s note: I don’t name my workplace since the views and opinions here are meant to reflect my professional and personal experience and in no way reflects the views of my employer, past or present.
Sarahí Almonte Caraballo, BSN-RN, CCCTM is a Dominican-Puerto Rican poet, writer, performer, and nurse raised in New York City who has been writing since the age of fifteen. Her writing is raw and real. She is a storyteller that is not afraid to be vulnerable on the page. She makes connections between her memories and the lessons she has taken from them.
Sarahí is an alumna of Voices of Our Nations Arts (VONA) 2020, Writing Our Lives and Sankofa Sisterhood Writer’s Retreat. She has performed her works at various community events and colleges and universities including Brown University, UCONN, Rutgers and Trinity College. Currently, she is working on her memoir in prose, Louder than Love.
Currently living in Connecticut, when she is not writing, Sarahi is a public health nurse who builds community trust one patient at a time. She is also a very tired mother of twin toddlers, known for making amazing forts out of bed sheets and sofa cushions. IG: @poeticlens Twitter: @SarahiYajaira