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Health care providers work to ensure everyone gets second COVID-19 shot

The news about COVID-19 vaccines has only been getting better in Kern County: Every week there are more doses, more places to get vaccinated and more locations accepting everyone.

Now the effort is shifting gears: making sure that everyone can get a vaccine and get it most effectively. For the two most widely available vaccines — Pfizer and Moderna — that means getting two doses the way the drug manufacturers intend.

That's especially important for the communities that have been hit hard by COVID, said Jay Tamsi, co-founder of the Kern County Latino COVID-19 Task Force. But as more residents have been getting their first shots, he and community partners started noticing something worrisome. One weekend 100 people called into the task force's mental health hotline wanting to cancel appointments for their second vaccine shot.

It started about two weeks ago, said Bianca Torres, the hotline's manager. Now she and other health care providers in Kern County are trying to get the word out that it is just as crucial to get that second shot of Pfizer and Moderna as the first. Torres and her operators do it caller by caller, and they have a good success rate, she said.

Some callers feel secure after getting one shot: they were canceling shots in lieu of a trip. But most were worried about how they would fare after the second dose, when side effects tend to be more pronounced.

"People were saying they heard the symptoms would be bad," she said.

Torres notes that bad news about the side effects of the second dose tends to travel more quickly than the stories of people who have none. She tells callers that some people may not have any symptoms while some have flu-like symptoms that will usually resolve within a day or two, like a headache, fatigue, body aches, chills, fever and nausea.

She stresses that getting one dose is only one half of the medicine, and they need both doses to be as fully protected as possible.

That lines up with a statement put out by the FDA in January warning that there has been little study on how well and how long a single dose would offer protection. In clinical trials, Pfizer was 95 percent effective and Moderna was 94.1 percent in preventing COVID-19 in trials that used two doses.  

"If people do not truly know how protective a vaccine is, there is the potential for harm because they may assume that they are fully protected when they are not, and accordingly, alter their behavior to take unnecessary risks," the statement read.

Torres reaches out to the public phone call by phone call, but the Kern County Latino COVID-19 Task Force in partnership with Dignity Health is working on scaling up the messaging through employers.

Dignity Health created a flyer in English and Spanish that it has distributed to the Kern County Farm Bureau that employers can distribute to farmworkers, according to Robin Mangarin-Scott, vice president of marketing and communications at Dignity Health Central California.

She notes that for agricultural workers, there are many reasons that they are not getting vaccinated or fully vaccinated, including untrustworthy information or because they don't feel like they have the time.

Mangarin-Scott noted that even health care workers within Dignity Health needed reminders to get their second shots, though largely they have been on track. But farmworkers have been hit particularly hard by the pandemic.

That's why Dignity Health is concentrating vaccination and education efforts in those communities and pushing the information through employers, so workers know they are supporting the effort to get them fully vaccinated.

"In order for us to move to some sense of normalcy, it’s critical that that second dose is received," she said.

Health care providers say that as they start to focus on harder-to-reach communities that haven't been vaccinated yet, the Johnson & Johnson vaccine, which requires only one dose, will be especially critical, according to Kiyoshi Tomono, Kern County Community Partnership Executive at Adventist Health.

So far the availability of the Johnson & Johnson vaccine has been relatively scarce compared to Pfizer and Moderna. But Tomono said that Adventist Health has been reserving it for the mobile vaccination clinics that reach homeless and rural populations.

"Once you get that person once, and they feel slightly ill, they may not be back," he said. "Or it may be hard to find that individual again."

Even those reached by these clinics who do intend to come back for the second shot and don't need extra education, might have hurdles like finding transportation. Having to arrange two dates within a specific window becomes so much more logistically challenging than finishing a vaccination all in one swoop. It also allows the clinics to hit more places since they only need to show up once.

That's just what happened in Boron where Adventist Health was able to vaccinate 600 people with the Johnson & Johnson vaccine recently. The provider is hoping to do the same for many more outlying and underserved communities in Kern County.

Tamsi and Mangarin-Scott said they're working every day to advocate for the Kern County Latino COVID-19 Task Force to receive more Johnson & Johnson vaccine.

In the meantime, Tamsi suggests those who are truly worried about side effects to schedule it before a day off. And he points out that even the worst side effects are nothing compared to the worst case scenarios of what could happen if you or someone you love contracts COVID-19.

"You’d rather have a few side effects than COVID and end up in the hospital," he said.