School of Nursing associate professor Alona Angosta knows first-hand the trepidation behind people who are wary of the COVID-19 vaccine.  Her own mother had concerns. She was unsure of its safety and efficacy, despite having chronic health conditions that the virus could exacerbate.

Like many nurses and health care professionals, Angosta has been advocating for a widely distributed vaccine. With her mother, she had to share research and reliable feedback from those who already had received it. It's a technique medical professionals — and the general public — can use to address vaccine reluctance.

Where does fear and doubt about the COVID-19 vaccine come from? What are effective ways to combat misinformation and build trust?

There are many people skeptical about the vaccine, particularly the marginalized populations, and people of color. Literature indicates there are factors contributing to this skepticism, mainly the lack of trust for the medical and government systems due to its historical roots. Other factors include safety and efficacy, long-term health effects, misinformation, politicization of the vaccine, uncertainty, lack of financial resources or health insurance, and accessibility. This is concerning because we already face health disparities, and COVID-19 has amplified this situation. For example, hospitalizations and deaths related to COVID-19 are higher among African Americans, Hispanics, and Asian Americans compared to whites. 

We need to double down our efforts in combating this problem. Honest messaging, listening to the vulnerable, providing empathy, acknowledging reasons for medical mistrust, and working with faith leaders within their communities may help build trust. For example, health care providers should have a one-on-one talk with their patients about the importance of getting vaccination. Social media posts of getting the vaccines by public health officials, nurses, and health care workers from diverse demographics is a powerful means of public awareness and may help promote vaccination. 

How does the COVID-19 vaccine work?

The two vaccines we have in Southern Nevada are the Pfizer-BioNTech and Moderna. These vaccines are fragments of messenger RNA that codes for the spike protein of the COVID-19. When injected, our own cells make the fragment of that protein, then we have an immune response to that protein. Two shots are needed to get the most protection. The timing between the first and second shot depends on the type of vaccine. For Pfizer-BioNTech, 21 days after the first shot and for Moderna, 28 days. The first dose of vaccine causes the immune system to generate a response and produces antibodies, which takes time. The second dose helps build up a longer and stronger response. 

How have you personally gotten involved in local vaccination efforts?

I was one of the first volunteers to administer the vaccines among the very first cohort in Southern Nevada in December. I also monitor those who received it and educate those who are giving the vaccine. It was reassuring to see the many volunteers. It made me feel good to see people who received the vaccine and, after 15 minutes, had no allergic reactions. I shared that information with my family members, friends, and colleagues, as well as my clinical patients and students.

When treating patients one-on-one, what methods do you use to ease their vaccine concerns? 

I share information highlighting the importance of getting the vaccine in terms of reducing health disparities because hospitalization and mortality rates are higher among communities of color than others. I’m also a vaccine recipient and discuss my personal experience. Being a role model can positively influence others to get vaccinated. Based on my own personal observation, those who are currently most receptive to take the vaccine are white and young adults.  

Tell us more about the reluctance among minority groups and communities of color?  

It's a combination of factors. There is a lack of trust in medical and government systems that's rooted in history. Lack of resources, transportation, and access to health care providers including telehealth services have also been reported. We are now seeing an equity crisis in the distribution of COVID-19 vaccines.  In Southern Nevada, there are certain ZIP codes that experience a high number of COVID-19 positive cases but have the lowest frequency of vaccination. According to Gov. Steve Sisolak, the Nevada Immunization Team will work with the Nevada Minority Health & Equity Coalition to create an equity task force to tackle this problem. 

How do you see this whole experience changing nursing education and clinical experiences? 

I see this as an opportunity to create and implement innovative teaching and learning approaches using technology while maintaining quality education. In clinical, we know telehealth will not go away even after the pandemic ceases. I think the telehealth model should be incorporated in any nurse practitioner curriculum.

Also, online lectures will be a permanent adjustment in nursing education and other programs. Faculty should be up-to-date and equipped with the best practices for teaching online to ensure quality education. I think [pandemic education] is more amplified, in terms of educating students and the public about infection control, use of personal protective equipment, and disaster preparedness. All these should be part of the nursing curriculum.