An informed guide to the pandemic, with the latest developments and expert advice about prevention and treatment. |
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 | | The New York Times |
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This week the last federally operated mass vaccination site in the U.S. closed, along with many state-run locations. |
The shift away from high-volume vaccination centers is a major turning point in the country's vaccination effort — but also an acknowledgment of the hard road ahead. Health officials are pivoting to the so called "ground game": a targeted, labor-intensive mobilization effort to persuade vaccine-hesitant people to get their shots. |
Convincing this group isn't easy. Dr. Anthony Fauci said he spent 90 minutes yesterday in Newark talking to people on their front porches, offering incentives and gift certificates if they would walk just the few blocks to get a shot. Many were hesitant and Fauci was able to persuade only about 10 people to get a dose. |
If a celebrity doctor is struggling to change people's minds, what hope do the rest of us have? For tools, I turned to Dr. Arnaud Gagneur, a neonatologist who devised a successful prepandemic method of speaking with mothers who were hesitant about vaccinating their children. |
For many people, it's sufficient when an authority — like a doctor — offers reassurances that vaccines are safe and essential. But for those who are vaccine hesitant, this approach can backfire because the patient may feel a lack of autonomy. |
Gagneur suggests motivational interviewing, used frequently to treat addiction, to engage people "in the spirit of compassion, without judgment, and in partnership to find their own motivation to change." |
Start with an open question. The goal here is to establish trust and determine the main reason for someone's hesitation. Examples include: What do you think about the Covid vaccine? What more do you want to know about the vaccine? |
Listen, and remain open. It's important to show that you are in favor of vaccination, but also open to the idea that someone may not be open to immunization, Gagneur said. "Try not to give all of your arguments for immunization at the beginning because you are going to pick a fight and they will be thinking of all the counterpoints they have, and it's not going to be very constructive." |
Introduce new information. That may include explaining how the vaccine was developed, or the science behind it, or the side effects. It is crucial, Gagneur said, to "ask for permission to give the new information. Because if people allow you to give new information, they are going to listen to you. But if you give unsolicited information, they are not going to listen to you." |
Ask them about potential upsides. Maybe it's being able to travel, or protecting a grandparent, or going to school without a mask. Whatever it is, don't suggest reasons, Gagneur said. "It's more effective if people express it themselves." |
Take it slow. "If you're faced with very hesitant people, you will not change their mind in five or 10 minutes," Gagneur said. "If you move too fast it could be counterproductive. So you could say, 'Thank you very much for the discussion, and if you want, we could have another discussion tomorrow, or in two weeks, or whenever.' This is important. It's a seed we put in someone's mind that they can trust us, that we are going to listen to them, and that we are not going to make them change their mind too quickly. And you can continue the discussion later." |
When the virus breaks through |
Quite rare — but the vast size of the immunized population means that there is a considerable number of cases, including the TV host Bill Maher and the Yankees' two-time All-Star shortstop, Gleyber Torres. |
As of April 30, out of about 101 million vaccinated people at the time, there were about 10,000 breakthrough infections reported in the U.S., according to the C.D.C. The agency has since stopped recording infections that do not involve severe symptoms. |
How serious are breakthrough symptoms? |
Because of the protection provided by the vaccines, experts say that most infected people who had been vaccinated are likely to have mild symptoms — nasal congestion and mild body aches — or no symptoms at all. That might be more severe for vaccinated people with weak immune systems, older adults and people with certain medical conditions. |
What if it happens to me? |
The guidelines are not much different than for unvaccinated people who get the vaccine, though the chances of severe Covid cases are much lower. |
If you are fully vaccinated and experience symptoms consistent with Covid-19, the C.D.C. recommends that you self-isolate. If you test positive, experts suggest you participate in contact tracing efforts, inform your health care provider and, if you leave home, go to the doctor, wear a mask and practice social distancing. |
Are breakthrough patients infectious? |
A vaccinated infected person — even one without symptoms — could pass the virus on to someone else, including children under the age of 12, who currently don't qualify for a vaccine, and people who cannot get a vaccine because of immune-related or other health issues. |
Experts say that the level of virus in the nose and aspirated droplets are not as contagious in a vaccinated person. Nevertheless, you should still wear a mask around others, disinfect surfaces, and turn on fans and open doors to increase ventilation. |
What else we're following |
I worried about our pandemic baby's social skills. Would she be terrified of people? Or would quarantine be a comfort? Then she made a friend. Our neighbor, Ms. Wong, is 94, lives alone, and speaks only Cantonese. Our daughter spotted her sitting in the window one day and lit up with delight. Ms. Wong tapped on the window and waved. These days, Ms. Wong sits in the window at our usual walk time. Our daughter looks up at the window, waves and squeals, "Hi!" Ms. Wong taps and waves back. We didn't see grandparents. Our baby didn't have play dates. Ms. Wong was her first friend. They were both born in the roaring twenties (1920s and 2020s). Their unexpected friendship has been a joy of the pandemic. — Juliet, San Francisco |
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