S1E80 / Vaccine Joy / Andy Slavitt & Celine Gounder

Well, it's a really interesting question is how do we get closure in this pandemic? And I think a lot of people, to really reconcile what happened, have hurt and have loss to deal with that has not been acknowledged. I think acknowledging that loss and acknowledging others' loss, even if it's different from your own, is very important and it can be done in a very generous way.

You're listening to Epidemic, the podcast about the science, public health, and social impacts of the coronavirus pandemic. I'm your host, Dr. Celine Gounder. Over the past year and a half, all of our lives have been touched in some way by COVID. When the first case of coronavirus was reported in the United States in January 2020, most Americans didn't think much of it. Now words like quarantine, pandemic, and mRNA are part of our everyday vocabulary. I saw firsthand the devastation that the virus caused in hospitals. We were overwhelmed. Patients were dying. I walked by mortuary trucks parked near the hospital on the way to work. PPE was scarce, and there was so much we didn't know. All these emotions and questions were in the air when we launched this podcast. Listening back to those early interviews feels like opening a time capsule. One of our first guests was a former head of the Centers for Medicare and Medicaid Services, Andy Slavitt.

So let's think about 3 things we're going to need.

We're going to need testing.

We're going to need therapeutics, and eventually, soon, hopefully around the corner, we're going to need a vaccine.

Back then, even getting a COVID test was a challenge. Vaccines felt like a distant dream. But in December, the FDA authorized the first COVID vaccine. And when President Joe Biden took office on January 20, 2021, Andy was there. He was a senior advisor for the White House Pandemic Response Team.

If you put yourself back to January 20th, not only were thousands of people dying every day, but people were confused and upset about not being able to get a vaccine.

Now the challenge was getting these newly authorized vaccines out to the country.

We had to really work to increase the availability, the access of vaccines, particularly in communities that were suffering the most. And we needed to work to really help Americans get the facts that they needed to make a decision about whether to get vaccinated or not. And I think those two efforts have been critical. Neither one are done yet. And of course, we've got to start to do those things, the same things we've done here in the US. We've got to do them around the globe.

At this recording, 56% of adults in the United States have been fully vaccinated. New COVID infections in the US are at the lowest they've been in over a year. But among those who are not vaccinated, transmission rates are as high as they were back at their peak in January. The pandemic isn't over. But after this, our 80th episode, we've decided to conclude this season of Epidemic. In this final episode of the season, we'll hear more from Andy Slavitt. We'll talk about his new book, Preventable. We'll reflect back on the journey to vaccinate as many Americans as possible. And we'll hear about the challenges that lie ahead.

So I hope that as a country, we start to have a dialogue which acknowledges what so many people went through and how it didn't have to happen. Because only through that dialogue are we slowly going to be able to make the real substantive changes.

But we're also going to do something different. We're going to hear stories from you, our listeners, about how getting vaccinated has changed your life.

When I got the actual COVID shot, I was overjoyed.

We got the call and I was like, oh my God, really? And I go, I gotta go. I got a vaccine appointment. Bye.

It felt amazing, you know, to like touch somebody else.

You know, it's given me a degree of freedom that I think I'd kind of forgotten existed for some time.

Today on Epidemic: Vaccine Joy. Here's my conversation with Andy Slavitt. Communities of color have suffered disproportionately. They are getting left behind in terms of vaccination coverage. What are some of the strategies that the administration recently rolled out to address that, and why were those selected?

We are intercepting a problem that has been ongoing for generations, which is the inequity in the healthcare system, just plain racism and structural racism. Racism, access to child care, the inability to get off work, the people working multiple jobs, distrust of the medical system. So unless we talk openly and honestly about those issues and address them, we don't solve them. So for example, we have community health centers in neighborhoods that are going to disproportionately serve communities of color. And over the last, I'd say, month if not more, something like 60% of the shots given out through the federal channels have gone to people of color.

How do we get Americans to care about COVID in some of these more left-behind vulnerable communities, not to mention in the rest of the world, even if things seem to be returning to normal in their own lives?

As tough as the pandemic was on certain communities, there are other communities that it wasn't hard on at all. There's a chapter in the book called "The Room Service Pandemic." And if you were on the room service ordering side of the pandemic, you were getting Amazon packages every day, living in comfortable and safe housing, and the threat wasn't very real to you. The problem was, in order to get that food delivered to you, there were people who have to grow it in the ground. There are people that have to serve it up to you in the store. And so we went through the pandemic in a way that structurally said, if you work in a job that serves the needs of the privileged parts of the population, you're going to need to keep doing your job even if it puts you at risk.

So in the last few weeks, a number of states have passed laws restricting public health authority. What does this mean about what we've learned from the pandemic, and what will that mean for the next epidemic or pandemic?

I think we're a country that believes that we're largely immune to the world's problems. And I think that's very much a function of who we've become as a society. If we had asked people to say, sorry, you're not going to be able to have as much beef but hundreds of thousands of more people would live. That's a very difficult thing for a country to accept in the year 2020. Now, my grandmother lived through a 10-year depression and a 6-year world war. She went through years without even getting a cup of coffee. If I have to skip my Starbucks dark roast in the morning, I get whiny. That's kind of where we've evolved, and that makes us less prepared and less capable of fighting a pandemic, but it also makes us less capable of looking out for one another. And I think we saw that during the pandemic.

So how do we get Americans to sacrifice on behalf of one another? And how do we create a culture of public health? At least in my mind, a culture of public health would be recognizing the need to protect the most vulnerable, not the most privileged.

On our best days, I think this country is capable of anything. But it does require leadership. It does require a mentality that's different than the mentality that managed the pandemic for the first year. And it probably requires that this country come to grips with the fact that we have taken away a safety net. We have eaten holes in it in the name of saying we don't want to have a big deficit or we don't want to pay too many taxes. So I hope that as a country, we start to have a dialogue which acknowledges what so many people went through and how it didn't have to happen.

So you describe in your book that sort of change in attitude begins by grieving everything that we've lost. And that's not just about grieving lives lost, but also things like businesses lost or lost school years. Could you talk a little bit about what we need to be grieving and how to bring people together?

I think acknowledging that loss and acknowledging others' loss, even if it's different from your own, is very important. And it can be done in a very generous way. And rather than compare suffering, maybe coming out of the pandemic, we can treat each other better than we often did during the pandemic.

So finally, Andy, tell us a bit about when and where you got vaccinated and how that experience made you feel.

I felt the sense that a lot of people have felt, which is probably a rush of all of the things that have been missed and lost, not just by me, but by, but by others. This sort of opportunity to return to The people I loved that I hadn't seen. Recently, having been vaccinated, I have seen my mom, my wife and I and my kids have gotten together. So, you know, those things that we may have taken for granted once are hopefully things we won't take for granted again in the future.

Vaccination allowed Andy to reconnect with his family and all around the country, others are doing the same. We'll hear stories about how vaccines have transformed people's lives. And I'll offer some final thoughts on this season of Epidemic. That's after the break. When we put out a call for your stories about vaccine joy, it probably won't surprise you that we heard from a lot of people who've been working on the front lines of the pandemic.

Peace and blessings, everyone.

This is Jumaane Williams, the Public Advocate of New York City.

In March, I got my vaccine.

I was excited to have access and the ability to be civic-minded, not just protecting myself and my family, but to protect the entire community. Very rare is something that you can do to protect everyone.

Getting the vaccine is one of those.

Hi, my name is Stella Sappo, and I'm an HIV primary care doctor based in Brooklyn, New York, and I got vaccinated for my patients. When COVID first hit New York, a lot of my patients who have HIV were really scared to leave their house. And throughout the pandemic, we were really worried about what would happen to people who had a compromised immune system. So once we knew the vaccines were safe, I was able to get vaccinated, and it makes me able to take care of my patients much better than before. And I encourage everyone to go ahead and get vaccinated. It's really the only way forward. Take care.

Hello, Epidemic Podcast. My name is Vic Lawyer. I'm a physician assistant at Clark Fork Valley Hospital. In western Montana. The COVID vaccine has changed a lot of aspects of my work. I'm the health officer for our county. I work in primary care, and now every visit I have with every patient is about the same basic principles of how these vaccines work, why they are so important, and why people might be hesitant to take them and how to help them overcome those concerns.

Hi, my name is Magaly from Seattle, Washington. I was very excited to be vaccinated after losing my grandma Dolores from COVID and working as a Spanish-speaking contact tracer. I've talked to so many households who have had just a household member become infected with COVID because someone wasn't able to work from home or were working in a service industry and weren't able to leave. And so I'm really doing it for the people who live within my own county and just the greater population.

New York City was ground zero for COVID back in the spring of 2020. So when vaccines became available, Wesley Hamm was eager to get vaccinated.

And I registered for a vaccine, like, pretty early.

Wesley is an educator and software designer who lives in Brooklyn with his partner Natalie. Getting to see family again was his top priority.

The first thing that went through my mind was that my mom would be able to get it. Our family is getting older and we wanted to see them, but we didn't want to put them at risk.

Wesley hadn't seen his family in person in more than a year, and a lot had happened in that time.

I was really excited to see my mom because she's been sick. She got diagnosed with cancer during the pandemic. You know, my dad's gone. She's been— she's been alone.

Wesley's dad had passed away a few years before. The thought of losing his mom to cancer or COVID was scary. His mom went through chemotherapy and lost her hair, but Wesley couldn't be there for her because of the virus.

Because of the pandemic, but also because she's been going through cancer, she couldn't really see friends because she needed to really stay away from people.

But in the middle of all the chaos of the pandemic and his mother's illness, Wesley's family was growing.

My sister had a baby, so my mom hadn't even met her grandchild yet, her first grandchild. So yeah, I was excited for us to all see each other.

And as soon as he and his partner were vaccinated, they immediately started mapping out an itinerary for a family reunion. They got in the car and drove to Virginia to see Natalie's parents.

When we got to their house in Virginia, we pulled up, we parked, we walked around the back of the house. They were all sitting in the garden, like, having drinks and snacks. And we all went to hug. And I think, like, her parents had hugged each other, but they hadn't hugged anybody else in a year and a half. And we all started hugging and everybody started crying. And I realized I hadn't hugged anyone other than Natalie, you know, in a year and a half or whatever. It felt amazing to, like, touch somebody else.

Next, they flew to Baton Rouge to see his mother.

So she drove and picked us up at the airport. She pulled up and she had hair, and I was like, shit, I thought you lost all your hair. Your hair already grew back? But it was a wig. But it was a good wig.

His sister and brother-in-law drove in from Houston to introduce Wesley to his nephew Noah for the first time.

I was really proud of my sister and her husband because they were trying to have a baby for a really long time. And they were pretty down about not being able to conceive and they really wanted it. And she had a lot of difficulty even while pregnant, a lot of health issues. So it's a hard thing and it was especially hard for them.

Being reunited with his family for the first time in more than a year brought back a lot of memories.

You know, a lot of family pictures came out trying to figure out who Noah looks like. All these baby pictures of, you know, family members and me and my sister when we were young.

And Wesley couldn't help but think about his father.

He would have obviously loved to have met Noah. So to like sit there looking through family albums and see Noah playing on the floor, just to see like a future member of the family, you know, while we're sitting around reminiscing about the past and family members, it felt special.

The vaccine made it possible for Wesley to finally reunite with his family, old and new.

Hey, Dr. Gounder, it is Jana from Brooklyn, and I'm a Black woman, Black teacher, math teacher, and I just want to share why I got the vaccine. I'm actually terrified of COVID and I knew that if I had any chance facing this virus that I would probably die. So I got the vaccine for my sake. I also want to see my family. They are far and apart from Florida to England all the way to Jamaica. So I made sure I got the vaccine to protect them as well.

The vaccine has changed my life by reconfirming the power of science and data to solve real human problems. It also makes me profoundly grateful to the scientists, the doctors and nurses and essential workers who saw us through the worst parts of this pandemic so I could be so lucky to have access to care when many people elsewhere in our country and in the world are still struggling.

Hi, my name is Gemma. I was vaccinated 2 months ago here in Crown Heights. I was able to do that because I have asthma, and it has changed my life a lot. At this point in time, my whole family has also gotten vaccinated. So it's been really great to spend time with everyone inside and not have to worry about it. You know, it's given me a degree of freedom that I think I'd kind of forgotten existed for some time.

So my name is Jeff Lando. I am a 10th and 12th grade English teacher at Lafayette High School in Wildwood, Missouri. I have ulcerative colitis, which is an autoimmune disorder that messes with your gastric system. And what that means is that I am on several immunosuppressant drugs. Were I to catch COVID my body would not be able to fight back the way that a non-immunosuppressed person would be able to. I remember those very early days when there was very little information about COVID I was paranoid about going anywhere. I do remember the first time, you know, I went to stop to get gas because like my car needed gas. I was really worried about getting out of the car and just even standing next to somebody at the next pump. That seemed like, you know, dangerous. I did not go to the grocery store for a year, basically. So our school decided to go back to in-person education 4 days a week. And so that meant that October, November, December, and January, so basically 4 months, I was in person with my students, but I was not vaccinated. And that was really scary. I did have several N95 masks, and I wore those every day into the building, and I never took them off. Not even for water or food. I ate lunch in my car, for instance. So I made sure that any time I was in the building, I had on that N95 and it never came off my face for anything. I was vaccinated in very late January and early February. I remember walking out just feeling like, wow, you know, I cannot believe that it's been, you know, a year plus since I've been able to really be a part of the world. And yet I just got this almost what seemed like a magic drug, this magic formula that's gonna allow me to reenter society and to go back into my classroom and all the things that I'd been missing for so long. So the first thing that made me sort of realize that my phase of being really on edge and scared and worried, I knew that was over when I got my first COVID shot 2 weeks had passed and my best friend, who was another English teacher at the school, came into my room and said, "Do you wanna have lunch together?" And I had been eating lunch in my car every day for 4 months. And so, you know, I thought to myself, "Okay, I got this magic shot. Like, I should be able to do this safely." And it was really scary, but we took off our masks and we sat in my classroom and, you know, for 25 minutes we had lunch together and we sat far apart, But it was amazing. Like, I had not seen her face in months and it felt, I don't know, I'm Jewish and we call it a mitzvah, you know? It was like this amazing blessing that we were able to do this. And so it really felt like we were sort of seeing each other again, meeting each other again, you know, for the first time in over a year. You know, there's something very intimate about taking off the mask at this point and eating with another person. And that all felt like something that that we just couldn't do for so long, and just to have that community again that we'd all been missing for a year plus. And that was really special.

Vaccines have let people safely gather with friends and do things together they would have taken for granted before the pandemic. And they also made it possible for some to have their wedding.

My name is Naseema Safi. I'm a doctor, a writer, and a content curator who's currently taking care of patients at Lummi Nation. I've been vaccinated since January, but other than huge relief that I wouldn't become seriously ill from COVID or die from it, my life didn't change very much until later this spring when all all my family members got their shots. Our first big collective moment of vaccine joy arrived when my youngest sister got married, itself a pandemic romance fairytale. Only immediate family attended and all of us were vaccinated. It was so special to celebrate, cook, and hug each other indoors and unmasked. It was at once strangely normal and also like a precious, longed-for gift that I, for one, will never take for granted again.

We liked this story so much, we asked Nassim to put us in touch with her sister Leila and her husband Justin so we could hear them tell the whole story.

I'm Leila Assefi, and Justin and I know each other actually from high school.

I am Justin Barnes, and I will confirm what Leila Assefi said.

In the summer of 2019, the two of them reunited in Moscow, Idaho for their 20-year high school reunion. Justin and Leila hit it off and after the reunion kept in contact and exchanged text messages, but they lived on opposite ends of the country, so planning dates was complicated. Even so, they found a way.

My family lives in Seattle, so I go to Seattle often, and Seattle isn't too far away from Idaho. It's about a 5-hour drive.

So in the fall of 2019, Leila planned a trip.

I threw out, hey, well, what about meeting up in Seattle, just the two of us? And then we chose a weekend to fly to Seattle to spend together. So that was our first date, was a weekend in Seattle together.

And it went well.

I just took the leap of faith and it was the best decision I ever made.

Around the same time, Leila moved to San Francisco. Now that they were at least a bit closer, it was easier for Leila and Justin to begin a long-distance relationship. But come winter, news of the virus grew more menacing.

I said, hey, if this comes into and takes hold in California, they're going to shut your office down. And so that's when we really had that initial conversation about what is our plan if this happens and how bad it could be.

Justin was right. Shelter-in-place orders started to go out across the country, and Leila headed up to Idaho to quarantine with Justin.

I packed my car with as much stuff as I thought I needed and took the 2-day drive here.

Leila thought she'd be there for just a few months.

I didn't even bring summer clothes here because I was convinced I would be going back and it would kind of blow over.

Justin and Leila's relationship had been put on fast forward. Suddenly they were both living and working from the same home. But as it turned out, Moscow, Idaho was a pretty good place to hunker down and quarantine.

Yeah, that was one of the great things about living where we are, where once you step, you know, a foot outside the town here, you have mountains and rivers.

One of their favorite things to do was go on hikes near their house. And in August 2020, Justin decided to take another leap during one of their daily walks.

And so I remember he asked earlier, do you want to go on a walk? And I said, I do. But the thing was, I had a 6:00 PM Zoom call that night, so I couldn't be late for it. And this was like 4:45 PM when he asked me.

They went to a nearby stream where they often saw animals. But Justin wasn't himself.

I'm like on a mission because I don't like to be late for things. And so he was kind of lollygagging, and he's a fast walker. I'm the slower walker of the two. I think I said, what are you doing? Like, chop chop. Like, I got, I got, I got places to be.

Justin kept insisting he wanted to show her a beaver he'd seen the day before.

And so I get there where he was, and he's like, well, I have a really important question I want to ask you. And then he got down on one knee and totally caught me off guard. So that's, that's how he did it. And I am proud to say I was only 5 minutes late to that Zoom call and I was totally distracted for it, for the record.

Justin and Leila were engaged, but the pandemic wasn't close to being over. Leila and Justin signed up for a vaccine waitlist for unused extra vaccines. Leila got a call in February 2021.

I remember being on the phone and it was a Sunday and there were multiple inches of snow. And then we got the call and I was like, oh my God, really? And I go, I gotta go. I got a vaccine appointment, bye.

Leila and Justin were the first people in their families to get vaccinated. But by May, most of Leila and Justin's immediate family had been vaccinated and they could finally throw a small wedding.

We had planned for May 8th and everybody had been vaccinated and had been, you know, at least 2 to 3 weeks removed from their vaccination. And it was just this celebration, not only of Leila and I, but I think the bigger thing was here was the first time we were together with our families.

But Leila and Justin were not sure that everyone would be able to make it.

My sister Seema, she has been spending the last year in New Zealand. She's married to a Kiwi.

The infection rate in New Zealand has remained relatively low throughout the pandemic.

They have been able to be there for the year and essentially live a COVID-free life.

But New Zealand, like many other countries, struggled to get enough vaccine supply for their citizens. And until she could get vaccinated, Seema wouldn't be able to come.

I had already kind of mentally prepped that she wasn't going to be there, which was really sad because she's my sister.

But then at the last minute, something wonderful happened.

And then she was able to get a vaccination appointment. It was like the best delight ever.

During quarantine, Seema and her husband had been posting daily videos of them singing songs.

And they called it Quarantunes.

Zima played a recording of one of their performances at the wedding, one that was made specially for Justin and Lila.

One night we had requested them to play "Don't Stop Believin'." This is a song that we have about Justin and Lila. And they had performed it and taken a video of it, but doing a rendition to our love story. It was totally— it was hilarious and awesome.

Looking back over the last year, Justin says it feels like he won the lottery.

It was almost like Leila and I arrived at the craps table on a night at a casino, and we arrived with $2 when we met at our 20-year reunion, and we walked away 18 months later millionaires.

But the past year also put things into focus for them.

This pandemic was awful, but it also made us realize the value of family, friends, touching each other. But it also helped us reconnect with a lot of people that we hadn't had a chance to connect with. I would say the worst but best year of our life.

It's been 16 long months since we released the first episode of this podcast as the pandemic was taking off around the world in late February of 2020. Like many of you right now, I'm experiencing a lot of different emotions. I'm relieved we're seeing fewer and fewer patients sick with COVID at the hospital. I'm thankful I got vaccinated. And as a healthcare worker seeing patients on the front lines, I got vaccinated early. But my husband and my family weren't eligible to get vaccinated until this spring. Between that wait and my work, we didn't start to see friends in person until recently. That's been literally life-changing and life-affirming. Last week, I saw my mom, my sisters, and their families for the first time since December 2019. There's so much for us to celebrate right now. But meanwhile, 3 members of my family back in India have died of COVID Others have been hospitalized. We live in two worlds: the vaccinated, for whom the pandemic no longer threatens our personal health, and the unvaccinated, for whom the pandemic continues. In this country, especially people of color and essential workers who've suffered the most throughout the pandemic. It could be years before much of the world gets vaccinated. We still don't have enough supply for everyone. And even if we solve that problem, we'll then need to figure out how to get shots in arms. Our experience here in the US shows how challenging that can be. And we're still in a race— vaccines versus the variants. The Delta variant that emerged in India and others like it could jeopardize the progress we've made toward getting back to normal life. I started my career in the 1990s working in tuberculosis and HIV. What I'm seeing now has me terrified. COVID is quickly turning into diseases like TB and HIV, diseases of vulnerable communities here in the US diseases of the global south, relegated to the history books in the minds of some, but among the deadliest infectious disease killers in the here and now for so many. I fear we'll soon turn our backs on those who don't share the privilege of vaccination and immunity. This is the last episode of this season of Epidemic. We're closing the season not because the pandemic is over or because there's no work left to do, but because my staff and I need a break. We're going to take some hard-earned time off to recharge. I'll be doing some fundraising because, like I say at the end of every episode, we've got to pay our staff, and salaries and benefits don't come free. And we're going to get to work reporting and producing our next seasons of Epidemic and our sister podcast, American Diagnosis. Season 2 of Epidemic will go back in time to the history of smallpox eradication on the Indian subcontinent, one of the final frontiers in the battle against smallpox. We'll step back and reflect on lessons from that pandemic and how we can strengthen public health in the here and now. We may also release some bonus episodes of Epidemic for you this summer if there's important breaking news. So this isn't goodbye or mission accomplished. This is be well, celebrate, and remember, we'll be back soon. EPIDEMIC is brought to you by Just Human Productions. We're funded in part by listeners like you. We're powered and distributed by Simplecast. Today's episode was produced by Zach Dyer, Temitayo Fegbenle, and me. Our music is by The Blue Dot Sessions. Our interns are Annabel Chen, Brian Chen, Sophie Varma, and Julia Levy. If you enjoy the show, please tell a friend about it today. And if you haven't already done so, leave us a review on Apple Podcasts. It helps more people find out about the show. Follow Epidemic on Twitter and Just Human Productions on Instagram to learn more about the characters and big ideas you hear on the podcast. We love providing this and our other podcasts to the public for free, but producing a podcast costs money, and we've got to pay our staff. So please make a donation to help us keep this going. Just Human Productions is a 501(c)(3) nonprofit organization, so your donations to support our podcasts are tax deductible. Go to justhumanproductions.org/donate to make a donation. That's justhumanproductions.org/donate. And if you like the storytelling you hear on Epidemic, check out our sister podcast, American Diagnosis. On American Diagnosis, we cover some of the biggest public health challenges affecting the nation today. Past seasons covered topics like youth and mental health, the opioid overdose crisis, and gun violence in America. I'm Dr. Celine Gounder. Thanks for listening to Epidemic.