Reflections From A “Trusted Community Messenger”

Rhonda Moore Johnson, MD, MPH
5 min readJul 19, 2021

https://www.youtube.com/channel/UCom_B8Wj5txTJTYY6sb8CcQ

For much of my professional career, I have done community education and health promotion. With all of the confusion and misinformation surrounding the pandemic in year one and the vaccine roll out in 2021, I voluntarily became what is now called a “Trusted Community Messenger” and volunteered time to combat misinformation for family and friends. I created a YouTube channel for home videotaped educational messages. This volunteerism also led to a paid short-term consulting role to support a local health department’s education and community effort’s related to COVID-19 and the COVID-19 vaccination program. In full transparency, I was never paid by any of the pharmaceutical or vaccine manufacturers and I have no conflicts of interest to disclose.

My audiences are what most people characterize as “hard to reach” and they could probably be classified as “vaccine hesitant” to “vaccine opposed.” I have done both in person and virtual sessions as a volunteer and paid consultant with health care workers, community groups, faith-based congregations and employees of health care services institutions. The audiences have been diverse in terms of gender, age, race, ethnicity, and education. Some of these sessions have included written surveys from participants immediately post-presentation to determine their willingness to get vaccination. In other sessions, I would take notes on the questions asked by participants — especially on mis-information and myths on social media that I was unaware of.

There are many reasons people are hesitant and opposed to receiving the Covid vaccine. In their own words; these were written responses from unvaccinated health care employees in sessions I conducted in mid-April:

· I am not ready

· It’s my body, my choice

· I’m still waiting for more data

· Not been tested long enough

· Concerned about the effects on fertility

· It’s my personal choice not to get the vaccine

· I’m healthy, I don’t believe in this shot, I will take my chance

· I just do not have enough information to decide

· I want more information about long term effects

· I’m not ready and I don’t think I ever will be ready

· I don’t believe someone should take anything where there is not enough information about long term side effects.

· Why take something that could make me sick?

· Why aren’t they reporting how many people are getting very ill?

· I’m unsure how my body will react to it

· Lack of trust in the system

· Personal and religious reasons

· As an individual that is often sick, I do not feel confident in getting the immediate shot side effects that would cause a loss of work

· I just don’t trust it

· I can still get Covid so why would I get the shot and not know what is going into my body

· I do not feel comfortable administering foreign bodies into my body without extensive research. My immune system has been working thus far and God willing will continue to.

· This won’t protect you 100%

Most sessions conducted from January through June had a high degree of engagement as by the number of people asking questions and they appeared interested in learning more about the manifestations of SARS-COV-2 infection and the Covid-19 vaccines.

If I could group the key themes for vaccine refusal across all settings that I have been engaged in educational outreach from January to June:

· Overall fear (non-specific)

· Concern for possible infertility and babies being borne with birth defects and autism in child bearing age women

· Concern about side effects (short and long-term)

· Concern about vaccine safety

· Concern about having to miss work from vaccine side effects

· Feelings of “it’s my body and my right to refuse.”

In majority Black audiences, the Tuskegee Syphilis Study emerged as a major reason for distrust with expressions such as “why would I trust a government sponsored vaccine — when the same government has allowed slavery, Jim Crow, discrimination and medical experimentation?” Some Black attendees strongly believed that herbal supplements such as sea moss, elderberry and foods such as garlic, ginger, lemon tea / lemon water — would strengthen their immune systems and provide protection against infection. Others struggled with feelings of conflict with their faith — they had to “pray about the vaccine.”

Reactions were mixed on the topic of incentives — it depended on the incentive and the affinity a person had towards the incentive. Parents of college age students responded favorably for the possibility of a free tuition, state lottery type incentive; beer drinkers responded favorably to the possibility of free beer incentives; most rejected the offer of “being paid on the job to take the Covid vaccine” — especially the health care workers who said they are required to take flu shots every year without paid incentives.

I have seen on some occasions where a few very vocal participants try to influence the less vocal. Ideally, I think the optimal environment is to conduct informational sessions with small groups of four to six participants when feasible. I have learned that convincing the vaccine hesitant will take patience, understanding, and for some, repeated informational sessions from multiple trusted community messengers. Who people trust is an interesting topic. In some sessions with younger black males, their trusted messengers were athletes, in particular, various Pittsburgh Steelers coaches and star players. I also observed that people responded intently to peer led testimonials — especially those who have recovered from serious Covid illness. And surprisingly, I frequently heard people say “my doctor told me to wait.”

My key learning — we clearly have a long way to go to increase vaccination rates amongst those who have not been vaccinated. I realize that this writing offers nothing new to the knowledge base but I wanted to share my journey. As for my experience as a YouTube creator and the comments from those opposed to Covid vaccination — well, that’s a story for another time.

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Rhonda Moore Johnson, MD, MPH

Dr. Rhonda Moore Johnson is an award-winning medical professional, author, social media influencer and educator. She is a health equity champion.