12/28/2020    Robert G. Smith DPM, MSc., RPh

NY Governor Signs Order Allowing Podiatrists to Administer COVID Vaccine ( Joseph Martin Quezada, DPM)

I fully respect the opinions and belief systems
of learned colleagues; and would like to foster
an open dialogue. I wish to offer my opinion
centered on Covid-19 vaccine hesitancy and wish
to provide a mitigating and buffering response
that may be used by podiatric physicians who wish
to participate with administering the Covid-19
vaccine and provide data to their patients as a
public health initiative.

As I have viewed this vaccine hesitancy through
the eyes of practicing two professions as well as
an FDA and DEA advisor; the most widely
recognized category of unavoidably unsafe
products is prescription drugs. Some courts hold
that all medications automatically qualify as
unavoidably unsafe on the theory that public
policy favors the development of beneficial drugs
even if their introduction poses some risk.

Further, as a pharmaceutical legal advisor some
courts also find medical devices, vaccines, and
blood products are unavoidable unsafe. When
deciding whether these products are unavoidably
unsafe the court may look at the type and quality
of research done on the drug or device. Courts
also look at how necessary to human life and
public health the product is and whether the FDA
looked at it to determine its risk vs utility.
Other products that have generally qualified as
unavoidably unsafe include guns, cleaning
compounds like commercial dry-cleaning solvent,
industrial-strength bathroom cleaners, and
acetone, as well as benzene and cosmetics like
hair perms, bleach, and dye.

There is no unique form of vaccine hesitancy, nor
a single reason behind this hesitancy: reasons
are contextual (cultural, religious, and
geographical) and sometimes even vaccine
specific.

Examples of tools to be used to counter Vaccine
Misinformation and Hesitancy
a. Multidisciplinary approach-Work
collaboratively
1. Utilize specific evidence-based strategies
2. Effective communication
3. Educate Children on the importance
immunization for health
4. Ensure healthcare professionals know their
impact on vaccine decision making
5. Use effective parent/patient discussion-
communication techniques
6. Use clear langue; be aware of effects of
framing
7. Reinforce the important of role community
protection
8. Address pain at immunization

b. Social Media
c. Culturally tailored approaches for diverse
ethnic populations
d. Dispel false information
e. Social Marketing
f. Use of digital surveillance and mobile apps by
public health officials
g. Utilize Storytelling
h. The Power of Experience
i. Vaccine Ambassadors

Specific questions that may invoke vaccine
hesitancy:

1. COVID-19 vaccine will give you COVID-19

Answer- None of the United States vaccines
contain the live virus.

2. COVID-19 vaccine will cause you to test
positive for COVID-19

Answer- Current United States vaccines in
development would not cause a patient to test
positive for COVID-19.

3. If I’ve had COVID-19, I won’t benefit from the
vaccine

Answer- The amount of time someone has protection
after being infected with COVID-19 is uncertain.
Therefor having both natural and vaccine-produced
immunity is important.

4 “I’m healthy and most people have very mild
COVID-19, so I won’t need it.”

Answer- At this time it is not known how severe
an illness could be or if could be pass to
another individual.

5. The vaccine has been developed too quickly. It
can’t be safe.

Answer- Indeed the process was sped up in time;
However, the number safe precautions applied to
the vaccines tested were also increased during
this time frame.

6. Natural immunity is better than vaccine-
acquired immunity.

Answer- It is important fact that both natural
and vaccine-produced immunity is important.

7. Vaccines contain toxins.

Answer- First, formaldehyde is diluted during the
vaccine manufacturing process, but residual
quantities of formaldehyde may be found in some
current vaccines. The amount of formaldehyde
present in some vaccines is so small compared to
the concentration that occurs naturally in the
body that it does not pose a safety concern.
Secondly, Thimerosal is a different form of
mercury (ethyl mercury) than the kind that causes
mercury poisoning (methylmercury). It is safer to
use ethyl mercury in vaccines because it’s
processed differently in the body.

Robert G. Smith DPM, MSc., RPh

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