A veterinarian’s take on vaccine hesitancy

In your op-ed, you point to herd immunity and the concept of humans being more like herd animals than we might think. Had you thought about that concept before this pandemic?

That’s something that just came up for me during the pandemic. I was trying to link the day-to-day work that we do with animals as veterinarians with the diligent and responsible use of vaccinations. So that was kind of the tag line I took with the op-ed, a way of engaging in a compassionate conversation. That’s my goal with any of these hard topics, whether it’s racism, climate change, vaccine hesitancy. We need a language and a frame with which we can talk to our audience.

We veterinarians know our clients pretty well. We know the farmers; we know the farm laborers, families, community members. We know the land and places where they live, we know about their values, and, importantly, we understand the animals. So the main point of the article was that, the same people who are hesitant about vaccines for themselves also understand that, if they don’t vaccinate their animals, they’re really in trouble. Their livelihood, their responsibility to the community, are all at stake.

Humans don’t live like solitary animals. We sit around the table with people, we go to the Rotary Club, we go to religious services together, we socialize and we work together. There’s just no way with a highly contagious disease that we could treat ourselves different than herd animals. The principles are the same.

One thing that stood out to me about your article is that there seemed to be an assumption of trust between farmers and their veterinarians.

You’re absolutely right. Veterinarians are one of the top most trusted professions. You’re on the farm, there in the farmer’s house, showing up at all hours. There is a deep trust around the animals because the animals are so important to them. It’s their livelihood.

The goal is to leverage that trust to be an access point for medical knowledge. As a veterinarian there are things you observe on the farm: who may be unvaccinated, who has a chronic disease that needs to be managed, who has issues with mental health, substance abuse.

I think it’s challenging because you have this trust, but you don’t want to lose the trust. You don’t want to push it too far. I joined Twitter recently and am trying to give my perspective there as a veterinarian. I have a love-hate relationship with it. But people are appreciative of good information. And veterinarians have a perspective on everything: climate change, racism, pandemics, food insecurity. We need to speak up.

As dean you’ve launched several dual degree programs, including one between Penn Vet and the School of Social Policy & Practice. Can you speak to how cross-disciplinary programs might allow veterinarians to address social and health issues in their communities?

I could talk all day about this. At Penn, because of the environment and geography of campus, with a medical center along with all the other schools in one place, it facilitates interdisciplinary training. There is a real sense of porous borders and a collaborative spirit.

We are the only school that has a dual degree with the VMD and social work. We have dual degree programs with nursing and with public health. The idea here is that veterinarians can be access points for health.

If you want to help somebody who you know probably needs a new hip or has diabetes or has a problem with alcohol or drugs, you can talk about it, but you’re not going to get very far or be able to refer somebody to a doctor or social worker unless you have professional credentials and you are integrated into the health care system.

I spoke on this earlier this month on a panel of the Pennsylvania Senate Agricultural Rural Affairs Committee, about the mental toll of the pandemic and diminished health care and social services in the rural environment. Having these credentials will expand the capacity of veterinarians to address these gaps in care.

To make participating in these programs more actionable, Penn Vet is growing our scholarship pot right now. Our VMD-PhD program is fully funded, but we don’t do that for our master’s students yet, so we want to move in that direction.

The other thing is, once we get credentialed people out there, we also need to provide a plan to integrate them and connect them with other human health care providers; that’s what I discussed at the Senate panel. We’ve put a proposal in to the Commonwealth to add veterinarians into the integrated health care system: Adding Veterinarians to Integrated Care in the Commonwealth of Pennsylvania. The acronym is ADVICE-PA. The idea is that we have subject matter experts who are trained as veterinarians with a second degree in nursing or social work or some other allied health care field. So if you had a veterinary practice somewhere, you can call them up and ask for a medical consult or a mental health consult. Integrated care is everywhere now; we want to be part of it.

You ended up getting certified as a vaccinator and have now vaccinated hundreds of people against COVID-19. What was the experience like?

I think in July or August of 2020 it was clear to me that there was going to be a vaccine, and I started preparing, even inviting the CEO of Pfizer to be our school’s commencement speaker. I was super excited about the vaccine; I felt, like many people, that’s how we’re going to get out of this.

And my feeling was that veterinarians could contribute to the vaccine rollout. We vaccinate animals all the time. So I put together a proposal to the Pennsylvania Department of Health and anyone who would listen in the legislature, designating authority to veterinarians to get credentialed to vaccinate people against COVID-19.

Pennsylvania didn’t do much with that proposal for several months. Then in March of 2021, President Biden authorized veterinarians and veterinary students to administer vaccines, and that’s when the Commonwealth pulled the lever and enabled veterinarians to be designated vaccinators.

But we still had to become certified through the American Pharmacists Association, just like pharmacists. That’s a 20-hour course. We had to do live, in-person CPR and basic life-support training and certification. We at Penn Vet had trained about 30 people. It was a community effort.

And individuals in that group started vaccinating whenever and wherever they could. When I worked at vaccine clinics in the summer, I always chose a place where I felt there was a health disparity. I did my work mainly in Chester, Pennsylvania. I vaccinated hundreds of people. It’s incredibly rewarding. People were so appreciative of getting the vaccine.

But then it seemed like we were going to get through the pandemic and nobody new wanted the vaccine, and the mass-vaccination sites dried up.

At that point, I still really wanted to be out there helping. I had joined the Delaware County Medical Reserve Corps in the spring of 2021. Once you’re part of it, you start receiving emails that you’re deployed. It’s all voluntary—we’re not paid volunteers—but in the fall we started seeing massive numbers in the hospitals again. There were cries for volunteers.

The Saturday before Christmas, the Pennsylvania National Guard called on county medical corps to help in the hospitals. I was called up and did some shifts. Bottom line is you’re a nursing assistant. They give you an N95, and then you’re taking vitals, cleaning beds, moving patients. It’s the simplest things you can do to help out. The nurses are so appreciative.

For me it’s a life experience. I was called up. And what it’s done is open my eyes about the social determinants of health. Intellectually and as a veterinarian I knew what that was, but now I’m seeing it with my own eyes: the social, economic, political, and environmental factors that make you sick in the first place are all on display during this pandemic. And it’s gotten me incredibly interested in the veterinarian’s role in mitigating these factors, speaking out, and understanding the intersectionality of what we do with those social determinants. It’s reaffirmed that our roles in the future need to be broader and more intersected and interconnected with the other disciplines.