S2:E23: trials and tribulations

Thursday, March 4, 2021

//

Shelter in Place is now part of the Hurrdat Media network. Hurrdat is a digital media and commercial video production company based in Omaha, NE. Find more podcasts and learn more about other services at HurrdatMedia.com.

-------

We’re proud to be sponsored by Delta Wines, whose dedication to fighting climate change is rivaled only by the quality of their delicious wines. Use the code SHELTER to get 10% off your order and support this show.

Have you taken our listener survey yet? We’d love to hear from you. Your advice and feedback will help us with everything from creating future episodes to talking to potential sponsors. Find the link on our website.

Thank you for sharing Shelter in Place with your friends! When you sign up to share using our unique referral link, we'll send YOU a special thanks!

https://refer.fm/shelter

-----

Episode description: COVID-19 cases are dropping as more people get vaccinated — so why isn't everyone pro-vaccine? These are questions about who we trust, where we get our information, how we make decisions — and what is our duty to society. Laura finds some encouraging answers by talking to an Dr. Joyce Sanchez, and a vaccine trial participant.

Show notes:

Dr. Joyce Sanchez is a graduate of the Johns Hopkins University School of Medicine, where she stayed to complete her internal medicine residency.  She received her infectious disease fellowship training at Stanford Hospital and the University of Minnesota.  She began her career at the Mayo Clinic in Minnesota, then joined the Medical College of Wisconsin in 2017 as Assistant Professor of Medicine in the Division of Infectious Disease where she serves as director of the Travel Health Clinic and Infusion Clinics.

Dr. Sanchez is an advocate for interprofessional collaboration and medical education, particularly as they relate to infectious disease topics of global significance with high impact on the Midwest. Dr. Sanchez has given over 50 invited regional, national and international presentations in the last 5 years.  She received an “Excellence in Clinical Teaching” award by Mayo Clinic’s Internal Medicine Residency Program in 2015 and a teaching award from the Medical College of Wisconsin School of Medicine in 2020. 

Garnet Henderson’s short bio:

Garnet Henderson is a journalist and professional dancer in New York. She reports on the intersections of culture, health, and science, with a particular focus on reproductive health and abortion access. She is the host and producer of ACCESS: A podcast about abortion.

-------

This is Shelter in Place, a podcast about coming together in a world that pulls us apart. From Oakland California to Hamilton Massachusetts, I’m Laura Joyce Davis.

Garnet: All day and night I heard sirens. I felt like people were dying all around me, and I live alone so I was also terrified of dying, because even though I'm young and healthy, I heard all these stories about people with COVID who felt okay until they were on death’s door. And I felt like if that happened to me, I would just die because there's nobody else who lives with me, who could call 9-1-1 for me. I would weigh fear of the vaccine with the very real consequences of getting COVID.


I got the vaccine. My fear is not gone. But I don't lie awake at night anymore worrying about dying alone in my apartment.  I would choose that any day over the risk of getting COVID.


Laura: So much of this past year has been marked by fear, but lately I’ve been feeling more hopeful. In the last six weeks, new coronavirus infections have fallen by almost 70% nationwide. For the first time in a while, health professionals are making predictions that actually sound optimistic. They’re talking about summertime, about returning to some sense of normalcy, about maybe even seeing the end of this pandemic. 

But beneath all of that optimism there have also been other conversations. When a pregnant friend who is an essential worker in hospitality decided to get the vaccine, she opted not to post it on social media because she’d already received criticism from some of her friends who were worried about the vaccine’s safety. Others feel disgruntled that they aren’t getting their shots first. Misinformation is so rampant today that it can be tough to decipher between truth and fiction. Our near-constant consumption of information combined with the daily grind of a very long pandemic year has caught us in an exhausting cycle of suspicion, confusion, overwhelm, and fatigue.

According to a new poll from The Associated Press-NORC Center for Public Affairs Research, 1 in 3 Americans say they definitely or probably won’t get the Covid-19 vaccine. Among the top concerns are the speed at which the COVID-19 vaccine was developed, fear of side effects, and distrust of pharmaceuticals and the government. This poll is highly concerning, especially to the experts, who say that vaccinations are necessary to reach herd immunity and end this pandemic.

Over the past couple of months, our team at Shelter in Place has been talking a lot about vaccines for what we thought would be a single episode. We were interested in exploring vaccine hesitancy not just because we’re in the middle of a pandemic, but because it was becoming increasingly clear that the conversation was about more than medicine. Beneath our views on vaccination are bigger questions: Do we have the right information to make good decisions? Does that information match or contradict our personal experiences? Can we trust that the information we’re getting is true?

These are the same questions we ask in conversations about education or immigration or gun control or climate change. They tap into the values and experiences that matter most to us. Often we let those questions guide us without even realizing how profoundly they affect us

Rather than tackle all of those questions at once, we’re going to take them one at a time over the course of several upcoming episodes that explore why a third of our adult population feels hesitant about COVID-19 vaccines--and also what questions are behind that skepticism. 

Today, we’re going to tackle the first of those big questions: What information do we need to make good decisions?

If you combine my extended family with my husband’s together we come from no less than ten essential workers in medicine . . . which is to say that I have no excuse for not being more knowledgeable when it comes to all things medical. Medicine was the background noise to my childhood, the conversation that floated down the hallway between my open door and my parents’ late at night, the topic of almost every dinner conversation. But maybe because medicine was always there, I often tuned it out. As an adult, I regret that sometimes, like when I’m reading in the news about COVID -19 vaccine trials and realize that I don’t actually know as much about that process as I thought I did. To help me close the gap in my understanding, I turned to someone who understands vaccines well.

Joyce: I'm Joyce Sanchez. I'm an infectious disease specialist, a physician, a mother of two beautiful children, a wife, and daughter of an epidemiologist and pharmacist. 

Laura: Joyce directs the travel clinic at Froedtert and the Medical College of Wisconsin. Long before COVID-19, Joyce was anticipating this pandemic. Whenever there would be any sort of outbreak, Joyce and her colleagues would follow it closely so they could give recommendations to any of their patients who had traveled internationally and may have been exposed. 

Joyce: When we first heard about an unknown pneumonia in Wuhan China, we were keeping tabs on that pretty closely. And then as things spread around Southeast Asia and eventually Italy and the United States, it was something that I suppose as an infectious disease specialist I was always preparing for, but never actually imagined that our world would be living through. So when it happened, it was surprising, but (also) confirmation that what I'm doing is meaningful and can have a huge impact. 

I love one of the statements made by the World Health Organization or WHO and I'll just quote them here:

“The two public health interventions that have had the greatest impact on the world's health are clean water and vaccines.” 

I don't think anyone would argue that clean water is a good thing, and vaccines are up there on the list, too. Of all of the medical disciplines, when we talk about clean water and vaccines, those are the two biggest public health measures that have saved the greatest number of people in the past two centuries, I'm just so grateful to be part of a community that values that. What's happened has been life-changing obviously for everybody, but very validating for me and the field that I've chosen.

Laura: Like me, Joyce grew up in a medical family. I know Joyce because she married my brother (who incidentally is also a doctor). But while I was tuning out conversations about medicine, Joyce was tuning in.

Joyce: I really have to credit my parents, who've fostered my interest and supported me every step along the way in my education and my training and career. My father has a career in infectious disease surveillance with the department of defense. His experience really opened my eyes to how cool infectious disease is. And I also have to credit my mother. She was a full-time working pharmacist. She managed to raise three kids. She juggled both of those roles beautifully, while also prioritizing my father's career with frequent moves in the military. And every move, every time she halted her pharmaceutical degree, she used that as an opportunity to learn new skills and network. And by the time she retired, she was a national leader with the U.S. Department of Veterans Affairs.  

Laura: I interviewed Joyce’s dad, Dr. Jose Sanchez, in season 1, episode 76, and even though we were talking about COVID-19, somehow he made that conversation fun. Joyce has taken that heart into her own profession. Like her mom, Joyce has adapted quickly and become one of the nation’s leading experts, quoted in publications like the Wall Street Journal and National Geographic.

Until I met Joyce, I never understood the appeal of infectious disease, but learning that only clean water has done more than vaccines to improve our global public health has shifted my understanding. I think Joyce is right. Infectious disease is cool. It’s an area of medicine where we’ve made a ton of exciting progress. 

I should say upfront that I am not hesitant about vaccines, but when I sat down with Joyce, I expected that Joyce would probably say they were pretty good, but there was still a lot to learn. What she told me was so much better than what I'd expected.

Joyce: When we think about evaluating safety, there are a couple of things that I like to talk to my patients about. The first is that clinical trials today are the most vigorous that we've seen in the history of medicine, certainly at least in the United States. We actually have a lot of data now. Back in the summer when we were going through phase one, two, three clinical trials, we didn't have a lot of data, but at least as of this recording, over 40 million people have been vaccinated--and that's just in the U.S. When we think about the globe, we're talking about more than a hundred million people who have received at least one dose of the MRNA vaccine. And we're actually coming up on the one-year mark of when the very first person was enrolled in that phase one clinical trial, and over six months now since the start of phase three clinical trial. And phase three is basically thousands of people in a clinical trial who get either the vaccine or a placebo. So at least six to 12 months worth of time and data to look back at. 

Laura: There’s been a lot of talk about these phase three clinical trials in the news. I trust Joyce when she says that those clinical trials are more vigorous today than ever before. But I also wanted to better understand what those trials actually looked like, so we spoke to someone who had experienced them firsthand. 

Garnet: My name is Garnet Henderson. I'm a professional dancer and a freelance journalist in New York. I participated in the Pfizer vaccine clinical trial. I'm a science journalist and a health nerd. I was really interested in this race to produce a vaccine. And I was particularly interested in the mRNA vaccines just because it's a whole new technology and it seemed really exciting to me.

Laura: A quick note here about mRNA vaccines--also called Messenger RNA vaccines. mRNA vaccines are a new type of vaccine--but researchers have been studying them for decades. 

Traditional vaccines put a weakened version of the disease into our body so we build up antibodies to fight off that disease. But mRNA vaccines work differently. When we get that injection in our upper arm, that shot delivers a set of instructions. Those instructions teach our cells how to make a harmless piece of protein called a “spike protein” that is found on the surface of the virus that causes COVID-19. That spike protein triggers our body to make antibodies. It’s the same response that happens when we’re actually infected by COVID-19--but this way we can make those antibodies without risking the serious consequences of getting COVID-19. 

As a science journalist, Garnet already knew about mRNA vaccines, so she was excited when she saw an opportunity to be a part of a clinical trial to test a new COVID-19 mRNA vaccine. 

Garnet: I actually got a Facebook ad looking for participants to join what I later learned was the Pfizer clinical trial--which is an mRNA vaccine. I filled out the little survey and I kind of forgot about it. And then I got a call from Pfizer. And then once they determined that I was eligible, then I got a call from the actual test site. They went through another short questionnaire with me, and then I went in for the first appointment.

Laura: That first appointment was back in mid-October, when predictions about vaccine approval were still cautious at best. Trials like the one that Garnet took part in have given us some really important data. But Garnet said that when she was participating in the trial, she got a lot of questions from people in her life who had concerns.

Garnet: I got a lot of questions from people--and people who aren't really skeptical of vaccines--a lot of questions that reflected to me the fact that most people just don't know that much about how vaccines work and also that people don't know how clinical trials work, which is understandable because most people have never participated in a clinical trial. Like I got lots of questions about did I even know that it was a vaccine trial I was participating in? And I would explain to people, “Oh, Oh, of course. You don't know whether you're getting the vaccine or the placebo, but you know everything else.”  

At the first visit, the lead investigator of the study, the doctor who was running that test site, came in and sat down with me and went over all of it and asked me if I had any questions, any concerns. The informed consent process is very involved. They really make sure that they have all the information about any medications that you might be taking, any past bad reactions to vaccines, any chronic illnesses you have that they need to know about.

Because I was an eligible candidate, I got an injection that day. But before they do the injections, they tested us all for COVID. There's nasal swab, and then they also took a blood test, which they said was to establish our baseline antibodies because you know, a lot of people--especially in New York--may have had, or been exposed to COVID even if they didn't know that they were sick. So they took everybody's blood to get a baseline level of antibodies so that they could compare it down the line. And then also a pregnancy test, because they didn't want anyone who was pregnant included in the study. 

Once they determined that I was not pregnant I got an injection. But it's a double blind study. That means that I didn't know for sure whether I was going to get the vaccine or the placebo, and neither did that nurse who was taking my medical history and doing the COVID test and the blood test. So they'd be in the room with you, and then they would put in an order on their computer that goes down to the hospital pharmacy. They use a computer program that just randomizes you to placebo or vaccine. And then the hospital pharmacist prepares your dose--whatever that is, the vaccine or the placebo in this study it was just saline. It was just like a shot of saltwater in the arm. And then there is a nurse or nurse practitioner who's the one who injects you, and that person does know. So it's a different person who comes and gives you the injection. 

And then they had us wait for 30 minutes afterward. They do that to monitor just in case anybody does have a serious reaction. And then you leave. And I came back three weeks later and essentially did the same thing again for the second dose. 

Laura: Garnet’s second dose was in early November, more than a month before the FDA would approve the first COVID-19 vaccine. 

Garnet: I think it's really cool that I got to see what a clinical trial looks like from the inside.

When I was getting my second dose, the woman who came into the room with the needle, I was like, “so I'm not trying to get you to tell me, but like, do you know whether you're giving me the vaccine or the placebo?” And she said, “yes, I do know.” 

But then that person doesn't interact with you in any other way. So they don't know anything about you or your medical history. It's all kept separate so that no one can accidentally reveal to you and therefore influence your experience, whether you're getting the vaccine or the placebo.

It definitely was my first experience participating in a clinical trial. I took a few psychology classes when I was in college, and so I had participated in some scientific studies that did have a similar double-blind structure.

This might sound kind of simplistic, but my first impression of the whole thing was that they were just incredibly organized. I'm certainly no great fan of pharmaceutical companies, but I was like, wow, I really can tell that Pfizer just does this all the time. And that did make me feel good because they clearly had this whole apparatus in place

Laura: I found this incredibly helpful, to pull back the curtain on this process and hear from someone who had actually experienced it not as a doctor but as a trial participant. Garnet said that the smooth running of that Pfizer machine didn’t stop when she got her second shot. 

Garnet: Another part of the study is that we report any COVID symptoms or positive COVID test results every week. And there's an app, so you just download this app and then it prompts you every week, “hey, fill in your diary!”

Laura: This was something Joyce talked about as well, not just for trial participants, but for anyone who gets the vaccine. 

Joyce: There's a very robust reporting system for adverse effects. For those who do get the vaccine. As long as you're plugged in to some kind of internet where you can get notifications to report your symptoms, that is actually being scrutinized very rigorously and very regularly by entities that are outside of pharmaceutical companies. Entities like the American College of Immunization Practices and the FDA are looking at these and making sure that there's no signal for something that is going to be consequential and may pause us from continuing to administer vaccines.

The CDC recently published a report looking at the early safety monitoring findings and as far as serious allergic reactions, which is the biggest concern for most people. It's exceedingly rare. We're talking about 11 cases per million. So that's very, very, very low. And when we think about general vaccines, like tetanus or flu, historically, that ballpark is in the one to a million doses that there's a severe adverse reaction. So really good promising statistics here. And again, over a hundred million doses of these vaccines. 

Laura: Garnet said she did experience side effects--side effects that we now know are common--but that they didn’t last for long.

Garnet: I had a pretty strong reaction to the second dose. So I kind of knew that I had gotten the vaccine even before I was officially unblinded. And it wasn't anything bad or scary. It was just the side effects that I think everybody is now aware are really common with the second dose of both the Pfizer and Maderna vaccines, which is that I felt really tired. My body was really achy. I didn't actually run a fever, but I kind of had the chills. I was having trouble sleeping.

And then the day after I got the second dose, my injection site was red and swollen and my lymph nodes were a little bit swollen in my neck on that side. So that's how I kind of knew that it probably was not my imagination. It probably was not the placebo effect. I probably got the real thing. And I do think that Pfizer and Moderna both have done a decent job of communicating this, that there are side effects that are associated with these vaccines that are a bit stronger than what most of us are used to from other adult vaccines. 

----

Laura: If you’ve been following Shelter in Place, then you know that the story behind these episodes is a pandemic Odyssey my family and I have been on since September, when wildfires and the challenges of pandemic parenting launched us from our home in Oakland across the country to Massachusetts so we could get help from extended family. Many times along that journey we’ve wished that we could predict the future, or at the very least know the endpoint of this pandemic. 

In the original Odyssey, Odysseus has those moments, too. About halfway through the story, this desire to predict the future and find their way home brings them to the underworld, the land of the dead. What they’re doing is new; no living human has ever visited before. Their walk among the dead brings them to the dead prophet Tyresius, who can foretell the future and help them get home. As if walking among a bunch of dead people weren’t scary enough, the only way to get Tyreseus to talk to them is to sacrifice some sheep, spill the blood on the ground with milk, honey, wine, and barley, all the while promising the dead spirits that once he got back to Ithaca, Odysseus would do another animal sacrifice to honor Tiresias and his spirits. 

It’s a gruesome scene that involves lapping up blood. I have to say I’m glad that we no longer live in a time when animal sacrifices were the norm. But this pandemic has at times felt like visiting the underworld. Certainly, it’s been scary, and our scientists and doctors have wished they could tell the future. Many have died along the way. 

But thanks to the clinical trials like the one Garnet participated in, those numbers have fallen dramatically. There’s real hope that someday soon, the only blood spilled over this vaccine will be a tiny dot at the site of the injection, a wound so small that it can be covered with a band-aid.

---

Laura: When the Pfizer vaccine was approved in December, Garnet already knew that she’d probably gotten the real thing and not the placebo. But knowing that didn’t prepare her for how she would feel when that vaccine was approved. 

Garnet: I actually cried. It sort of surprised me, when they first released the efficacy data for the vaccine, I just started crying.

I live in New York city, and it was absolutely terrifying to live here in late March and early April. There's a hospital right up the street from me. All day and night I heard sirens. I felt like people were dying all around me, and I live alone, so I was also terrified of dying, because even though I'm young and healthy, I heard all these stories about people with COVID who felt okay until they were on death’s door. And I felt like if that happened to me, I would just die because there's nobody else who lives with me who could call 9-1-1 for me, or help me get to the hospital or even to the urgent care that's a block away. 

As a young, overall very healthy person, I'm low priority in so many ways, and low priority for vaccination. If I had gotten COVID, I probably would have survived. And so that's part of what made me feel like I really should participate, because I can. And I felt like I'm a safe test subject. I trusted the science, but I also felt like if it turns out that there is some kind of complication that can result from having this vaccine, I'll probably be fine. They need to test a vaccine like that in as wide, an array of people as possible. I participated in the trial out of curiosity and because I felt like it was something that I could do. So it did make me really emotional when that turned out, not just to be an effective vaccine, but to be like, the vaccine, the first one that got approved. I just, I had no idea when I signed up for the trial, that that's what was going to happen.

Laura: Joyce had a similar reaction. She’d hoped that some of the trial vaccines would be effective, but the results far surpassed her expectations. 

Joyce: Many of us in the medical community were frankly holding our breath for phase three clinical trial data to come out in regards to safety and efficacy, because these had not been used on a global scale before. 

When that came out and we saw this glimmer of hope with really, really good efficacy. That was one thing that surprised me because most of our vaccine performances, when we think about flu vaccine, batting averages, maybe 40 to 60%, which is still something better than zero, but not the best when we think about vaccines.

And when you hear 94-95% effective, that is just amazing, and that's where  I saw a glimmer of hope when we think about how do we get over this pandemic.

Laura: I just want to pause here to make sure that you got that. 94-95% effective.

When you look at our most common vaccines--tetanus, polio, MMR--most of them are somewhere between 93-100%. Even at this early stage, our currently approved COVID vaccines have numbers almost as good as some of the most effective vaccines ever made.  

I found that fascinating, that the numbers were so much higher than I’d realized. Most of us don’t worry about the efficacy of vaccines like polio. We take it for granted that that disease is behind us. Hearing that we are in a similar place with these COVID vaccines now is this first time in a long time that I’ve felt hopeful that the end of this pandemic is coming. 

I asked Joyce if it was reasonable to think that we’ll return to some sense of normalcy, or if we should be bracing ourselves for more of the same in years to come, for future pandemics. 

Joyce: Well, that's the million dollar question. If we look at the past 30 years, about every 10 years has been the average where we had SARS and then we had MERS and then we have this it's, it's been 10 years. So we'll see. Is it going to be every 10 years where we get some major new strain? Maybe, but who knows?  

And then we have flu. So are there times where we may be dealing with two pandemics? That was a big question last spring: are we going to deal with flu? And interestingly, all of the measures that we've taken to help protect ourselves against COVID has really protected us against flu, so we didn't have to deal with two pandemics, which is great.  

I've been surprised at every point in this pandemic--surprised for the worst and surprised for the better. But there's a lot to be hopeful for. The drops and the number of cases, at least in the U.S., the number of hospitalizations, number of deaths--and this is happening at the height of freezing weather at the height of people being indoors at the height of the winter blues post holidays. The fact that we're seeing this drop is amazing to me. This is the time where flu season really runs rampant.

It's January, February. That's where we see big flu spikes traditionally. That we're not seeing that, we're not saying COVID continue to rise, it gives me hope that people are getting immune and people are getting vaccinated. And while the distribution process hasn't been perfect, at least the needle is moving forward. I hope that's a motivator for people to say yes when it becomes available for them to receive the vaccine.  

Laura: One of the fears that is commonly voiced right now is about how effective the vaccines are against variants of the virus. Joyce says that these variants are not a surprise, and that this is also an area where the mRNA vaccines give us a huge advantage since they can be produced in a lab quickly and in large quantities. 

Joyce: That is something that we expected from day one.  That's what. Viruses do  it's normal for them as they replicate  there'll be certain mistakes that happen and that's just by chance.

And occasionally  there is a new tent where. It gives it an advantage, maybe more infectious as is the case with some of these variants of concern that have come from the UK or South Africa, Brazil. that's where we really want to ensure that our current measures, our current vaccines, our current therapies are still able to do what they should be doing.

These mutations have caused them to be more contagious. So if one person gets infected with one of these variants, they're more likely to spread it to more people than the former variant.   What's promising is that our immune systems. Are really amazing. They form these antibodies and it's a rich population of antibodies. It's not just one clone of antibody and even with variance, a lot of  the lab data, as well as some of the population data show that these vaccines that we're using. Even if they were not formulated for these variants, initially the immune systems that people Mount are so rich that they can still recognize and neutralize and reduce the severity disease and reduce the hospitalizations and reduce the deaths.

We’re keeping a very close eye on variants as they come up.  these won't be the last variants. As long as this virus is multiplying and spreading, there are opportunities for more variants to come up. But thankfully, so far, we haven't seen anything that has caused us concern for. These variants to escape protection from the currently available vaccines that might change.

I hope it won't, but if it does change, then we are in a position where these. Currently available vaccines can be manufactured very quickly.   If you get the genome, you can manufacturer the vaccine in a lab with these platforms. It doesn't take months like influenza vaccine, where you have to grow a virus. these are vaccines that can be manufactured quickly. So that's, one advantage of these platforms.  if it takes getting a booster in a couple of years, or the development of a future iterations of.  Corona virus vaccines that may incorporate more than one strain. And, thankfully, some of the efforts that are being done now, both by the FDA and the pharmaceutical companies that are manufacturing vaccines  they're interested in knowing this is going to be something that is long lasting and if we have to evolve and, make new formulations,  time will tell.

Laura: Garnet says  that getting vaccinated hasn't taken away, all of her fears, she's still being careful wearing a mask, social distancing, trying to be smart, but the vaccine has given her something that has been on short supply in this pandemic. It's restored her hope.

Garnet: . . . which is something that I had kind of forgotten how to feel.

My fear is not gone, but I don't lie awake at night anymore worrying about dying alone in my apartment.

Even though the vaccine is approved, they still are following us for two years, because now they're turning to new questions, like does the vaccine prevent asymptomatic transmission? And how long does the immunity last? That's another thing that I hope will reassure people, that it's not that they developed this vaccine really fast, got it approved, and then bailed. The study is still ongoing. If I were to have any problems, I have an on-call number for a doctor with the study to call. They're very much still involved with us and monitoring us.

I would encourage people to weigh their potential fear of the vaccine with the very real consequences of getting COVID or giving COVID to someone else, so that even if you live, they might die. I would encourage people to weigh those two things against each other. And at least to me, the potential risks of the vaccine, which we know are incredibly low, I would choose that any day over the risk of getting COVID.

I understand people not having faith in institutions, and pharmaceutical companies, and our government. I don't think Pfizer is a good company. I don't really trust them either. What I do trust is  the doctors and the other scientists and the nurses and the medical assistants and the administrators who were working at my test site and who were working so incredibly hard to save lives. I chatted with the people when I was there. A lot of the nurses in particular were people who worked on the front lines in the spring, in New York, and then they went to work at this vaccine test site. I trust them and I trust their work and I trust that they wouldn't have been involved with the trial and the development of the vaccine, if they didn't believe that it was safe and effective.

You see so much about the fear and the what ifs. And I just don't see as much of the excitement and the joy that comes along with just reveling in the fact that humanity did an incredible thing. We created multiple effective vaccines for a new disease in less than a year. That's amazing. That's something to be really excited about and not to fear. These vaccines were built on decades of work that were done by scientists who have nothing to do with any of these pharmaceutical companies who worked on this stuff for decades when their research was terribly underfunded and it might not ever have been used were it not for this horrible pandemic. I have trust in them. And so where I don't trust institutions, I try to look for the people that I can put my faith in.

Laura: We talk a lot at Shelter in Place about transforming communities by transforming ourselves. Garnet transformed herself in a very tangible way--she took part in a clinical trial that had the potential to end the pandemic, that ended up being one of the most hopeful moments of progress in the history of medicine. And as is often the case, there was risk involved. It could have gone wrong. But without people like Garnet, we wouldn’t be where we are today. 

We’ll hear from Garnet and Joyce more in future episodes, but in the meantime I want to end this episode with an invitation. For better or worse the decisions that we make for ourselves and our families do have an impact on our communities. We are interconnected--whether or not we want to be. Sometimes that interconnectedness can feel like a burden. It can feel overwhelming. But ultimately it's a gift. What if the question we were asking ourselves weren’t what’s best for ourselves and our families, but what’s best for our community? For our country? For our world? The answer to that question might just give us what we need to face the long months that are still ahead in this pandemic. They might just help us to push past the fear that is so easy to give into, and instead find our way to being able to celebrate the good and hopeful things that are happening all around us. 

--

As always, if you listen to the very end of the episode, you’ll hear Shelter in Place outtakes, but first, if you haven’t taken our listener survey yet, we’d love to hear from you. Your advice and feedback will help us with everything from creating future episodes to talking to potential sponsors. Find the link on our website, shelterinplacepodcast.info.

Shelter in Place is listener-supported. If you’d like to support the good things happening here, including our new apprenticeship program where we’re training the next generation of women podcasters, you can find information on how to donate to Shelter in Place on our website. If you’d like to help us but can’t donate, asking your friends and loved ones to subscribe to Shelter in Place helps Hurrdat find us sponsors and expands our community. Check out our new referral program where we send you gifts when you get your friends to subscribe. You can find that at refer.fm/shelter.

Shelter in Place is part of the Hurrdat Media network. The Shelter in Place music was created by Chase Horsman at Reaktor Productions. Additional music and sound effects for this episode come from Storyblocks. Alana Herlands was our assistant editor for this episode, Isobel Obrecht was our assistant producer, and Melissa Lent was our assistant audio editor. Nate Davis is our creative director, Sarah Edgell is our design director, and our amazing season 2 apprentices are Sarai Waters, Winnie Shi, Alana Herlands, Eve Bishop, Gabi Mrozowski, Isobel Obrecht, and Melissa Lent.