How do people respond to a gift, especially if it is lifesaving? Pretty much as they would many millennia ago. Over the past five months, while helping inoculate about 100,000 people at one of Tucson, Arizona’s COVID vaccination centers, I was constantly reminded of Passover’s story of the four children. Each differs in personality, knowledge, and response to the ceremony.
Originating in Exodus and Deuteronomy, their descriptions mirror the people we inoculated.
The initial crush of patients who were able to navigate the complex and often frustrating appointment registration system reflected the wise child. All expressed relief that they had received their first “jab” and were scheduled for the second. Some wept for joy. Others asked important questions about their immunity level, possible side effects and treatments, interactions with their other medications or diseases, and, occasionally, more complex scientific questions — some of which we still cannot answer. This group was a pleasure to assist.
Some patients, analogous to the child who does not know how to ask, are patients who speak languages other than English and Spanish with which we are comfortable. They would often have trouble asking questions about the vaccine or the procedure. In some cases, Google Translate came to the rescue; in others, a relative could act as a translator — like my experiences in emergency departments. Patience, flexibility, and humor got everyone through those situations.
We also saw some patients like the simple child, who, due to dementia, illness, congenital or developmental issues, could not fully understand what we were doing or why it was being done. Relying on their caregivers’ instructions and approached with a compassionate attitude, they all, in my experience, cooperated with what must have been a disturbing episode.
The last group, gratefully small, has reflected the wicked child. They are easily identified, with facemasks that barely cover their mouths and rarely their noses. Through their disdainful attitudes or explicit comments that they are doing us (volunteer health care professionals s) a favor by receiving the shot, they overtly separate themselves from the greater community striving to rid themselves of the COVID scourge. Despite the pall these remarks cast over the vaccinators, we were pleased that they were vaccinated.
According to some, there was a fifth child who was absent from the Passover table. It is unclear whether he did not want to attend, could not attend, was fearful of attending, or was frustrated in trying to get there. This is the group we now urgently seek to vaccinate. With growing supplies of well-tested vaccines in the United States, access problems are limited to those in remote settings or with mobility problems. Some in this final group may simply be selfish, hiding behind curtains of anti-science rhetoric, political antagonism, and fears of “contaminating” their bodies while allowing others to carry the burden of providing the population with herd immunity. The imagined barriers may crumble with a realization that they may be denied employment and entrance to businesses, public events, and vacation venues without proof of vaccination. They may also be swayed by the promise of protecting their children and grandchildren, many of whom cannot yet be vaccinated.
We must actively reach out to the “wicked children,” enlisting Hollywood stars, musicians and sports figures, social media influencers, public relations firms, and religious leaders to inform and sway this group. Since statistics and science are not enough, personality, humor, and trust may do the job.
Kenneth V. Iserson is an emergency physician.
Image credit: Shutterstock.com
