PROVIDENCE – The lighting of the first WaterFire on Saturday evening, Sept. 4, since the coronavirus pandemic struck, provided a convergence of images that captured the ongoing conflicts around the political divisions in Rhode Island, perhaps more clearly than the exquisite Mike Cohea photograph that illuminated the beauty of downtown Providence aglow that evening.

The torchbearers honored were COVID heroes, according to Gov. Dan McKee – “first responders, health care workers, teachers and so many other selfless individuals who have stepped up to keep us safe.”

Gov. McKee offered these grateful words to his followers on Twitter: “To all the COVID heroes across RI and everyone who carried a torch tonight – thank you.”

At the event, dozens of vocal protesters alleging to be health care workers, under the shouted slogan of “Freedom Not Force,” descended upon the WaterFire lighting ceremony, arguing against what they claimed were forced vaccination and mask mandates issued by Gov. McKee.

The two opposing views appeared to be much like two ships passing in the night, as darkness enveloped the Rhode Island skies, illuminated by WaterFire.

Cognitive dissonance
For many within the public health and teaching communities, the idea that requiring vaccines and masks would be seen as imposing constraints on individual freedoms is a bridge too far to comprehend, particularly when it is allegedly coming from health care workers, including doctors and nurses, given the comprehensive education and professional training that is required to pursue those careers.

Further, there appears to be virulent misinformation campaigns with political overtones being carried out nationally by Fox News and on numerous social media platforms, questioning and attacking the safety of vaccines and masking. "The misinformation that goes uncorrected is astonishing,” one public health expert complained to ConvergenceRI.

Meanwhile, emergency rooms across the nation are being flooded with unvaccinated patients who have contracted COVID.

Schools without masking requirements have opened, only to be forced to go to virtual learning – such as South Carolina schools in Lexington County, where three weeks into school year some 19 schools were forced to go virtual due to COVID-19, as reported by Julia Kauffman from WLTX on Sept. 3. Statewide, more than 42,000 South Carolina students have returned to remote learning as educators grappled with how to stop the latest surge of the virus, The Post and Courier reported. South Carolina Gov. Henry McMaster had made the decision not to allow schools to have mask mandates, precipitating the crisis.

Clearing the air
ConvergenceRI reached out to Lynn P. Blanchette, Ph.D., RN, PHNA-BC, Associate Dean and Associate Professor at the Rhode Island College, School of Nursing, to get a better understanding of the educational requirements regarding vaccines.

ConvergenceRI: How are vaccines taught as part of the basic curriculum of nursing education?
BLANCHETTE: Nursing students are introduced to the concepts related to how vaccines work in the human body as part of their biology course work. In the nursing curriculum, they learn about the standards for administering them, the schedule that is set by the ACIP [Advisory Committee on Immunization] and contra-indications. Then they are given the opportunity to administer them. The concept of herd immunity are also taught, along with vaccine hesitancy.

ConvergenceRI: Why does there seem to be so much disconnect around the public health benefits of vaccinations?
BLANCHETTE: I would love to say that I understand the disconnect; I can’t. People make decisions about their health for many reasons – social context, family, relationships with health care providers, and messaging. Keep in mind that many people alive today in America have not survived a public health crisis that could be managed with a vaccine, such as polio, smallpox, etc.

ConvergenceRI: How could the messaging around vaccines have been handled better, in your opinion? Is it the messaging, or is it the way the messages are being delivered?
BLANCHETTE: I believe this kind of messaging is received best from people that you know, or at least someone you can make a connection with.

For the most part, in Rhode Island, we have used the strategy of “experts” like physicians with whom most people had no connection. I think we could have done better using trusted health professionals, such as nurses.

And made it local instead of statewide. If all communities had a relationship with a nurse, we might have done a lot better.

Keep in mind, even health care students do not have much contact with our public health clinicians, so they may be unfamiliar with them. We have made health care so focused on the medical model, hospital- and acute-care focused, people do not often recognize how they are being kept safe and healthy through decisions made at the public health level.

ConvergenceRI: How much of the resistance is from folks who do not want to be told about how best to control their own bodies, in your opinion?
BLANCHETTE: This pandemic was definitely politicized, presenting a huge challenge. People aligned themselves with parties and that influenced their decisions. There were already some in the community who were against vaccination for their children, and this added fuel to that fire.

ConvergenceRI: What is the best way to combat misinformation about vaccines, in your opinion?
BLANCHETTE: Right down at the local level. I know there is some work going on in communities, through the HEZ and other places. Also, I have to say, sometimes the only thing to do is to make mandates.

And, add in some education in the schools about vaccines. Most people have no clear understanding of how they work, what they do in your body, so when this one came along, the language was new to some folks.

I administer seasonal flu in a community clinical every year, and I am always surprised about how little people understand what the vaccine will do to protect them. The gap in health literacy is contributing to the challenges.

ConvergenceRI: What can the news media do in providing better coverage of the issues around vaccines, and around public health in general?
BLANCHETTE: It would be beneficial if the media covered general public health issues – as well as the large decrease in funding over the last two decades. We need more stories about how we spend our health care dollars currently and why we have little success to show for it.

I am always glad when people want to understand their health choices and very much support creating an educated population. There should be more emphasis on helping people understand how vaccines work, what the outcome of previous vaccine efforts have been, and how many lives have been saved.