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Full Interview: Marcella Nunez-Smith on COVID equity

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"Face the Nation" sat down with White House COVID Health Equity Task force Chair this Sunday.

Video Transcript

MARGARET BRENNAN: I'm joined now by the chair of the White House COVID Equity Task Force and associate dean at Yale. That is Dr. Marcella Nunez-Smith. Welcome to the program.

MARCELLA NUNEZ-SMITH: Thank you so much. Great to be here.

MARGARET BRENNAN: Doctor, our new CBS News poll shows that vaccine hesitancy has actually ebbed among racial minorities, and that started about mid-January. We are now seeing that Black Americans are as likely as white Americans to say that they're willing to get vaccinated. Are you also seeing that shift?

MARCELLA NUNEZ-SMITH: Yes. This is great news. We see vaccine confidence growing in all groups across the country. And so now the work is to make sure that people can connect with vaccine when they're eligible. But it is very promising. I'm hearing the same thing, that confidence is high. We are at a great moment. We have three vaccines authorized in the United States for emergency use, and people are getting more eager to get connected with those.

MARGARET BRENNAN: So is vaccine hesitancy no longer an issue?

MARCELLA NUNEZ-SMITH: You know, we absolutely have to meet people where they are, whether we are talking about vaccine confidence or really engagement with health care more broadly. You know, there are institutions, unfortunately, when we think of our history, both in terms of health care, even at times the federal government, that have actively earned distrust in many communities, including communities of color.

You know, President Biden has acknowledged that himself many times. And the reality is that people don't always have to look historically for examples of subpar treatment when they're trying to seek health care. Many people have contemporary examples of that. We have to make sure people have the information they need to make the decision about getting vaccinated.

The reality is that the process has been data-driven, grounded in science, thoroughly and rigorously reviewed by independent scientists. The three vaccines that are available are safe and highly, highly effective on the things we care about most. That's preventing serious illness, hospitalization, and death. And so one of the tools that we make sure we communicate all the opportunities I have to talk directly to folks who are on the fence.

You know, they are very eager to hear who was involved in the process. We've had diverse scientists at every step of the way. And also who was involved in the clinical trials. I'm so grateful to the scientists and the clinical trial participants. You know, over 30% of them identify as diverse. So these are some of the key bits of information that trusted messengers across the country are getting out. I think it's making a huge difference. We're starting to see those shifts, as you mentioned, in vaccine confidence.

MARGARET BRENNAN: Well, you are seeing those shifts, but it was just last month when you said there was only about a 38% uptake among brown and Black hospital workers and employees at these long-term care facilities or nursing homes. So do you think the answer to that is mandating that health care workers get vaccinated?

MARCELLA NUNEZ-SMITH: Yes, you're absolutely right. Looking at those early data, that was the first month of the rollout before President Biden was even in place and we saw that 38% number as far as uptake. So one of the key things is making sure that we go back to people as people get more information, as they see their neighbors, their friends, co-workers, you know, colleagues getting vaccinated. That often does boost the confidence as well as this information sharing.

So many people said they didn't want to be the first. And thankfully we are close to having so many people in our country fully vaccinated at this point. So no one is the first at all. So importantly, going back to those health care workers, offering opportunities now to get vaccinated.

You know, I think it's early to talk about mandating. We are grateful to have these vaccines authorized for emergency use-- not yet approved; you know, the clinical trials are still ongoing. It is certainly the case-- I know, I'm a health care worker. I'm a physician. My employer mandates that I get the influenza vaccine, which I gladly do. It keeps me safe, keeps my patients safe. So that is a future question.

But right now, I think we are very excited to see the movement, as we've talked about, in terms of people's interest getting vaccinated. And of course, this is so important for all of us in health care to do.

MARGARET BRENNAN: So one of the areas where we are still seeing hesitation is, according to our CBS News poll, is among partisan lines. In fact, unwillingness to get the vaccine is higher among Republicans, specifically younger Republicans. I'm wondering what your plan is to reach them.

MARCELLA NUNEZ-SMITH: Yeah, absolutely. You know, I think one of the other tragedies of the pandemic has been how it has been so politicized. You know, we see kind of the politicization of just basic public health practice-- wearing masks, which we know works, and we're asking Americans to do for a bit longer.

But we are hopeful, and we know that the vaccine is just a clear path to getting to the other side of this pandemic to our new normal and, quite frankly, just to reclaiming our joy and reconnecting with family and friends, gathering at houses of worship, at sports games, and really importantly, getting our kids safely back in school. So just lots of great science that's there that suggests that the vaccines, again, are safe and effective on our pathway.

So we recognize that we have kind of unique messages for different groups. That's so important. So tailoring that message, addressing the concerns of any particular constituent and constituency, and also making sure that we're working so closely with trusted messengers have been honored and humbled to be hosting various stakeholder roundtables and conversations recently with people across the political spectrum. And I think that is incredibly valuable in informing both our national public education campaign as well as policy moving forward.

MARGARET BRENNAN: But how do you persuade people who aren't supporters of the president? I mean, I'm looking at your doses right now. You'll have 500 million doses by the end of May. Are you going to launch public service ads here, reaching out to celebrities who may appeal to these constituents? I mean, what is the way in?

MARCELLA NUNEZ-SMITH: Yeah, absolutely. So it is fantastic. The president just announced this week that by May 1, every adult in the country should be eligible for a vaccination. And we will have that supply by the end of May, and so that's great. Again, not everybody will be able to get their vaccination right then, but to be able to queue up and get in line.

So we are absolutely aware of the need to reach out and reach across. That is a core principle of this administration, how we want to make sure we are meeting everybody where they are. And to your point, we're getting ready to launch that national public education campaign. And we'll work closely with trusted messengers, influencers, and others to get to everyone, whether the hesitancy is based in political view--

MARGARET BRENNAN: When will that be?

MARCELLA NUNEZ-SMITH: --or anything else. So we are on the cusp of launching that national public education campaign, timed really appropriately with that increased supply in vaccine that we see coming right down the pike.

MARGARET BRENNAN: So let's talk about some of the specifics of what the president announced this week. The administration is now going to be directly supplying vaccine doses into community health centers. What does bypassing the governors and going direct to these centers accomplish?

MARCELLA NUNEZ-SMITH: So, you know, I always say equity is a team sport. We're going to continue to work so closely and collaboratively with state and local leaders, as we have been this entire time. And you know, boosting the supply is great for equity and for everyone. We're going to be able to increase those allocations to states moving forward for states to distribute through their channels.

So the federal programs--

MARGARET BRENNAN: But this is supplying directly.

MARCELLA NUNEZ-SMITH: --with the direct allocations of vaccine--


MARCELLA NUNEZ-SMITH: Yeah. So there are several federal programs that directly supply vaccine, and all of those have been designed with equity in mind from the beginning. So there aren't new programs. These programs were all launched in the first three weeks of the administration. That includes the community vaccination centers, those mass vaccination sites. And we have located those in those areas that are hardest hit using best practice to make sure people can actually overcome many of those structural barriers to get registered and get vaccinated, as well as the retail pharmacy program.

And so that is doubled in number in this past week. We announced that. Again, a third of those pharmacies in areas that have been hardest hit. And then, of course, you know, you mentioned the community health centers, and those are tremendous assets in our neighborhoods and our communities serving over 30 million people, many of whom have been deeply affected by the pandemic. And so the announcement this week is that we're expanding all of those channels and programs, including the community health centers, adding up to 700 new community centers online, taking that number to 900.

So this is in addition to the work of the states and localities. And I have to say, you know, just this weekend I had an opportunity to go door-to-door, knocking on the homes of folks and helping them get registered. And that's something that was coordinated by a community health center as well as community leaders here in one of our neighborhoods in New Haven that has been the hardest hit. So the opportunities for coordination and collaboration are there, and these programs all work synergistically.

MARGARET BRENNAN: So what is the thought behind making doses available to dentists and podiatrists and veterinarians-- new providers here? Is the idea that you go in for your teeth to be cleaned and you get a shot in the arm with the COVID vaccine?

MARCELLA NUNEZ-SMITH: So we're very excited to have also announced this week expanding who can vaccinate. You know, it's so important. The core of this work is making sure there's more vaccine, and we have pushed on that, making sure that there are more vaccination sites and venues, and we have pushed on that as well and made great progress. And also being sure that we have more vaccinators so that doesn't become a rate-limiting step.

And so our announcement this week says that all the people you mention will be able to vaccinate. And we encourage them all to go to PHE.gov and sign up. See what your state needs and where your state needs you. And so the idea is that these vaccinators will be able to plug into a lot of these existing vaccination venues and give vaccination there.

MARGARET BRENNAN: So this is those providers going to work on location at other sites. It's not in their private offices?


MARGARET BRENNAN: I want to ask you about data. I know you've talked a lot about this, and you've said a person's zip code is a stronger driver of health than their genetic code. Tell me what you're doing to actually get better data. Because we know the CDC has reported that race and ethnicity is only available to them for about 53% of all the people who've been vaccinated. So they've only got a partial snapshot of what this country is actually doing. So why can't the federal government get a handle on it?

MARCELLA NUNEZ-SMITH: Yeah, this is a key priority. We're pushing for data. We have to be data-driven in our responses. We need better data to know where to target resources. We are working very closely, again, with both providers as well as state and local health officials. We've already seen great partnerships in that space, and we're seeing the completeness of our data increase. We're going to stay focused on that issue.

Very importantly, though, as I mentioned before, when we think about things like where we're going to cite those federal resources, those mass vaccination centers, those pharmacies, we're able to use additional data. And so the equity metric toolkit is growing. And I think that's really important to recognize when we look at things like measures of, you know, social vulnerability, for example, or areas that have been medically underserved and what we can learn at the zip code level.

So while we're pushing for better race/ethnicity data, we're continuing to use the data that we have available to guide our resource distribution.

MARGARET BRENNAN: So how do you actually measure whether what you're doing is successful or not?

MARCELLA NUNEZ-SMITH: So we, again, will keep pushing to get better, more complete data around variables that are important and relevant like race and ethnicity. And alongside that, we have been using other equity metrics, and so things like social vulnerability and zip code. And we can do those analyses now to keep track. And we have already communicated--

MARGARET BRENNAN: But could the president mandate that?

MARCELLA NUNEZ-SMITH: I think our first step in this process has been to work very collaboratively with states and locals. We're working to overcome any challenges that might exist in terms of just data systems and infrastructure. And that's the place where we are now, and we are making some progress there.

MARGARET BRENNAN: I want to ask you about two really at-risk communities. If you look at the US border right now, there are about 8,000 unaccompanied migrant children in the custody of Health and Human Services. And COVID distancing policies have been lifted inside of those federal facilities just because there are so many kids there. Are you concerned that this is a real health risk?

MARCELLA NUNEZ-SMITH: You know, this is a high priority in the administration. And you know, I-- we definitely are concerned so much for the children who are there at the border for so many reasons, including health. And so this is absolutely something that as a response team we're focused on and thinking about. And it is a high priority for us to make sure that everyone, certainly that we are charged with taking care of, will be safe.

MARGARET BRENNAN: The governor of Texas has said that some of these undocumented migrants who are crossing into his state are spreading the virus. Have you seen any evidence to support that?

MARCELLA NUNEZ-SMITH: You know, I have not seen any evidence to support that at all. I mean, I think that it's very important for us, again, as we talk about our goal to vaccinate an entire nation, that we not divide ourselves in this process. You know, it's key vaccinations are free. We need to make them easy and convenient, and we need to make sure everyone knows that regardless of documentation status, or anything else, quite frankly, that you are eligible for a vaccination here.

MARGARET BRENNAN: All right. Dr. Nunez-Smith, thank you very much for your time today.

MARCELLA NUNEZ-SMITH: Oh, thank you so much.