Short Wave - Why Puerto Rico Is A Leader In Vaccinating Against COVID-19

Episode Date: November 29, 2021

Puerto Rico was still recovering from Hurricane Maria and a string of earthquakes when the pandemic started. The island was initially hit hard by COVID-19, but is now is a leader in vaccination rates across the United States. Ciencia Puerto Rico's Mónica Feliú-Mójer explains the cultural factors that may have contributed to the success of Puerto Rico's COVID-19 vaccination efforts.See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Monica Filio Moher was terrified when COVID-19 hit Puerto Rico. It was really scary. I mean, I think that's the thing that I remember the most. Being really scared about the uncertainty. You know, Puerto Rico has been through a lot in the past, especially in the past four years, with hurricanes, earthquakes, a pandemic, you know, political instability.

Monica's the director of communications and science outreach for Siencia Puerto Rico. What lingered in her mind most of all was Hurricane Maria in 2017. You know, people, a lot of people, especially marginalized communities around Puerto Rico, they were left to their own devices. Thousands of people died. And after Maria, some communities didn't have power for nearly a year. The island is still very much recovering. Monica was worried that COVID would be, in her words,

Hurricane Maria 2.0. The failure of the government to be prepared and respond to Hurricane Maria, I was concerned that that was going to happen again, that things were just going to go into total chaos, that the pandemic was just going to hit so hard that the health care system could collapse. and that people were just going to die. Now, initially, the pandemic did hit Puerto Rico hard,

first in 2020, then with a big spike last spring. But lately, the island has been doing better, especially in one key area, vaccinations. It's over 70%. And it's among the top two vaccination rates in all of the U.S. in its jurisdictions. Which is a huge accomplishment. And we're going to take some time today to understand how Puerto Rico got there.

Today on the show, we talk about the unique cultural factors that may have turned the tide in the island's fight against COVID-19. I'm Emily Kwong. You're listening to Shorewave, the Daily Science podcast from NPR. First, there was Hurricane Maria. Then in January of 2020, a strong earthquake struck. weeks later, people were still reckoning with the damage, sleeping outside, fearing aftershocks. And then in March, a global pandemic was declared.

You know, all the pandemic closures really started hitting in March of 2020. And in January of 2020, southern Puerto Rico had faced the strongest earthquake that Puerto Rico had seen in more than 100 years. And so, you know, you have one. emergency who is, you know, people have to be sheltered. You know, they have to be in common shelters. And then, you know, with the pandemic, you're being told like, you know, you can't be with other people. And so what needed to be done to address the two different emergencies was very, very different. And so people, you know, people were tired. I mean, people are tired. And it seems like those conditions, the hurricane, the resulting strains on health care and infrastructure, the earthquake, all of this changed the country.

And in some cases, let it to be more resilient. You know, you've written that in Puerto Rico. There have been broad coalitions working towards combating the pandemic. What is a coalition? And how do you see that? working day to day in the response to the pandemic and in getting Puerto Rico to the place where they have such high vaccination rates? Well, first I want to say a word or two about resilience. I mean, I wish we didn't have to be resilient. You know, I think it's obviously important that communities and countries are resilient because, you know, we're facing changes and challenges that require us to adapt, you know, think about climate change. In that sense, the definition of of resilience and being resilient is really important. But, you know, in Puerto Rico, I feel like resilience has become, I don't know, I feel like it's kind of become a trope in a way where it's like,

well, you know, you've been through a lot and you just continue to be resilient. Way to go. You know, go resilient Puerto Ricans. And it's like, well, we don't want to be resilient. Like, we don't want to have to be resilient. But, you know, I think in terms of the pandemic, when I talk about broad coalitions is that in, quote, unquote, normal times or, you know, pre-pendemic or non-emergency times, you really didn't see, for example, like the scientific community collaborating with grassroots community groups. I'll speak for my experience as a Puerto Rican scientist and somebody who's a leader within the scientific community. Partly because we have been through so much in the past four years, I think there was a collective understanding of if we don't come together and put our differences aside, things can get really bad. And so I think everybody from individuals to communities, to organizations, to even the government, have done their part to respond to the pandemic pretty well. And in a Twitter thread, you also said another reason that you attribute to these high rates of vaccination and a lot of vaccine awareness is solidarity.

What does that word mean for you? and how does it fit in with these relationships between all these different agencies and institutions in Puerto Rico? Well, for me, solidarity is really at the core of what it means to be Puerto Rican. You know, culturally, we are family and very community-oriented.

Like, we truly, we take care of each other. And so that solidarity, that caring for the other person, the empathy, that solidarity has manifested from, you know, people pretty much universally masking, which hasn't been true in the U.S. And we know that non-pharmacological interventions, namely masks, physical distancing, avoiding large groups of people, like those are really important ways to decrease transmission. And so Puerto Rico has been vaccinating.

We have, we still have preventive measures in place. So I see that solidarity manifesting in many different ways in the way that Puerto Rico has responded to COVID-19. Yeah. Thank you for laying that out. I'm wondering what role misinformation has played in undermining some people's confidence in getting the vaccine. Because there is a lot of anti-vaccine misinformation circulating English and in Spanish. How did you see these coalitions and these grassroots leaders working around the misinformation, combating it? Yeah. I mean, misinformation and disinformation are a big challenge.

And just quickly, the difference between misinformation and disinformation is basically the intent. Think about your aunt who wants to make sure you're staying safe from COVID, and they share an image on WhatsApp. that contains false information. They want you to be safe, but they just don't recognize that that information is false or misleading. Disinformation is more organized, intentional.

Right. Think propaganda, you know, like people are intentionally spreading false information. And one of the projects that my organization, Ciencia Puerto Rico, has been working on, actually in collaboration with a few other non-profits, in Puerto Rico. We did a rumor tracking project. So we worked with community leaders in,

you know, in different areas of Puerto Rico. And they basically were like our eyes and our ears out in the community. And in Puerto Rico, WhatsApp is really popular. And it's actually a really popular community tool, like communities organize on WhatsApp. And so often these community leaders are getting misinformation and disinformation that people share on WhatsApp and they would report them back to us. This is what I'm seeing, hearing, this is what's being shared. And so what we saw is a lot of the rumors, they were in a few categories. Like people were concerned about the safety and effectiveness of vaccines. People were concerned about how fast the vaccines came to the market. There were also.

government mistrust. You know, there's a lot of government mistrust in Puerto Rico, just generally. So we created materials that responded to those rumors. We share them on social media. But importantly, we share them with those community leaders so that they would have tools to then respond to misinformation and disinformation. So for the materials out there, you created your own materials backed by science and then funnel them to the people who would need them. Right. Wow. So I understand that Puerto Rico still has challenges, though. Some areas have a higher rate of vaccinated people than others. Where are some of the gaps? I mean, to be clear, even the 70 plus percentage of vaccination we have across Puerto Rico is not enough. With a variant as contagious as Delta, ideally vaccination rates, need to be up to 90%. We still have people over 85 in Puerto Rico that have not been vaccinated. We've seen throughout the pandemic that populations that are vulnerable because of social

economic or racial and ethnic factors, they have been disproportionately negatively impacted by the pandemic. And so I'm concerned about the inequities that remain and have. the failure to get those people vaccinated is going to even add to the disproportionate negative effects that they've been facing. And I am concerned because the holidays are around the corner. People get together. Right.

And culturally, it's a time that's really important for Puerto Ricans, you know, and we didn't have traditional holidays last year. So I am a bit concerned about getting. another surge. Well, on that note, so just moving forward, what would you hope the world does to follow

Puerto Rico's example? Well, first is not, I mean, do better with communication. Amen. I mean, that's just been, you know, I mean, that's something that's just been driving me up walls

during the pandemic, just seeing how things get so poorly communicated, you know, vaccination being framed as the silver bullet and the one solution. I think that's wrong because vaccination is not just the one solution. It's a very important solution to get us out of the pandemic, but it's certainly not the only one. And just creating an illusion of this is going to get us out. And then it doesn't. It creates all sorts of challenges that we're seeing right now. So up your communication. Up your communication. make it more nuanced.

And I will say, you know, I think it's been possible for Puerto Rico to take these evidence-based approaches, in part because the science and the response to COVID hasn't been polarized. So the context and the culture, like there's no one-size-fits-all to promote vaccination and to promote masking and, you know, what needs to. be done. It needs to be hyper local. And so understanding context and culture and how people's values and political ideologies, how those relate to the way that, not just people respond to COVID, but the people that understand and value science has been really key as well. And then finally, I would say, you know, give community leaders their rightful place.

They are experts in their communities. In the United States, I think the culture is very individualistic, and we've seen that really manifest during COVID. And so I think kind of reframing the response around community is something that's been, it's certainly been very valuable in Puerto Rico. Yeah, yeah. Thank you so much for taking all this time to talk to us. It's been really, really, really awesome.

This episode was produced by Britt Hansen and edited by Giselle Grayson. Margaret Serino checked the facts. I'm Emily Kwong. Thank you so much for listening to Shortwave, the Daily Science Podcast from NPR.