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Drug users face obstacles and mistrust when it comes to getting COVID vaccine

LULU GARCIA-NAVARRO, HOST:

More than 93,000 people have died due to drug overdose during this pandemic. According to the Centers for Disease Control and Prevention, it's the largest one-year increase in overdose deaths ever recorded. Now, it may seem ironic, but many people who inject drugs are wary of receiving the vaccine due to misinformation and a distrust of government programs and the health care system. Joining us to talk about these challenges is Dr. Hansel Tookes. He's the founder of Miami's Infectious Disease Elimination Act Exchange. His organization helps people who inject drugs to exchange used syringes for clean ones to slow the spread of infectious diseases. Welcome to the program.

HANSEL TOOKES: Thank you for having me, Lulu.

GARCIA-NAVARRO: What does this large spike in overdose deaths look like? What are you seeing?

TOOKES: Well, just like everybody else, people who inject drugs during the pandemic experience a lot of despair. People who had been in recovery, who had jobs in the service industry - they lost their employment during the shutdown. So in order to cope with their emotional pain, a lot of people returned to injecting drugs. We went from a time where we always tell people to never use alone so that if there is an overdose, somebody can intervene, and then all of a sudden, we were living in a world of social and physical distancing. So with the emotional despair, with people being alone, with all of these syndemic issues, we had this horrible spike in preventable overdose deaths during 2020.

GARCIA-NAVARRO: And how does that sort of intersect with vaccination? I mean, these are people who might regularly use needles. So it's not phobia. So why are they so hesitant to get vaccinated?

TOOKES: My patients, I find, are so targeted by misinformation. We don't even see the things that they see when we go on Facebook because of the algorithms. But they are just prey to so much misinformation, whether that be about fertility, whether that be about Nicki Minaj's cousin. It's very, very sad the way that they have been targeted by the algorithms and targeted by misinformation. And so there's a lot of fear of the vaccine. People are scared that the vaccine was rushed. People are scared that the vaccine has a microchip, that it's going to turn people into zombies. These are all things that I hear on a daily basis. It's a very challenging time to be a physician to combat this wave, the tsunami of misinformation.

GARCIA-NAVARRO: Dr. Tookes, and forgive me, but I'm going to ask you something that I think maybe somebody listening to this might ask, which is these are people who are habitual drug users. And clearly, there is a risk to injecting certain types of drugs into your system. And so then why would they be so frightened of something that so many other people are taking? There seems to be a kind of disconnect there.

TOOKES: You know, given the complete instability of the drug supply, people not knowing at all what's in the drugs that they purchase on the street, I was so surprised when they said to me, I don't want that vaccine. I don't know what's in it. I actually had to take a moment as a doctor to compose my face so that I could come up with a response that was not rude (laughter), you know, about that because, you know, their questions are valid. But at the same time, I was very, very concerned that they had received so much misinformation that they were scared of a vaccine that's gone through the FDA and all of these regulatory checks that we have in the United States. So it's really quite ironic, but it's something that we're able to work through.

GARCIA-NAVARRO: I mean, do you point it out to them that, you know, perhaps the drugs that you're taking - we certainly don't know what's in them or where they've come from, and this vaccine is very different to that? And how do they respond?

TOOKES: So I have actually been able to use it as sort of a point to break the ice. I said, well, you know, what they're receiving on the streets - we have no idea what's in it, as opposed to the vaccine, where I can tell you all of the exact ingredients that are in there. And then they laugh. And we laugh together. And they remember that I care about them, and I would never recommend something that would be detrimental. And, you know, I'm the doctor that fought for needle exchange to be legal in the state of Florida. And I asked them to trust me the same way that they've trusted me through the years to advocate and protect their health.

GARCIA-NAVARRO: And has it worked?

TOOKES: It's worked. It's worked. I mean, one of the most gratifying things is when I receive a text message with a picture of one of my patients receiving the vaccine.

GARCIA-NAVARRO: What would you like to see the government or other providers do to get more vulnerable populations like the ones you are dealing with vaccinated?

TOOKES: Well, harm reduction is all about meeting people where they are, and we have learned that the best way to protect people from getting HIV and hepatitis C is to go to them with safe supplies. I think the best way to deliver the vaccine is to deliver it through trusted health care venues. I do a lot of HIV care out of the needle exchange because people trust the needle exchange. It's a nonstigmatizing environment. And so I would like to see more syringe services programs, which are - encompass needle exchange. I'd like to see more of these programs have vaccine on site because there's the additional barrier. I can be in clinic speaking to a patient about the vaccine, but then in the state of Florida, it's commercial pharmacies that have the vaccine. So then I have to send somebody who has substance use disorder - I have to send them off to a Walgreens or a Publix or a CVS. It would be much more convenient when they've made the decision that, yes, they want to get the vaccine - they've received the information from their physician - it would be very nice for them to be able to access the vaccine immediately.

GARCIA-NAVARRO: Dr. Hansel Tookes is the founder of Miami's Infectious Disease Elimination Act Exchange.

Thank you very much.

TOOKES: Thank you for having me. Transcript provided by NPR, Copyright NPR.