Building trust in vaccines a challenge at community colleges

Photos courtesy of Borough of Manhattan Community College

Earlier this week, New York Gov. Andrew Cuomo announced a significant mandate for students in the State University of New York and City University of New York systems. To attend classes in the fall, they will need to get one of three COVID-19 vaccines once they are FDA-approved.

The requirement affects larger institutions and a large portion of community colleges across the state, including one in the heart of New York City.

Borough of Manhattan Community College is located about 10 blocks north of One World Trade Center. It boasts more than 25,000 students who come largely from across the city’s five boroughs. Around 44% are Hispanic/Latinx, 26% are Black, 12% are Asian and 10% are White.

Due to logistical nightmares of getting students onto campus during the pandemic, BMCC has operated almost exclusively remotely during the 2020-21 academic year, save for some healthcare programs. But in the fall, like most institutions, it expects to reopen further for in-person learning.

Up until a few days ago – and before the mandate – there was a lot of uncertainly about how that might happen. In a poll conducted on campus on St. Patrick’s Day, only 50% of students had gotten the vaccine or planned to get it. The faculty numbers weren’t much higher, at 64%.

On the student side, 18% said they would not get the vaccine while 30% said they were hesitant. That reluctance is also felt among staff and faculty (25%). Both of those numbers are above the national average of 15.6%. It has been one of the fears from community colleges across the nation: if we mandate it, what will be the reaction? Will enrollments drop further? Will students who are here just drop out? Will faculty walk away? Those are some of the reasons why so many haven’t.

Lesley Rennis

“Being a community college, our doors are open to everyone. There is no admissions test. We’re serving primarily immigrant and minority students,” says Professor Lesley Rennis, the college’s Health Education Department Chairperson. “So, to start putting those roadblocks in the way of their admission, we have to be very careful about how those are going to impact them.”

So BMCC decided more than a month ago to begin a campaign not to change minds, but to present the data and answer questions about the vaccines. Rennis has been sharing her knowledge with students and with the community, helping BMCC host two town halls that addressed concerns, giving attendees feedback and information they were looking for.

“The purpose is to get information out to the college population from one source,” Rennis says. “As you can imagine, BMCC is a big place, and everyone has their version of what’s going on. Town halls allow the message to come from the President, for people to get the same message, and then respond to that message. We were encouraged by those who attended and their questions.”

Facing hesitancy head on

Those who haven’t made a commitment to getting vaccinated at BMCC have their reasons. Some may not believe in the data or the science. Some may not have enough evidence yet to be convinced they are safe. And some have other concerns.

“Most vaccine hesitancy studies point to trust and respect of the messenger as often having more weight than scientific data, especially among marginalized populations,” Rennis says. “Scientific facts are good, but the real issues of trust and perception are often more important.”

Rennis says the tumult of the past year – the combined chaos of the pandemic and politically charged atmosphere – has made would-be vaccine candidates pause. There are those who may have shied anyway because of “deep mistrust” in the system.

“What I have found is in a lot of these situations where I’m giving a talk, or even if I’m having a personal conversation, you get to a roadblock and the person says ‘yes, the science is correct. Yes, I understand the nature of pandemics, epidemics, and viruses and why this is important. But I just don’t want to because I don’t trust it,” she says.

So how does a public health professor like Rennis who is well respected gain the trust to even have those conversations?

“The best way to reach them is the same way to reach anybody. It’s understanding that it’s an individual choice,” Rennis says. “People make these choices based on a host of factors – allowing them to express their choice, but then having an open enough dialogue where you can present the science, present the positives about vaccination. Our population is primarily students of color, low income, so to mandate them to do something related to their health, thought has to be put into it, so that it’s not seen as discriminatory in any way or forcing them to do something that they consider to be outside of their belief systems.”

In hindsight, she says there may have been more of an embrace had the vaccines been rolled out and delivered through medical establishments.

“To have that conversation with a medical professional who could go through the kind of pros and cons – What are your risks? How did you make that decision based on what you think is most beneficial for you and your family?,” Rennis says. “But I understand why they had to do it.”

Difficult decisions

It appears BMCC students won’t have a choice if vaccines do get the nod from the FDA before the fall. A mandate will put those on the fence in a very unique position – get COVID-19 shots and come back to campus, or don’t. It is unclear whether BMCC officials would consider more remote learning (it is expected to have 50-60% of classes face-to-face) or whether they would even be in position to do so.

Rennis said she has had discussions with both faculty and students on campus about her own experiences with getting the vaccine – “I was a little bit under the weather, but then it quickly passed” – as well as other mandates outside of the college.

Because many of the public health courses she teaches involve students who are in their final semesters at BMCC, they have asked questions about employers requiring vaccines from workers.

“We had a conversation about a company’s right to [mandate vaccines],” she says. “Public health is forever about the conflict between personal rights and choices vs. public good. That choice is never easy. When it comes to things like infectious diseases, there’s a huge public responsibility that the individual has. So, your decision not to get vaccinated is 100% your decision. But understand that when you step onto a campus or a workplace where there are 25,000 other individuals, the likelihood that if you were infected and that you would infect someone else goes up. So that changes things.”

For the 330-plus campuses that have said they would mandate vaccines, they appear unwilling to take those risks, leaning toward public health guidance and vaccine efficacy to make those tough decisions. Rennis says she understand the concerns but also understands the science.

“As a public health professional, I’m very much aware of situations where there’s a need for regulatory body around the things that people do in the name of medical research,” she says. “I am not saying trust medical professionals 100%, and I’m also a big proponent of complementarian, alternative therapies. However, I’m also steeped in science. I understand bacteria and viruses. I understand the ecosystem and where the world is heading in terms of these repeated exposures to viral epidemics.”

For community colleges outside of New York that have not imposed mandates, the work continues to try to get their populations vaccinated. Town halls, workshops, and a continuous barrage of materials and incentives might help sway those on the fence. But time is a factor as they race toward the fall.

“I hear more people who are saying, I want to wait,” Rennis says. “I want to see how things fall out in terms of how quickly the vaccines are put on the market. That makes sense if you’re in your home and working from home. However, the minute you start interacting with others, then you’ve got to rethink that timeframe in terms of waiting.”