BOSTON — Whenever his mother told him about her newfound mistrust of vaccines, Jorge David Gutierrez saw it as a kind of cognitive dissonance. She was proud of him, the first person in their family to graduate from college — Brown University, no less, in neuroscience. He was applying to medical school. Here he was, in the meantime, working on a clinical trial for Brigham and Women’s Hospital. She valued the work he did.
Yet friends also sent her posts on social media. She trusted her friends, so she trusted what they sent. It frustrated him. He’d tried to point out the telltale signs that something online might not be worth believing in — the post with less-than-reputable sources, the shoddy quality of a video, the ad posing as an article — but she was never quite convinced.
She was online more and more these days. She’d been, at various times, a nanny, a custodian, and a warehouse worker — and then suddenly she was swept up in the pandemic’s layoffs. She’d since managed to get a part-time job cleaning offices, but it was only six hours a week.
With no car, little work, and the worry that she might get sick on public transportation, she was home a lot, with her phone and tablet as a primary link to the world. As Gutierrez saw it, that influenced how she thought about Covid-19 vaccines: “She’s said, ‘This is the work of the devil, to get a chip in us, to track us.’”
He wondered, in that moment, if she didn’t realize that the project he’s working on is a Covid-19 vaccine.
Gutierrez is 23, a true believer in his work. He wishes he could volunteer for the study he’s recruiting for. If he weren’t ineligible, as a hospital employee working on the trial, he’d sign up in a second — one more person, nudging toward the 30,000 needed. Instead, he talks to strangers about it. He knows there’s a risk, striking up conversations in the line waiting for coronavirus tests. It’s worth it. Even a face shield feels like too much of a barrier to him, so he doesn’t use one. Just wears his glasses and mask and tries not to get too close.
Building trust is everything. He asks for permission to broach the subject. Waits, scans the person’s face. Sometimes people brush past him, ignore him, tell him to go away. He wishes they didn’t have to be so rude about it. I’m just doing my job, he thinks, just trying to make some small contribution toward ending the pandemic. He doesn’t say that. He just smiles under his mask and wishes them a good day.
Sometimes, after a string of refusals, he’ll take a break, cheer himself up with TikToks and memes.
If someone has even the slightest bit of interest, he might say, “We’re looking for volunteers in the hopes of finding a vaccine that will protect people from getting or developing Covid. It will involve around six visits over two years. You will not get or develop Covid because of the vaccine. We will not expose you to the virus. You will live your normal life.”
He’s been giving this spiel since July, when he signed on to the Brigham’s trial for the Moderna vaccine. The conversations take place in the parking lot of the Brookside Community Health Center, where a cluster of tents are open Wednesdays and Thursdays for walk-in coronavirus testing and a handful of other services. People come to have their nose swabbed and leave registered to vote, carrying a white garbage bag, plastic stretched under the weight of free food. Sometimes the lines wrap around the block — a measure of the surrounding neighborhoods’ need. Employees might hand out 1,050 diapers, 750 apples, 600 oranges, and 450 tomatoes in a day.
Technically, it’s in the southwest Boston neighborhood of Jamaica Plain. Here, the crowd waiting is diverse, chatting to pass the time in Spanish and Haitian Creole and Portuguese and Mandarin, health care workers in scrubs and construction workers in paint-spattered jeans.
That’s why Gutierrez is there: to recruit the communities of color that have been alienated by American medicine, left out of clinical research, hit hardest by the pandemic. “If we want to make sure this vaccine works for everyone, then we need to include everyone,” he said.
It isn’t easy. In early August, for instance, only 5% of Moderna’s enrollees were Black — less than half their share of the U.S. population. Eventually, the organizers became worried enough that they slowed down the breakneck pace of recruitment, instructing some sites not to sign people up if they were white.
For outreach workers, that meant overcoming people’s deep-seated distrust. To try to prevent coronavirus spread, a lot of that had to happen on Zoom or Facebook, in webinars or virtual town halls. At Brookside, it’s happening face-to-face, the recruiters decked out like clipboard-carrying fundraisers on the street — except what they’re hoping for is not people’s money, but a donation of their time and body. It means discussing everything from their fear of deportation to their understanding of immunology.
Gutierrez is Colombian American himself, his co-worker Nicole Taikeff Gabela, Ecuadorian. They speak Spanish with the Dominicans, the Salvadorans, the Puerto Ricans, the Guatemalans. They’d both spent time recruiting for other research projects, with the goal of including people of color. They know to avoid the word “investigacion,” which is one way of translating “study,” but which can also carry a connotation of law enforcement.
“It can cause a lot of harm, it can push people away,” said Taikeff Gabela. “We can’t ignore that there’s a specific climate that has caused a lot of fear in immigrant communities.”
Her experience has been different from Gutierrez’s. She said that the majority of people she approaches want to hear about the trial. Some are enthusiastic enough to start filling out the pre-screening questionnaire right then and there. Most, though, want to talk to her and then read more at home. She gives them her name and phone number. She tells them they can find her there again next week. People ask about where the study is taking place and how they can get there. To some, a potential side effect of a headache, for instance, seems manageable. To others, that might get in the way of balancing work with childcare.
People also wonder about the American government’s involvement in the project and what that means for participants. “Is this the Trump vaccine?” Gutierrez remembered people saying. “Are they going to ask me about my citizenship, my legal status?”
They’d always been close. He was her only son. In fact, she was part of the reason for his interest in medicine. She’d gotten polio as a kid in Colombia. Her house had had no running water; she’d helped haul what her family needed for drinking and washing home in buckets. Some must have been contaminated, she said, and made her sick. It left one leg shorter than the other, nerves damaged, muscles withered. He watched her stumble as she walked, and watched how her pain worsened with every fall. Growing up, he’d massage her bad ankle, to try to give her some relief.
Because of her many medical conditions, her doctors thought she might not be able to have kids. “She had a couple of miscarriages,” Gutierrez said. “I was lucky to be born, I guess.”
She didn’t want to be interviewed for this article herself, but Gutierrez knows she wasn’t suspicious of all vaccines. He got all his immunizations growing up. When he was 15, they moved from Cali, Colombia, to Elizabeth, N.J., and he often thought about how different his life was from hers, by the mere coincidence of circumstance: When and where you lived, and how much money you had, had such a profound effect.
He was home in Elizabeth one of the last times she’d brought up her conspiracy theories. It was late summer. Usually, he drove back from Boston every few weeks, but because of the pandemic, he hadn’t been in nearly six months. Seeing his mom was a relief.
He drove her to doctors’ appointments. They did errands, went walking on the beach. He was lying on one of the living room couches — the longest one, with the most room to stretch out — laptop on chest, streaming a “Legend of Korra” episode, when the subject resurfaced. It might’ve started with his desire to take part in the study. She was fiddling around in the living room, idly tidying, when she said she was against the idea. Here we go again, he thought.
I don’t want you to be like a rabbit, she told him. You don’t know the side effects. There are other people that can be doing this.
At some point he paused the program and sat up. She was back onto what she’d heard online, that this vaccine had something to do with Bill Gates, that it was a surveillance tactic, that it contained a microchip.
We’ve already been through this, mom, he said. There’s no chip.
You can hear a hint of exasperation in the way Gutierrez recounts this — the familiar tone of hamster-wheel conversations with close relatives, an inner eye-roll tempered with affection. No matter how many times they talked about it, he wasn’t going to back down. He works on a Covid-19 vaccine trial, knows for a fact that the Bill Gates microchip stuff is nonsense, that such conspiracy theories create harmful divisions — and eventually his mom changed the subject, asking about his med school application instead. “She was like, ‘OK, OK, I don’t want to talk about it, because you love to make me upset,’” Gutierrez recalled.
“Multiple touches,” they call it. One week, someone in line might snap a picture of the flyer with their phone, not wanting to handle anything that could be carrying the virus. Next week they might recognize the recruiter who’d held the paper up for them, might strike up a conversation.
Gutierrez might walk with people until it’s their turn for a nose swab, and then they might speak with Taikeff Gabela by the food distribution tent. She might lead them away from the hubbub, onto a little patch of grass, underneath some trees, to create more of a sense of intimacy. She wants them to feel comfortable asking questions, telling her about their fears. One woman, waiting in line for a bag of food, stands out in Taikeff Gabela’s mind. “This person said, ‘I don’t want to hear about this, because I know I can get Covid-19 from this vaccine,’” she recalled.
It was something they heard a lot. Taikeff Gabela was careful; she didn’t want to push it. She asked the woman to tell her more about what she’d heard, and the woman said the vaccine contained the virus, that you could get respiratory symptoms from the injection.
It’s an understandable mistake. Some vaccines do contain weakened live viruses, so that your body learns to recognize them and fight them off without getting sick. Taikeff Gabela asked if the woman felt OK hearing more about how this particular vaccine was made, and the woman said yes. So Taikeff Gabela explained that this shot contains just a tiny, synthetic fragment of the virus — just enough for the body to learn to recognize the pathogen, but nothing that can actually cause the disease. “In order to have the infection, you need to have the whole virus,” Taikeff Gabela said.
It didn’t mean that the woman was ready to sign up right away — but she thanked the recruiter for the clarification. Over the course of a few minutes, her tone had shifted.
“You don’t try to push people into this, it’s not like a hard business sell,” said Paulette Chandler, an epidemiologist and family doctor who’s helping coordinate recruitment for the Brigham. “Ideally you provide the information about what it is, about what the benefits and what the potential harms are, and then you let the person decide, because it truly is an act of altruism.”
Every so often, during his paperwork days, Gutierrez sees a name he recognizes, and feels a little burst of excitement. “I’m like, ‘I enrolled that person,’” he said. More often, he’s just happy if he’s able to spark even the shortest conversation.
As the 30,000 spots across the country have started to fill up, though, the outreach has paid off: According to the company, as of August 21, about 18% of all participants so far were Black, Latinx, American Indian or Alaska Native, but as of October 2, about 33% were “from diverse communities.” A company spokesperson said he did not have a more detailed breakdown.
Gutierrez knows firsthand the sort of enthusiasm that underlies this trend. For some, it emerges from loss: One woman told him about her husband who’d just died from Covid-19, the trips they’d hoped to take together, how she saw a vaccine trial as a way of preventing others from being left bereaved and alone. For others, it’s only logical: They don’t like the virus-altered version of their world, so have a stake in the development of vaccines. For all of them, it’s motivated by a strong sense of altruism.
But he’s also become a grudging connoisseur of the fears and conspiracy theories that cling burr-like in people’s minds. Whenever someone tells him that this vaccine is part of a plot by Bill Gates, to keep tabs on people by injecting them with microchips, he gently tries to tell them otherwise. Yes, it was made in a lab, he says, but not by Gates. Yes, it’s synthetic, but it doesn’t contain any microchips. He imagines that he’s talking to his mom. But his tone is light and professional, with no trace of arguments past, no hint of exasperation.
“If I haven’t been able to change my mom’s mind, would I be able to change the mind of some stranger outside of a health center?” he asked. “Maybe. But most likely not.”
Who knows? He might see the person again, back for another bag of food next week.
This story has been updated to include new comments from Nicole Taikeff Gabela.
I am sympathetic to this man’s frustration and understand we need some public buy-in for public health, especially vaccines, to work – but reading about endless irrational objections to them starts to make me feel we need to just force it, make it the law, and stop all the BS. The stakes in childhood vaccinations, to be very blunt, were nowhere near as high as they are now – and, knock on wood – as they may be, repeatedly, if we uncover and promulgate more and more novel zoonotic viruses – they may keep on coming, unfortunately. Make it the law – if you want to go back to work, if you want your kids in school, if you want medical care – you get vaccinated. Most of the objectors are not really committed to not being vaccinated, they just feel distrust and unease. We have to shut this down already.
This article was amazing. I feel like it talked about real issues with real people. Too often articles deal with issues in terms of politics. This was an article that was compassionate and understanding of peoples’ fears and these dedicated medical professionals that are changing the world for the better, one person at a time. Thank you.
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