BERREMAN: COVID-19 vaccine: The science and the heart

Kaua‘i residents have performed admirably in the face of the pandemic, leading the rest of the state in keeping the virus in check.

Much of our success so far has been the result of Kaua‘i residents taking prevention seriously. We have been good about physical-distancing, wearing masks, avoiding large gatherings and limiting travel.

We can continue to lead by example in the coming months. Each of us will have the opportunity to receive a COVID-19 vaccine. Understandably, some Kaua‘i residents have concerns about taking the vaccine.

As a public-health physician and a pediatrician, I would like to share insights about the science of the vaccine, and then share from my heart as a mother, spouse and daughter.

Let me start with the science. Although the SARS-CoV-2 virus itself is new, research and understanding about coronaviruses date back decades: science did not start from scratch in this pandemic. The two vaccines expected this month are from Pfizer and Moderna. The data released for both vaccines show very-high levels of protection from disease after two doses of vaccine — more than 90%. Even if actual protection is lower, vaccination can dramatically reduce the spread of disease in our community.

These two vaccines are called mRNA vaccines. Unlike other vaccines, they are not made from killed or inactivated viruses. This offers two major advantages. First, because they contain no virus, they cannot pose any risk of disease or disease transmission. Second, mRNA is broken down by the body, so it has no lasting presence after it stimulates an immune response. It is also important to note that these vaccines can be produced rapidly, inexpensively and in large volume — something critically important to an effective response.

The trials held to date have involved tens of thousands of people rather than hundreds of thousands of people, so naturally there are things we do not yet know about these vaccines. First, we do not know how long immunity lasts or whether a booster dose will eventually be needed.

Second, we don’t know whether they may have rare side effects that have not yet been detected. A “one-in-a-million” event is statistically unlikely to appear when only tens of thousands of people have received the vaccine. Similarly, side effects that occur months to years after vaccination would not have come to light yet. To see those effects, we will need to follow large numbers of vaccinated individuals over long periods of time.

Third, the vaccines available in the next weeks and months are for adults. We are still learning about their safety and effectiveness in children or during pregnancy, and whether they can prevent asymptomatic spread of disease.

Although Kaua‘i has not been as impacted by the disease as other counties, we are aware of its devastating effects. There is strong science about this virus. We know it is very easily transmitted from person to person. We know that it can cause serious disease and even death. We know that some are at higher risk of severe disease than others: those with high blood pressure, diabetes or heart disease, and those age 65 or older are all at higher risk of becoming seriously ill if infected. Pregnant women and their fetuses experience higher rates of severe disease.

We also know that young and healthy people — including children — can experience severe disease and even death if infected. Young adults with seemingly mild disease have died suddenly of heart attacks — a severe complication of COVID-19. The rates are lower, but the risk is real. We know that even those with relatively mild disease can experience lingering poor health for many months after their acute illness. And everyone who becomes infected can, inadvertently, spread disease to others, including to high-risk family and loved ones.

Let me take off my hat as a doctor and speak from my heart, offering my perspective as a mother, spouse and daughter. Like most of you, I am tired of the isolation of this last year. And, like many of you, I have experienced up-close the effects this virus can have. I lost my elderly stepfather to COVID-19 this year. He died alone. His memorial service took place online.

Our family has not had the opportunity to exchange hugs and grieve together in person. My husband and I have not seen our daughters for a year. Both of them live in new places and have new jobs, and one a new fiancée, since we last saw them. My frail mother-in-law has seen my husband only once this year, rather than on his regular monthly visits. Like most Kaua‘i residents, we are ready for a change.

The choice of whether to be vaccinated is not just a personal decision. The pandemic has shown us, more than ever, that we are connected to each other. The decisions we make affect our families, our friends and our community.

The decision to vaccinate or not involves weighing risks, including unknown risks, against benefits. Being vaccinated carries the risk of potential, yet-to-be-discovered, rare side effects of the vaccine. It provides the benefit of a significant added layer of protection from disease.

Not being vaccinated carries the ongoing risk of infection with SARS-CoV-2, possible severe disease or death, and potentially spreading disease to family, loved ones and coworkers. We can lessen the risks associated with not being vaccinated by wearing masks, keeping our distance, limiting our exposure to others and limiting our travel. These behaviors, as we know, come with a steep price, and take an increasing toll over time.

When I balance the science and the heart, the knowns and the unknowns, my choice is clear. I plan to be vaccinated when it is my turn. When my family and friends ask for my guidance, I will share this thinking with them and tell them my decision.

In making your decision, I encourage you to balance the risks and benefits. Please seek out strong science — more is emerging every day. Please talk with your loved ones and trusted advisors. Consider what matters most to you. Pay attention to the course of the pandemic. We all share the goal of leading safe and healthy lives together in harmony. The coming months can bring us closer to that ideal.


Dr. Janet M. Berreman has been the state Department of Health Kaua‘i District Health Office officer since January 2017. Prior to that, she was the health officer for the City of Berkeley, California, for 10 years. She was one of the first pediatricians to join the Wai‘anae Coast Comprehensive Health Center on O‘ahu, where she cared for children for 11 years. Before that, she served as a pediatrician at the Lyndon B. Johnson Tropical Medical Center in Pago Pago, American Samoa. She trained at the University of California San Francisco School of Medicine.

  1. Mr.Ford December 14, 2020 6:12 am Reply

    I thought I was going to hear something about the soul but, all I got was get yourself vaccines so we have God given rights back?

  2. Rick December 14, 2020 7:09 am Reply

    Don’t let them play on your desire to “do the right thing”. Why would you believe all of these corporations and government entities that have terrible track records? Just looking into the history of how many things the FDA said was “perfectly fine” and now we know are terrible for you and most often banned in the US should be enough for any free thinker to see that this is a load of BULL CRAP. You know why people who don’t vaccinate their kids never go back? Because their kids are super fricken healthy compared to kids who have done the entire schedule.

  3. Jonathan Karpf December 14, 2020 7:37 am Reply

    What a sensitive and nuanced article that seeks only to inform rather than to preach. Kauai is incredibly fortunate to have as its district health officer someone like Dr. Berreman with her extensive experience in Polynesia and in public health.

    1. Huh December 14, 2020 2:33 pm Reply

      What article are you reading?! How did you infer that from this article. Haha

  4. Oia'i'o December 14, 2020 8:30 am Reply

    More fear mongering from the doctor. You obviously again are not telling the whole truth of testing and science again. Contradicting yourself again from yesterday’s quotes. You must think we are all unable to think for ourselves. Why are you pushing so hard? What happens when people in our community fall victim to your recommended vaccine? The vaccine companies have no liability. Why? If they were so safe, don’t you think they would take ownership of adverse side effects and have compensation for the injured? Infact all children’s vaccinations are exempt from liability from adverse reactions or death. Why? There is a vaccine court. Very hard to get a trial, very hard to win, and the court has different rules other than our normal court prossess. Why? Are you going to take responsibility Dr. Berreman? Are you personally going to compensate? Of course not ! Our ohana, our kapuna! Is this about public health or keeping your job? Your article is very clear to those who can think for themselves and who are conscious of our current situation. When you push what you think is best for the community, it is your opion. You disrespect the intellect and spiritual beliefs of others in OUR community. We all have choice. This oppression colonialism mentality has to stop. Your way is not the only way. We don’t need you to think for us!! If you and your followers choose to inoculate yourselves, that’s great! If this is your choice and believe you all will be protected then have nothing to worry about those who choose not to be inoculated. That goes for all vaccinations! Your so called “90 % protection.” My views are not anti vaccine but that of pro safety and clear transparency with compensation for the injured and dead. Why is that not the case in the pharmaceutical world Dr Berreman? I think we know the answer $$$$$$$ power control and you are just another obvious tool in their army. Shame

    1. Nancy R December 17, 2020 10:53 am Reply

      Mayor Kawakami was a step ahead……

      As of today, major cities on the West Coast are requiring a 10 Day mandatory quarantine for anyone coming from outside the Bay Area. Probably not a lot of enforcement happening but the message is clear.

  5. Rev Dr Malama December 14, 2020 8:30 am Reply

    History is packed with detailed information on mass epidemics and PLAGUE that decimated whole communities of vunerable people who never saw it coming…. HENSE,
    I do support the vaccination of children and anyone who has low immunity to any deadly disease, especially Measles and polio!
    Flu viruses are hit and miss yearly as these mutations develop ahead of what science can keep up with. The Big Phama companies make mistakes and I was unlucky to be on the recieving end of bad vaccines and still suffer from the side effects…..
    We are watching carefully who, what and when Kauai gets the covid19 vaccine!
    Meanwhile I beg you, Dr. B.

  6. Makani B. Howard December 14, 2020 10:19 am Reply

    Thank you for this informative article.

    I will be first in line to get the vaccine. I am 100% for being inoculated against this horrible virus.

    We go to restaurants and eat food that we have no idea about how safely it is being prepared, we trust the people behind the counter. We get our cars fixed, a deadly weapon, having no clue if it is safe. We do many things daily trusting others with our safety. Why is this any different, especially knowing that many many experts are behind this?

    If you decide not to get the vaccine, and you get sick, it’s you’re own darn fault!

  7. KoKoKook December 14, 2020 2:03 pm Reply

    The author of the article uses the words disease and virus interchangeably. That in itself shows a huge lack of understanding or knowledge of what is driving this pandemic. Really disappointing article.

  8. Unbelievable December 14, 2020 2:19 pm Reply

    This is the most ignorant, irresponsible article ever published and written. I read the entire 58-page FDA request from Pfizer and this article is nothing but lies. I suggest everyone read the actual FDA request to factually inform yourself on this vaccine and do not listen to this irresponsible doctor. The FDA shows much more than a “one-in-a-million chance” of an adverse reaction. And this doctor is right about one thing: this vaccine is not a killed or inactive virus being injected such as a normal vaccine. This is a genetically modified vaccine. People should follow the science and make their own decision. What an irresponsible doctor.

  9. scary stuff December 14, 2020 3:00 pm Reply

    Was it intentionally left out that this COVID-19 vaccine is THE FIRST mRNA vaccine to ever be made and used on humans? We have never had such a vaccine and we rushed it to the market. Anyone who wants to be first in line is using their body as a guinea pig. She even said that we don’t know the long term effects….maybe increased cancer rates, or autoimmune diseases, or infertility, or??? Maybe if you are over 60 years old you don’t care since you don’t have many years left on this great earth, but if you are 20 or 30 or 40 years old, you should care! Of course there will be “effects”…they are injecting RNA into your body! There are only called “side” effects because then the effect is something unwanted. You are so nieve if you think the only thing that it is doing is to protect you from getting COVID-19. Think about it.

  10. we all have a choice December 14, 2020 3:11 pm Reply

    It is a personal choice whether or not to get vaccinated just as much it is a personal choice to treat your body like garbage by feeding it fast food, sugary sodas, and desserts, not exercising, etc etc which effects the community as whole by driving up health care costs for all, etc etc. Can you please write an article about actual HEALTH and what it means?!? Polynesians have some the highest obesity and type 2 diabetes rates around. How about some science based information for the community…like the recent study in which the covid death rates were 4 times higher in vitamin D deficient patients:( Such a bummer that the job of MD is often to push pharmaceuticals.

  11. RG DeSoto December 14, 2020 4:03 pm Reply

    Aldous Huxley said it all 60 years ago. Note the part about people willingly giving up their liberty and actually enjoying it. A quick read of the comments here show just home many are drinking the cool-aid.
    Here is what he said:
    “There will be, in the next generation or so, a pharmacological method of making people love their servitude, and producing dictatorship without tears, so to speak, producing a kind of painless concentration camp for entire societies, so that people will in fact have their liberties taken away from them, but will rather enjoy it, because they will be distracted from any desire to rebel by propaganda or brainwashing, or brainwashing enhanced by pharmacological methods. And this seems to be the final revolution.” (Aldous Huxley, Tavistock Group, California Medical School, 1961)
    Roll over all you caitiffs,
    RG DeSoto

  12. Fed Down December 14, 2020 10:29 pm Reply

    When you get the real Covid-19 virus, after 14 days your Immune System’s antibodies will have eliminated all the Covid-19 virus in your body, then the left over new antibodies will protect you from any 2nd or 3rd wave, etc., infection attempt by other Covid-19 virus, that means you will have Immunity against the Covid-19 vírus.

    And since you will have eliminated all the Covid-19 virus from your body during the 14 days of Quarantine, you will have no Covid-19 virus for spread to others.

    With No virus to spread to others means you are Non-Contageous.

    Having Immunity against the Covid-19 virus, and being Non-Contagious is what every person should want. This would also mean that person is positive when tested and this is good.

    It also means they are part of Herd Immunity, and this is what every person should want.

    This is also why science demands 14 day Quarantines because science knows that in 14 days of being infected with Covid-19 virus, you will become Immune against the Covid-19 virus, and Non-Contagious, and part of necessary Herd Immunity.

    This chain of events of the personal natural human Immune System is what results in elimination of seasonal flu, epidemics, amd pandemics.

    The more you hide from the Covid-19 virus, the longer it will stay.

    94% of those patients said to have died from Covid-19, only 6% of them actually died from the Virus, the rest died from disesss

  13. Carey Sutton December 19, 2020 11:19 am Reply

    Janet Berreman, you are a hero. And so is our mayor for, among other things, having the smarts to listen carefully to your advice throughout the course of this pandemic and letting science lead the way. We are fortunate indeed here on Kaua’i to have you and the mayor and all the people who work with both of you protecting us.

    Thank you, truly, from the bottom of my heart.

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