COVID-19 Vaccines: A Real Shot in the Arm


Should I get vaccinated…or not? That’s a dilemma for many people, but the decision was easy for Mikiʻala Pescaia, interpretive park ranger at Kalaupapa National Historical Park on Molokai. Safety was her top priority.

Pescaia’s husband, Keoki, operates heavy equipment and helps maintain the water, power and waste management systems at the park. Before the pandemic, when they weren’t at work, they lived “topside” on their Hoʻolehua homestead with their two teen sons, Puʻuhonua and Naiwa (the youngest of their nine children), and Keoki’s 86-year-old mother, Lorraine, a retired emergency room nurse at Molokai General Hospital.

From March through December last year, the couple juggled their schedules to handle their responsibilities as parents and park employees. Deciding minimal movement (hence, minimal exposure to others) would be best, Pescaia hunkered down in Kalaupapa for the majority of time while Keoki went home to Hoʻolehua every other weekend to make sure their family had everything they needed. The longest period Pescaia went without seeing Puʻuhonua and Naiwa was 11 weeks.

“Being in the health-care profession, my mother-in-law also took COVID-19 very seriously,” Pescaia said. “For her, it came down to peace of mind. My two sons spent most of 2020 in online school classes. We didn’t allow anyone except our immediate family into our house. We still have strict protocols for everything, including getting food and mail. When the vaccines became available, my mother-in-law said firmly, ‘I want to do it.’”

Pescaia was surprised at Lorraine’s resolve especially since her go-to remedies are pule and lāʻau lapaʻau, not Western medicine. “But she believes the vaccines are good science,” Pescaia said. “We were happy to be in agreement with her about that.”

The three adults got their first dose in January and their second dose in February. And even though Pescaia experienced flu-like symptoms for three days after her second shot, she has no regrets.

“Yes, having a fever, chills, headache and being sore all over wasn’t fun, but I imagined I was building my own army,” she said. “I thought the stronger my reaction, the stronger my immune system will be if I ever get the virus.”

Pescaia’s other ʻohana – the patients and her coworkers in Kalaupapa – also greatly influenced her decision to get vaccinated.

The community has a long, tragic history. In 1865, during the reign of King Kamehameha V, Hawaiʻi’s legislature passed an “isolation law” that designated Molokai as the quarantine site for people with Hansen’s disease (leprosy). At the time, the disease caused by the mycobacterium leprae bacterium was highly contagious and incurable, so the idea was to keep the afflicted away from those who were healthy.

A colony was established on the Kalawao (eastern) side of the Kalaupapa peninsula. At its peak in the late 1890s, some 1,200 men, women and children lived in exile there. A multidrug therapy introduced in the 1960s cured Hansen’s disease, and the isolation law was repealed in 1969.

“Hawaiians call Hansen’s disease maʻi hoʻokaʻawale, which means the separation disease, because it tore families apart,” Pescaia said. “It left many patients with severe, permanent disfigurements. For decades, they were shunned; they couldn’t touch or be touched by anyone. People were afraid of getting the disease, and the patients were afraid of giving it.”

Today, fewer than 10 patients in their eighties and nineties live in Kalaupapa; the eldest is 97 years old. Over the past 50 years, efforts have been made to break down the walls of separation, but the pain of their past is difficult to erase.

SARS-CoV-2, the strain of coronavirus that causes COVID-19, is spread in the same way as mycobacterium leprae – via respiratory droplets inhaled during close physical contact with an infected person. Because of that, patients once again can’t see friends and family, reopening deep emotional wounds.

“When the patients want to visit with us, we have to say, ‘Wait, Aunty; wait, Uncle,” Pescaia said. “We have to wear masks, we have to stay at least six feet apart. Our patients have endured so much trauma, and you see the hurt in their eyes. It’s as though they’re untouchable again.”

Keoki started planting a garden beside their house in Kalaupapa in April last year, knowing just seeing it would bring joy and comfort to the patients during this distressing time. One of the patients comes every day to check on the plants and talk story with Pescaia at a proper social distance.

“A few weeks ago, he picked the first papaya from the garden, and he was so delighted,” she said. “We planted the tree last July, and within a year, there’s fruit. It’s a measurement of time. That uncle hasn’t seen his friends and family for as long as the tree has been growing, and he’s patiently waiting for them to come again.”

All the patients have been vaccinated, and Pescaia is looking forward to the day when she can hug them and hold their hands again. “There are so many things in life that we don’t know, things that we can’t control, so we have to be overly cautious,” she said.

“There was a time when the patients didn’t have a choice about their care. But today each of us has a say about the vaccine. Exercising that right brings us hope.”