Healer, educator, advocate: Meet Dr. Florencia Polite
At home and overseas, Florencia Polite, MD, is on a mission to help patients and physicians understand how RSV vaccines protect newborns.
When she was 7 years old, Florencia Polite, MD, decided to become a doctor. “I loved the idea of having a career where every day I get to feel like I am helping someone,” she said. Her choice represented a departure from a family tradition—or so she thought.
Many of Polite’s family members were educators. Indeed, her grandparents helped open schools for Black students in then-segregated parts of the United States. “So, education has been the lens with which I have come to medicine,” said Polite, who is now Penn Medicine’s chief of Academic Specialists in Obstetrics and Gynecology and vice chair of the department’s clinical operations. That focus on teaching shows itself when she is training students at the Perelman School of Medicine or engaging one-on-one with her patients to help them learn about their care. Being a physician draws on her “natural gifts and talents” in this way.
In the last few years, however, Polite has leaned into a new role for her latent inner educator: vaccine advocacy, on a broad level. “It’s been my evolution as a physician,” she said, “continuing to educate in all these different settings.” Most recently, she has trained physicians globally about a relatively new vaccine for respiratory syncytial virus (RSV), which can cause serious illness in newborns and young infants, among other at-risk groups. While the vaccine does not protect most pregnant women directly, it does protect their babies. For Polite, sharing this powerful knowledge with both patients and their physicians presents a meaningful opportunity to have an impact, and to save lives across the globe as well as close to home.
The heart of a doctor
As an OB/Gyn, Polite is well-practiced in counseling her pregnant patients about the value of vaccination. The COVID-19, flu, and Tdap shots are all recommended prenatally, so that when a pregnant patient receives the vaccine their immunity can be passed on to their newborn. She’ll also often advise and answer questions about other vaccines outside of pregnancy, from human papillomavirus shots that can help teens and adults potentially avoid cancer later in life, to the shingles, pneumonia, and RSV shots recommended for older adults.
All these vaccine conversations, and the evolution of what her patients need over time, form a microcosm of what she loves about her field—“the longitudinal relationships.” Polite can take care of a young person whose main goal may be avoiding pregnancy and remain that patient’s trusted physician as they reach a stage where they perhaps decide to have children. She may even be asked to take care of a patient’s sister, mother, or daughter, enabling her to care for patients across different stages of life: “That to me is the biggest compliment you can get, is when someone says they want you to care for a member of their family.”
And it’s these moments in the exam room that represent the core of Polite’s interest in doctoring, even as she has taken on multiple administrative and academic leadership roles over the past two decades. “The clinical part is why I stay in medicine,” she said. “This is what makes me come home and feel like, wow, I changed somebody’s life today in very small ways sometimes, and then sometimes in very big ways.”
A call to action
Polite’s commitment to supporting her patients laid the groundwork for a shift in focus a few years ago. As a practicing obstetrician, she saw how deeply and dangerously the COVID-19 pandemic affected pregnant people and the children they were carrying. And as a Black physician, Polite was keenly aware of the reasons why some people of color mistrust medical institutions. That’s why, despite decidedly not being an “early adopter” in many things, she volunteered to be part of the first group of doctors and staff at Penn Medicine to receive the COVID-19 vaccine.
Polite noticed the abundance of people in white coats and scrubs lining up for shots—but few staff in other uniforms, such as environmental and dietary employees or transporters. The vaccine clinic was open to everyone who worked in proximity to patients, but few service workers seemed to be visiting it. “This was a big deal because those groups in the hospital were absolutely taking care of COVID patients. They’re cleaning the rooms, they’re taking in the meals, they had seen what we had seen,” Polite said. “But I also know that those groups are largely marginalized.”
She rallied other Penn colleagues and leaders to create a strategy aimed at assuring staff about the importance and safety of COVID-19 vaccines. The resulting initiative, Operation CAVEAT, featured teams of Black and non-Black physicians visiting employee breakrooms to answer questions and offer their experiences with the vaccine. Operation CAVEAT featured doctors of color talking about the vaccine on digital screens in the hospitals and in mailers sent to support staff, and prioritized vaccinating hourly workers quickly during clinics. Polite also helped to organize a webinar to address vaccine hesitancy, with an audience of about 700 viewers from the Penn Medicine workforce.
Polite received several prestigious national and local awards for this work, including the American College of Obstetricians & Gynecologists’ Immunization Champion Award. “It was really the first time I could say, I personally had a stake in vaccine education in an institution,” Polite said. “It was a career inflection point.”
Championing immunization against RSV
After the pandemic, Polite was set to take her advocacy to an even higher level. While serving as a healer of individual patients first gave her work purpose, the chance to expand the scope of her influence through educating others about vaccines emerged as a new passion. “What are the ways I can do that on a broader scale?” she asked herself.
Polite found her answer earlier this year in conference rooms, grand rounds, and even Singapore’s Ministry of Health, as a member of the Pfizer PEARL committee: PEARL (PEdiAtric and mateRnaL) Immunization Expert Group, a consortium of physicians counseling their counterparts in three Asian countries about the RSV vaccine.
Now in its third year since approval by the U.S. Food and Drug Administration, the RSV vaccine is given to pregnant people so that they can pass antibodies to RSV on to their newborns. The virus itself is common—most children catch it by their second birthday—and usually mostly harmless, but in infants younger than six months, who haven’t yet developed immunity to it, RSV infection can lead to hospitalization and sometimes even death. (Adults age 75 and older, and some younger adults with certain risk factors, also face higher risks from the virus and can benefit from the vaccine.)
Polite found the opportunity to speak about immunization to other clinicians both rewarding and eye-opening. Her experience with the consortium helped Polite realize that teaching providers is the way to help patients understand the importance of vaccination—and RSV prevents a unique challenge in this regard. “This is a vaccine that the OB/Gyns are talking to patients about, but we have not seen the burden of disease,” she said. “We don’t see the very sick babies that the pediatricians do.”
And even those providers who are aware of the potential seriousness of RSV may struggle to help pregnant patients understand it, especially first-time parents. “Often it's hard to get someone to take the vaccine for the first time unless they have had a child who had RSV or know somebody who had RSV,” she said. “Those other moms sign right up. If they had seen a sick baby in the winter with RSV, they were absolutely the ones who were like, ‘I know what that looks like. Let's go.’”
‘The goal is to educate’
The experience of providing RSV vaccine education to overseas clinicians has energized Polite to emphasize this aspect of her practice among her colleagues, as well as patients. She sees her role in enhancing awareness of the benefits of vaccines as a teacher, not a taskmaster. When Polite is counseling a pregnant patient, her focus is on sharing information, answering questions, and empowering the patient to choose for themselves. “My approach is, ‘I’m going to give you these tools, I’m going to give you this education, but then I want to engage you to make the decision,’” she said.
It's a challenging situation for physicians given the circumstances: Patients now have four vaccines recommended during pregnancy, there’s a great deal of misinformation about the vaccines, and office visits are brief. Polite tries to sensitively address patients’ concerns, whether they’ve previously had a bad reaction to a shot, or worry about something in it, or don’t think the disease is a big deal. “The goal is to educate, not pressure,” she said.
In each instance, Polite channels her inner teacher, coming full circle with her family’s legacy. The key to helping patients reach their own decision when fully informed about medical evidence, she said, is empathy. “It's the ability to connect with patients. It’s the ability to communicate with patients,” she said. “The trusted doctor–patient relationship matters now more than it ever has.”