Black Americans are reluctant to take a COVID-19 vaccine. Efforts to build trust are underway.
A history of unethical medical experimentation on Black people has raised vaccine concerns among communities of color.
Coronavirus vaccines were a topic of the day for volunteers at Global Scholars Academy in Durham last Saturday. The church across the street, Union Baptist just north of downtown, was hosting a coronavirus testing site on one side of the school, and volunteers were distributing meals and Christmas gifts on the other side.
The FDA had authorized the Pfizer vaccine for emergency use the night before. Public officials and some residents have turned their hopes to science to help lift the country out of the deadly and economically devastating COVID-19 pandemic.
But many are reluctant to take a coronavirus vaccine, and as a group, Black people are among those most wary. Discussion of the new vaccine among Saturday’s volunteers, most of whom were Black, was mixed with recollections of medical abuses and unethical scientific experimentation on Black people in the United States.
The most infamous study in the nation’s history of this kind was the Tuskegee experiment, which ran from 1932 until 1972. The U.S. Public Health Service provided free health care to 600 Black men, 399 with syphilis, and told them they were being treated for “bad blood.” The true purpose was to record how syphilis progressed. The researchers withheld treatment, and men in the study died of syphilis or suffered other effects of late-stage infection.
North Carolina in recent years acknowledged its role in abusive medical practices when it agreed to compensate people forced to be sterilized under a state-sponsored program. North Carolina’s 40-year eugenics program sterilized nearly 7,600 people before it ended in the 1970s. A majority of those sterilized were Black.
Dorothy Robertson, 41, on Saturday recalled the case of Henrietta Lacks of Maryland as an example of medical professionals withholding information. In the early 1950s, Lacks’ tumor cells were biopsied, cultured, and used in thousands of research studies without her family’s knowledge.
“If you don’t know, they won’t tell you,” said Robertson, who lives in Spring Lake. “We don’t know what’s in the vaccine.”
Michelle Laws, associate minister at Union Baptist, said it is important to acknowledge these traumas and valid fears while giving the facts about the new vaccines. “We don’t want our community at the back of the line,” she said. Laws works at the state Department of Health and Human Services as assistant director of consumer policy and community engagement in the Division of Mental Health, Development Disabilities and Substance Abuse Services.
Black, Indigenous, and Latinx people in the United States die from COVID-19 at higher rates than white people, according to a study by the APM Research Lab.
State officials and medical professionals are trying to respond to skepticism by explaining how the vaccines were developed and emphasizing that both the Pfizer and Moderna vaccine studies included Black and Latinx participants.
Pfizer reported that 10% of its study participants were Black and 13% of study participants in the United States were Hispanic/Latinx, and Moderna reported that 10% of study participants were Black and 20% were Hispanic/Latinx.
State and national polls of public views on coronavirus vaccines consistently show Black respondents are more reluctant to take them.
While 43% of white respondents to a recent Elon University Poll said they would take a COVID-19 vaccine if it was approved by the FDA, only 27% of Black respondents said they would take a vaccine. The poll of nearly 1,390 state residents was conducted from Dec. 4-6, before the FDA approved the Pfizer vaccine.
While some of the volunteers directing traffic at the Durham school on Saturday said they were eager to take a vaccine, others said they would not. Most of those interviewed said they would wait until they saw the effects on other people before deciding.
Glenn Mitchell, 57, said he would probably take the vaccine, though he worries that it hasn’t been fully tested and that all the side effects aren’t known. “Medically, they’ve done the best that they could, given the time,” said Mitchell, a Durham resident. “That’s what really scares me, because it was rushed.”
One volunteer said it wouldn’t be a good idea to take a vaccine developed at “warp speed,” the name of the federal government’s vaccine development operation.
In–person surveys conducted by NC Central University’s Advanced Center for COVID-19 Related Disparities in nine counties found 22% of African-Americans said they were ready to take a vaccine and 32.5% of Latinx respondents said they were ready.
“The messages were that they didn’t trust the government, most especially the current administration,” said William Pilkington, director of NCCU’s Health Equity, Environment and Population Health program. “They didn’t trust Trump.” People also worried about vaccine safety, he said.
Survey respondents said they trusted their doctors, Pilkington said. “We need to find Latinx doctors and nurses, African-American doctors and nurses. They need to be the folks on the radio and on TV saying it’s important to be vaccinated. That’s where the trust lies.”
Doctors, nurses and other hospital staff who work with and around COVID-19 patients started getting the Pfizer vaccine this week. Vaccines are expected to be available to the wider public in late spring or early summer.
Black and Latinx doctors are letting people know that they have been vaccinated, hoping they will serve as living examples of trust in vaccines.
Dr. Julius Wilder, a gastroenterologist at Duke Health, was one of the first there to get a shot of the Pfizer vaccine. Wilder said he wants to be able to speak from experience when he talks others in the Black community and to his patients about vaccines. “I thought it was important to serve as an example,” he said. “Many people have some vaccine hesitancy and certainly communities of color have some historic legacy of this for good reasons.”
That history and fear should be acknowledged, Wilder said, while letting people know why these vaccines are different, that “the appropriate, ethical studies were done in a diverse group of people to know that these vaccines are safe and they are efficacious.”
Trusted community influencers, working with health systems and people in medicine who understand the science should help spread the word about vaccines, Wilder said.
“The key piece will be to communicate with them, work with them to help those communities embrace it,” he said.
Qué Pasa, a Spanish-language newspaper, had a story and photos of three Latina health care workers, Drs. Viviana Martinez-Bianchi and Gabriela Maradiaga Panayotti of Duke and Luly Beckles, a child injury prevention coordinator at Brenner Children’s Hospital in Winston-Salem, getting COVID-19 vaccine shots this week.
The two Duke doctors co-founded LATIN-19 to get information about COVID-19 to Latinx communities and make testing sites convenient to them. LATIN-19 holds weekly Zoom meetings open to the public where Latinx community advocates share information and concerns.
At a Wednesday meeting of LATIN-19, Ben Money, Deputy Secretary for Health Services at NCDHHS told the group about plans to “create a proactive, inclusive, evidence-based communications plan that is guided by research.”
The state hired consultants to do research to be used to develop a communication plan, Money said. “We want to understand the barriers, values and motivations,” he said. “We want to understand that across many populations. We want to make sure messages are proactive and culturally and linguistically responsive.”
Research for the state showed that African Americans and women were the most hesitant about COVID-19 vaccines, he said.
“The politicization of the vaccine has created some of this hesitancy,” Money said. “We know there are concerns about how the vaccine was developed and the speed of development.”
Advocates and other participants said Latinx residents would be reluctant to take shots that are encouraged by the government, and with their contact information being collected.
At a news conference last week, Dr. Mandy Cohen, DHHS secretary, said the state is making sure that data systems are secure and data sharing is limited.
“This is the bread and butter work of public health,” Cohen said, “to make sure that we can handle this kind of sensitive information.”
The Pfizer and Moderna vaccines are given in two doses, weeks apart. Contact information is collected to remind people when they have to take the second shots, Cohen said.
“I would say particularly to our Hispanic and Latino communities, who I know have more concerns about giving information, we do not want that to stop folks from getting this potentially life-saving vaccine. This is not information that’s going to be shared beyond health care providers.”
Even as those around him Saturday said they were skeptical about a COVID-19 vaccine, Elliot Palmer of Raleigh said he would definitely take it. The Friday before, North Carolina reported more than 7,500 new coronavirus infections, a state record.
Coronavirus “is spreading across North Carolina like wildfire,” said Palmer, 57. “I know people who have gotten COVID and people who have died from COVID,” he said.
The Rev. Prince Rivers, senior pastor of Union Baptist, said in an interview Saturday that he was considering having a vaccine webinar for church members, to include Laws and others. Telling people to take a vaccine because the government says so isn’t going to work, Rivers said.
A church Q&A would “help people get a real objective sense of what the vaccine is about,” Rivers said. “Obviously, they have to make their own choice.”
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