Fear, wariness among Blacks, Latinos could limit reach of vaccines
A tradition of cruel and dismissive treatment by their government has communities of color mistrustful of virus vaccine effort.
James Marion Sims became known for scientific breakthroughs and inventions that earned him the nickname the "Father of Modern Gynecology."
Much of what he learned was through brutal and inhumane experimentation on enslaved Black women.
From 1932 to 1972, U.S. government researchers refused to provide adequate medical care to Black sharecroppers with syphilis, so researchers could study the progression of the disease. Many of the men they tracked in the now-infamous Tuskegee study went blind, insane or died, despite the fact that penicillin became available to treat syphilis in 1947.
Today, while Black patients are no longer experimented on or allowed to suffer for scientific illumination, many Black Americans still have an uneasy relationship with the field of medicine, which threatens to blunt the impact of any nationwide vaccination program.
Medical care is often financially out of reach for Black Americans. And, in instances when it can be accessed, surveys have shown that concerns Black patients raise about their health are frequently dismissed by medical professionals who are often white.
It is in that atmosphere, with that history, in which the U.S. government will attempt the broadest vaccination program in the nation's history, hoping the variety of vaccines in the approval pipeline will be administered to all — and trusted by all — including by Black Americans and other minorities who have their own histories of being treated cruelly and dismissively by the federal government.
Already, federal officials are pumping the message that the vaccines — and, by extension, the government that approved them — can be trusted. The success of that messaging will be crucial to the overall success of the vaccination regime.
Dr. Larry Bush, an infectious disease expert who is president of the Palm Beach County Medical Society, said 60% to 70% of Americans will need to get vaccinated for the virus to be stamped out.
It will be harder to reach those thresholds without broad vaccinations among minorities, and recent research shows skepticism and mistrust loom as significant danger signs.
Only 42% of Black Americans surveyed by the Pew Research Center said they would get vaccinated, according to a report released earlier this month. Some 63% of Hispanics said they would get vaccinated, while 83% of English-speaking Asian Americans and 61% of white Americans said they would get the shots.
Overall, 60% of Americans said they would get vaccinated, an increase from 51% in September.
Patrick Franklin, president and chief executive officer of the Urban League of Palm Beach County, said not nearly enough is being done to get the word out to minority communities that the vaccines can be trusted.
"There has not been any discussion about a plan that has come across my desk from the county, state or federal perspective," Franklin said. "We need a full, outright campaign to convince people to get onboard. It's going to take more than just, 'Do it.'"
Franklin said a public campaign needs to include prominent Black figures, and the campaign needs to reach all Black communities.
"We need help," Franklin said. "We need help on a broad scale to get us out of this deadly situation we're in right now."
Former President Barack Obama has said he would be willing to have his vaccination in public so more people can have confidence in its safety. Obama, the nation's first Black president, remains a revered figure to Black Americans.
Franklin said getting Black people to embrace the vaccines wouldn't be such a heavy lift if messaging on the coronavirus hadn't been so muddled from the start of the pandemic.
Indeed, President Donald Trump downplayed the threat, publicly mused about dangerous and ineffective treatments, led large gatherings that allowed the virus to spread and minimized the importance of wearing masks. His actions were often mimicked by other white political leaders.
Meanwhile, as the virus marched across the country, minorities found themselves, once again, getting sick and dying at greater rates than white Americans.
Non-Hispanic American Indian or Alaska Native people had a hospitalization rate about 5.3 times that of non-Hispanic white people, according to figures from the Centers for Disease Control and Prevention. Non-Hispanic Black people and Hispanic or Latino people had hospitalization rates that were about 4.7 times that of non-Hispanic white people.
Experts have not identified any type of racial or ethnic marker that makes people more susceptible to the virus, but underlying health factors like obesity and type 2 diabetes have been shown to increase the threat posed by COVID-19, the illness caused by the coronavirus.
The actions of white political officials who downplayed the threat of a virus rampaging through Black communities wasn't missed by members of those communities, Franklin said.
"The way COVID has been carried out, that trust factor is thin," he said. "We've got folks at the state and federal level who wouldn't even do the basics of wearing a mask. When they come out and say, 'Take this,' it's like, 'Oh, hell no. Why should I trust you?'"
With distrust deep and broad, getting many Black Americans to embrace new vaccines will be a tough sell, Franklin said.
"A lot of our seniors will revert back to Tuskegee and say, 'No, not today,'" Franklin said. "The vaccine is not an automatic given. We still have non-vaccine people who won't take a flu shot."
Maricela Torres, whose Esperanza Community Center in West Palm Beach provides assistance and services to immigrants and their families, said there is wariness among many Latinos as well.
Cost is a big concern, she said, recalling her own recent efforts to get day laborers and their families to get flu shots.
"It was, 'It's expensive. I don't have insurance, and I can't afford it,'" Torres said. "Many of them have not been vaccinating their children. They don't really believe in vaccines is what they were telling us."
Torres said she has had some success in turning that around and believes many of the people her organization works with would get a coronavirus vaccine if they could.
"Even though they are a little skeptical, they don't want to get sick," she said. "They are open to it."
Bush, who is enrolling people in the clinical trial for AstraZeneca's vaccine, said he has found that Latinos were more open to participating in the trial and will take a vaccine once one is approved.
But it has been a struggle to get Black participants, he said.
"In our trial right now, we have African-Americans, but not the numbers I'd like to see," he said.
Bush said the wariness of Black Americans should not be dismissed.
"I understand the skepticism of the African-American community," he said. "I get it. It's earned."
AstraZeneca produced a brochure to dispel myths about vaccines and assuage the concerns some Black people have expressed.
"Some African-Americans remember past abuses like the Tuskegee Experiment, in which syphilis treatment was withheld from a group of African American men for many years," the brochure states. "People wonder if something like that could happen today. The answer is NO. Federal guidelines and codes of ethics are in place to protect clinical research volunteers from harm."
Who participates in clinical trials has changed, too, the brochure notes.
"For many years, most clinical trials were done on white men only," the brochure states. "This meant that groups such as African-Americans, women and other minorities were not included. But today, clinical trials welcome the participation of all people, and those clinical trials are closely monitored for their safe and ethical treatment of volunteers."
One of the vaccines in line for approval and eventual use was developed by a Black woman, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, during an event hosted by the National Urban League Tuesday.
"The very vaccine that's one of the two that has absolutely exquisite levels — 94 to 95% efficacy against clinical disease and almost 100% efficacy against serious disease that are shown to be clearly safe — that vaccine was actually developed in my institute's vaccine research center by a team of scientists led by Dr. Barney Graham and his close colleague, Dr. Kizzmekia Corbett, or Kizzy Corbett," Fauci said.
Corbett, who has a Ph.D. in microbiology and immunology, is the National Institutes of Health's lead scientist for coronavirus vaccine research and helped develop the vaccine Moderna hopes to get authorized next week.
"So, the first thing you might want to say to my African-American brothers and sisters is that the vaccine that you're going to be taking was developed by an African-American woman," Fauci said. "And that is just a fact."
Black Americans can also play a role in AstraZeneca's vaccine by participating in the clinical trials underway for it now.
More Black participation will produce a better understood and better trusted vaccine, Bush said.
"If there is something that is disproportionately impacting people like you, do something about it," Bush said in an appeal for more Black participation.
AstraZeneca is giving its vaccine to two-thirds of study participants while one-third gets a placebo. Half of the participants in other vaccine clinical trials got the vaccine.
Bush said stipends are available to compensate study participants for their time and travel. People can learn more about the trial and inquire about signing up by contacting JEM Headlands at 561-612-2803.
"For me, the only way we're going to know how it impacts different groups is we need people to step up," he said. "People are saying, 'I'm going to wait.' What are you waiting for? Somebody else to do the work for you? If people didn't step up for polio, many more of us would be rolling kids around in wheelchairs. People stepped up."