For all the alarming news about surging cases of COVID-19 in the U.S., vaccines have increasingly seemed like a reason to hope. This month alone has been filled with positive reports from some of the 23 companies working toward a vaccine, including Moderna, Pfizer/BioNtech and AstraZeneca.
The best and brightest minds are working around the clock to find a vaccine that is safe and effective, buoying hopes that a solution to the coronavirus pandemic may be within reach. But as the science world remains laser-focused on finding the best vaccine candidate, other experts are worried about another piece of the puzzle: ensuring people will actually get it.
Vaccine hesitancy, which the World Health Organization defines as the “delay in acceptance or refusal of vaccines despite availability of vaccination services,” has been a growing problem in the U.S. for years. The phenomenon, which led to more than 19 measles outbreaks in the U.S. in 2019, transcends age, socioeconomic status and race, but in a pandemic that’s disproportionately affecting people of color, it’s hesitancy among the Black community that physicians and anthropologists are most concerned about.
Monica Schoch-Spana, a medical anthropologist and senior scholar at the Johns Hopkins Center for Health Security, led a paper released this month exploring that and other topics, and offering recommendations for how to “advance public understanding of, access to, and acceptance of vaccines that protect against COVID-19.”
When it comes to this issue, she says that “underserved, marginalized populations” need to be the priority — and that earning trust among some in this demographic will not be easy. “Vaccine hesitancy in the African-American community has a very specific shape to it because there is a past in the U.S. of experimentation on the bodies of Black men and women without their consent in an unethical fashion,” says Schoch-Spana. “People are very cognizant of that in the community. But this isn’t just about the so-called past, it’s also about the present.”
Schoch-Spana notes that even today, Black people and other people of color “face systemic bias” in the health care community. Indeed, a multitude of studies have shown that people of color receive less care and worse care than their white counterparts, and that white physicians in particular have an “implicit preference” for white patients. For all these reasons and more, many in the Black community remain skeptical of vaccines.
A 2016 Pew poll found that while 79 percent of white adults considered the measles, mumps and rubella (MMR) vaccine to have “high preventative benefits,” only 56 percent of Black adults felt the same way. The disparities continued when it came to the coronavirus vaccine. In a survey released in June, Pew found that only 54 percent of Black people said they would get a COVID-19 vaccine if it were available, compared with 74 percent of both Latino and white adults.
“They have very reasonable hesitations around a vaccine that would be recommended by health authorities that have not done right by them either today or in the past,” says Schoch-Spana. “So we have a paradox. We have a community that has suffered a greater impact than others; at the same time they are more hesitant around a safe, effective vaccine that could actually be protective. ... So, how do you reach the people who could benefit from the vaccine the most, yet that same population who has grave reservations?”
Dr. Uché Blackstock, Advancing Health Equity CEO and Yahoo Life medical contributor, has dedicated her career to fighting inequality in America’s health care system. In a recent talk she gave on the topic, Blackstock says she brought a 2016 study from the University of Virginia that “false beliefs about biological differences between Black and white people” leads physicians (in particular white ones) to underestimate Black people’s pain.
Blackstock says it’s facts like these that inform how many in the Black community view the medical world. “People like to say this is all in the past. And I said, no, what we know is provider bias right now is implicated in the racial health disparities that we see now,” she says. “Whether or not providers are being intentional or unintentional about it, it’s still happening and it’s still causing harm.”
Considering how long this issue has persisted, and the fact that it’s still a problem, Blackstock says that a solution will not be developed overnight. “This is over 400 years of this. That’s how deep we’re into these health inequities,” she says. “And so it’s going to take us probably twice as long to get out of it.”
So what can be done to fix the problem?
Schoch-Spana and others have been working to answer this question, calling for funding from Congress to provide education, making plans to ensure vaccines are available in safe, familiar places and forging relationships with trusted community groups and spokespeople who can communicate accurate and useful information about the COVID-19 vaccine.
Blackstock says one key component will be working to ensure that clinical trial participants are inclusive — citing recent data from the Moderna vaccine that showed 89 percent of participants in the trial were white. “You have to have the diversity reflected in the people who are being studied,” says Blackstock. “If that doesn’t happen, I could see a lot of Black people saying, ‘Well, it wasn’t even studied on people who look like me.’”
But she agrees that the last recommendation from Schoch-Spana — to connect with existing groups In these communities — will be vital. “There is going to have to be education and outreach in Black communities, and that should be done by trusted individuals like community health workers or community-based organizations,” Blackstock says. “People that are already on the ground doing the work.”
For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.
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