Adelabu has countless reasons to distrust a potential vaccine, and most of them lie in the federal government’s fumbling “response to the pandemic, which has killed more than 170,000 Americans in less than six months. But for a Black man like him, the spectacle of racist medical experiments is also great, he says.
Black Americans die from COVID-19 at about 2 times the rate of white people nationwide, according to the COVID Tracking Project, and despite representing about 13 percent of the population, they have accounted for 22 percent of coronavirus deaths in cases in what race and ethnicity are known. And yet, in a sign of deep-seated and well-deserved mistrust in the American medical institution, studies have consistently shown that Black Americans are less willing than other racial and ethnic groups to accept a vaccine for coronavirus.
A nationwide survey released earlier this month by researchers at Harvard, Rutgers, Northeastern and Northwestern Universities found that 52 percent of Black respondents are likely to take a COVID-19 vaccine, compared to 67 percent of white people, 71 percent of Latinos, and 77 percent of Asian Americans.
The Pew Research Center, which reported similar findings in June, found that Black Americans are generally more cautious about medical researchers and physicians, in addition to being more skeptical about experimental treatments. Fifty-fifty percent of Black adults surveyed by Pew had a most positive view of medical research scientists, compared with 68 percent of whites and 67 percent of Spanish respondents. An even smaller proportion of Black adults, 35 percent, expressed a “great confidence in medical scientists to act in the public interest.”
Black mistrust in health care and research stems from a long history of medical explosion and abuse. Nineteenth-century physician J. Marion Sims, the so-called father of modern gynecology, for example, developed his groundbreaking surgical tools and techniques by acting on enslaved Black women without anesthesia. In 1932, the U.S. Public Health Service launched the infamous Tuskegee study, a secret four-decade-long experiment in which hundreds of black men from rural Alabama were treated for syphilis without their informed consent so researchers could study the deadly disease Progression .
“The African American community has very, very important and historical reasons, including racism, segregation and experimentation, to be very distrustful,” said Dr. Joseph Betancourt, vice president and officer of chief equity and inclusion at Massachusetts General Hospital. “This is supplemented by the fact that African-Americans are significantly under-represented among physicians and researchers, so these communities do not have messengers.”
This mistrust extends to the current treatment of Black patients, who continue to have bias and inequality in medical care and access. Numerous studies show that Black Americans routinely receive less care than their white counterparts, in addition to experiencing prejudice from their medical providers and nasty stereotypes, including the false belief that Black people feel less pain.
“This is really about looking at the inequalities within our system and seeing who has access and who does not have access, and whose hospitals are the highest quality and how do certain people get care faster than other people?” said Dr. Bisola Ojikutu, a specialist in infectious disease at Mass. General and Brigham and Women’s hospitals. “It’s about structural inequality in our system.”
‘If you do not feel like all things are equal,’ she added, ‘why would you necessarily believe that new therapies and interventions are necessarily as effective as necessary for you to be accessible?’
Among public health researchers, the research data on black patients’ skepticism about a potential COVID-19 vaccine is not surprising. Black adults are consistently behind whites in immunization rates for other diseases, such as the flu, said Sandra Quinn, a professor and chair of the Department of Family Sciences at the University of Maryland, who investigates racial differences in acceptance of vaccines. In her research, Quinn found that Black people who believe they were treated fairly in health care settings were more likely to be on the flu vaccine.
“I think it’s important to recognize that people may be willing, and one of the things we’ll really need to be aware of is what health departments, government, and health care providers do to be reliable,” Quinn said. .
But the federal government’s response to the pandemic has not done much to boost confidence among communities of color destroyed by the virus, Quinn notes. Even the name of President Trump’s initiative to develop and distribute millions of doses of a COVID-19 vaccine by early 2021, Operation Warp Speed, has contributed to the public perception that security will be compromised in the rush to to deliver a fax, she said.
So what can healthcare providers do to restore the relationship with Black Americans, soured by centuries of medical abuse and mistreatment?
Michael Curry, deputy chief executive officer and general counsel for the Massachusetts League of Community Health Centers, said it was imperative that “trusted voices” in color-coded communities lead public information campaigns about the potential vaccine.
“We need to make sure that African Americans and others disparately affected by COVID-19 know that people are their advocates to ensure that medical efficacy and safety are ensured in which laboratories distribute these vaccines and what government- sanctioned faxes will be put forward, ”he said.
Ojikutu, who has worked closely with researchers to enroll Black and Latino participants in clinical trials for the COVID-19 vaccine through the Harvard University Center for AIDS Research, stresses the importance of recognizing the ‘bad history of’ the medical community, the justified distrust of Black Americans, and the ongoing problem of structural racism in health care.
“We need to think about ways to become more transparent in our behavior and activities so that patients and communities realize what is happening,” she added, especially when recruiting black and brown patients for clinical trials, another year-long battle for medical researchers .
Last year, Black patients represented just 9 percent of participants in trials for new drugs, according to the Food and Drug Administration, while 72 percent of participants were white.
“Be very clear about the research that is happening, what the pros and cons are, why they should do it or why they should not,” Ojikutu said. “And even in our conversations with patients, understand what we know and what we do not know.”
Pastor Dr. Ray Hammond, pastor of Bethel AME Church in Jamaica Plain, said he had already begun “laying the groundwork” for talks on the importance of taking the COVID-19 vaccine with its most black congregation. A former doctor of emergency medicine, Hammond said he had previously talked to interviewers about the need for diversity in participating in clinical trials and has held mobile services for vaccination in his church between services.
“What I discover is that there is both a warning, but there is also confusion about what faxes can and cannot do, and what the process looks like,” he said. ‘Some are deep and long lasting. Other elements I think are specific to this situation, but I think both can be patiently addressed. ”
In a recent webinar with other doctors on COVID-19 vaccination, Ojikutu recalled that he was asked by a community member, “Why should we trust you?” For the panel members, it was a sober moment.
‘I think everyone paused and said,’ Hmm. That is a difficult question. ” She said. ‘I’m not saying one should trust someone immediately. . . It is very clear that some level of mistrust is quite normal and highly anticipated. It is a normal reaction to a negative environment. But if someone says, ‘OK, let’s talk about this,’ we need to open the door to these discussions somehow. ‘
Deanna Pan can be reached at [email protected]. Follow her on Twitter @DDpan.
