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How to overcome vaccine distrust among Black Americans

How to overcome vaccine distrust among Black Americans
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Blacks are 60 percent less likely than other racial groups to say they will definitely or probably take the COVID-19 vaccine. Here are recommendations for how America should address this gap to properly ensure that the group hardest hit by COVID-19 gets the vaccine they so desperately deserve and need.

Acknowledge that medical distrust is rational

Blacks have less trust in medical research, scientists and doctors than other racial groups. This is a rational response that needs to continue to be acknowledged. Knowledge about the Tuskegee Syphilis Study, where 400 Black male farmers were untreated after contracting syphilis, has a direct impact on lowering health care utilization among Black men. Though there was a financial settlement and a public presidential apology, its legacy lives on and drives medical mistrust. 

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Similarly, the legacy of Henrietta Lacks lives on in the minds of Black people and the physical bodies of many of us. Lacks, whose cells were stolen from her without her knowledge, died at 31 of cervical cancer. She would have turned 100 in 2020. Lacks’ cells, commonly known as HeLa cells, are able to reproduce indefinitely and have been used to make historic discoveries in cancer, infectious disease, biotechnology and immunology. 

So, what has changed since the mid-1900s that should prevent the two incidents above, and other lesser known scientific atrocities — like the Terre Haute prison experiments and Guatemala syphilis experiments — from occurring? Policy regulation and transparency are key. 

Continue transparency about vaccine 

Following the atrocities mentioned above, the federal government established the Office for Human Research Protections, which is housed in the U.S. Department of Health and Human Services (HHS), to provide ethical oversight about biomedical and behavioral research. Universities have Institutional Review Boards (IRB) that ensure the protection and rights of research participants and prevent professors at universities such as Johns Hopkins and Tuskegee from conducting unethical and illegal research. As a professor, I can say that members of IRB take their positions very seriously. There are a series of stringent protocols that must be followed and there are consequences for not doing so. I have confidence about the effectiveness of regulation for scientific and medical research.

For COVID-19, a diverse group of scientists, medical doctors and public health practitioners were assembled to ensure that the vaccine was efficacious across racial groups. In particular, Dr. Kizzmekia Corbett, who is a Black woman, is noted as one of the lead scientists at the National Institutes of Health (NIH) in developing the Moderna vaccine. In Moderna and Pfizer/BioNTech clinical trials, Blacks represented about 10 percent of the more than 50,000 study participants. The percentage of Black participants provided a large enough sample to ensure similar effectiveness of the vaccines across racial groups.  

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Correspondingly, it is important to note that vaccines save lives. Vaccines have decreased death rates over 90 percent for smallpox, polio, measles, mumps and rubella. Receiving the flu shot reduces the likelihood of hospitalization by 80 percent. We should expect the COVID-19 vaccine to have a similar impact. COVID-19 vaccines are reporting over 90 percent effectiveness rates in preventing the contraction of the virus.  

Ensure effective social media messaging 

With COVID-19 restrictions, face-to-face communication is limited. The normal social interaction people have at work, church, or the gym is obsolete in many ways. This is coupled with an increasing group of people who do not watch cable or local news. They receive much of their information from social media. Research that I conducted with Alyasah Sewell, Keon Gilbert and Jennifer Roberts examined the role that mobile phone technology plays in health-seeking behavior among Blacks. We found that Blacks with more technological devices are more likely to rely on the Internet as a go-to source of health information. 

Accordingly, social media messaging about the COVID-19 vaccine is essential. The same way people did Instagram lives and social media collaborations to understand why racial disparities in COVID-19 and police brutality exist is the same approach that must be taken to level up and level set public knowledge about the vaccine. In addition to medical professionals and politicians, the public needs to see celebrities, entertainers and athletes discussing the importance of the vaccine and actually taking the vaccine. While Americans are conscious of people skipping the vaccine line, the upside may pay health dividends. 

 

Leverage Black community gatekeepers and pillars

Besides celebrities, it is important for community gatekeepers and trustees to be leveraged to establish trust in the vaccine. Politicians are important. However, there is a distrust of the government. It is important to leverage prominent and local pastors and clergy, popular barbers and hairstylists, well-known small business owners and hometown heroes, like first responders, veterans and athletes. They should be shown on local news and on social media discussing the vaccine and receiving their vaccine shots. Information will then be shared with congregations and clients.

It is also important to think deliberately about the location of vaccine dissemination. Hospitals may not be ideal in some communities. Besides some Blacks choosing to avoid hospitals because of previous mistreatment, hospitals do not exist in some communities. Instead, churches, community centers, barbershops, hair salons, schools and senior centers are ideal places. Research that I conducted with Sewell found that Black people who attend Black Protestant churches are more likely to utilize health care. My research on physical activity found that places like barbershops and hair salons help to increase exercise because there is a level of comfort to be vulnerable. These businesses and organizations are some of the first Black community pillars that operated as beacons of hope and provided Black people some forms of financial and cultural freedom. They are hubs of information, truth telling and trust building. No matter where Black people live from Washington, D.C., to Bloomington, Ind., they can normally find a Black church, barbershop or hair salon. 

Bottom line: trust must be earned. To overcome problematic political narratives and social media falsehoods, vaccine implementation and marketing must go local. 


Dr. Rashawn Ray is a David M. Rubenstein fellow at The Brookings Institution and a professor of sociology at the University of Maryland. He is on Twitter @SociologistRay.