By Glenn Ellis
COVID-19 is far, far from over. So we can’t just wait for it to go away. Regardless of how you feel about vaccines, it’s time to focus on what happening with the research and development.
Knowledge about the virus is evolving; the virus has shown that weather (hot or cold) doesn’t weaken it; this virus is one that scientists haven’t seen before; and as a nation, we are not doing what is necessary to stop the community spread and transmission of the viral infections.
With cases and deaths continuing to rise, the hopes of the entire nation are placed smack in the middle of the promise of a vaccine against this COVID-19 virus. Yet, we would all be remiss to not keep up with the recent announcements of progress, and what it means for you and your family. After all, how else can you truly make an informed decision when the time comes?
One of the areas of greatest concern with the vaccine developments efforts is that any vaccine that is ultimately developed, approved, and deemed to be safe, must work for everyone – young and old; Black and white. The evidence gathered from data during this pandemic indicates that “younger people of color die of coronavirus at twice the rate of white people, and that Black, Hispanic and Native Americans are hospitalized at four to five times the rate of white people in the same age groups,” according to a report in the Washington Post.
If these population groups are not included in the studies, how could we possibly know if the vaccine will have any positive effect on members of these communities?
We know from research by the American Heart Association that, “when trial participants are homogenous (e.g., primarily gender, race/ethnicity, or age group), findings may be skewed and result in a body of clinical knowledge that is not generalizable.”
Said another way, if the clinical trial for a drug, vaccine, or treatment doesn’t include representatives of the general population, the only thing that is certain is that not only is there is no way to know whether it will work for people not represented in the research, but it may actually be dangerous and unsafe.
A classic example of this takes us back to the HIV/AIDS epidemic of the 1980’s and 1990’s. At the time the first effective treatment was developed for the disease, it was based on a study conducted in white, gay men in San Francisco. Not only was drug effectiveness unknown to the Black community just across the bridge in Oakland, but since no Blacks were in the clinical trials, efficacy and safety were unknown in this population. Furthermore, having no representation in the clinical trials meant that any news, understanding, or awareness about the drug was greatly absent in the Black, gay community in Oakland.
So, you see, in spite of what is being heralded, now, about the promising news in the global race for COVID vaccine development, we are seeing that Black Americans are 13 percent of the population yet comprise less than 5 percent of clinical trial participants. For the Latino population in this country, things are even worse. Latinos are 18.1 percent of the population in this country, yet they make up barely 1 percent of clinical trial participants.
A major barrier to participation on clinical research is the lack of representation of Black and Brown people in the clinical research community. When it comes to the actual researchers themselves, 4.1 percent are Black, 4.4 percent are Latino, and almost 50 percent are white. As a component of the structural racism underpinning this pattern is the National Institute of Health, with a budget of NIH receives $41.68 billion in funding annually, of which 75 percent funds white researchers. There has seemingly been little done to disrupt this growing pattern of lack of inclusion of Black and Brown researchers. This has been the case for decades prior to the pandemic, and continues to be the situation today, as we navigate our very survival during this pandemic.
These are a few of the thoughts to ponder in order for us to fully prepared with enough complete and credible information about the COVID-19 vaccine when the time comes: Do you plan to get vaccinated against coronavirus?
A survey conducted in May 2020 by the University of Chicago found that if a vaccine against coronavirus becomes available to the public, 49 percent say they plan to get vaccinated, and 20 percent say they will not. Another 31 percent are not sure. Historical data indicates that due to some of the confounding factors outlined earlier in this column, realistically, we can expect this to be a real challenge.
This study confirmed what many of us already understand; Black and Brown Americans are more likely than any other population in this country to not plan to get the vaccine if it becomes available. Sadly, this attitude is understandable in light of historical experiences, mistrust, and a total lack of information and education.
Perhaps, some of that $41 billion that NIH is spending on the “Warp Speed” development of a COVID-19 vaccine should be modified, in its’ allocations and subsidies to the research industry, to include allocations for public education on the why’s and how’s of vaccine. It would be a first for this country.
Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Research Bioethics Fellow. He is author of Which Doctor? and Information is the Best Medicine. For more good health information visit: www.glennellis.com.