By Glenn Ellis
“Let’s change the narrative around vaccine hesitancy in Black communities to focus on institutional trustworthiness.”
-Uché Blackstock, MD-
Well, here we are, 2020 has come to an end – the virus is raging; vaccines are finally here; and Black folks are once again filled with mistrust. As a result, the rollout of the vaccine is bringing an unprecedented wave of media stories with Blacks across the spectrum taking the vaccine.
Once again, during the course of this pandemic, Blacks are the center of attention. We’ve been front and center through the early testing; the inability to “work from home”; the chronic diseases; the lack of full participation in the clinical trials; and now vaccine hesitancy.
It is clear that in the interest of public health, Blacks must take the vaccine. Yet, the record is indicating otherwise. A recent Kaiser study found that 35 percent of Black Americans would probably or definitely not get the vaccine if it was determined to be safe by scientists and widely available for free. But is messaging that implies that we just need to be convinced that what we think, just ain’t so. Maybe we’re getting it all wrong, maybe we should be addressing institutional trustworthiness instead of vaccine hesitancy.
Afterall, there has not been a single period throughout the entire medical history of this country when the overall experiences, treatment, and perception of Blacks has been anything but dark and painful. The canvas is filled with atrocity after atrocity. All emanating from a nation built on laws and principals grounded in racism and inequality. Some want to conveniently forget that our healthcare system is a cog in the wheel of structural racism that is America. That’s why it would seem plausible that in order to address vaccine hesitancy in Blacks, you just focus on their mistrust of vaccines.
Closing out 2020, Blacks, as does everyone else, have a long road ahead. Widespread public distribution of the vaccine won’t likely take place until late spring or early summer 2021; so you’ll have some time to think about your individual decision to get the vaccine. But make no mistake, you’re gonna have to make a decision.
Dr. Rueben Warren, Director at The National Bioethics Center at Tuskegee University says, “We need to know more, so we can do more.” Most of us will never understand the complexities of the science around the vaccines. We may never believe that they are safe and effective. But we can become trusting of those whom our history has told us otherwise. We can listen to honest acknowledgement of our voices and our experiences. What we can’t do is be expected to ignore the reality many of us have lived, generation after generation; lived experiences and stories that are etched in our cultural consciousness.
We can’t be expected to compartmentalize in that way. Ignoring the lack of institutional trustworthiness behind the mistrust, and the resulting vaccine hesitancy is dismissive, and can in no way be received by Blacks as sincere.
We are going into 2021 with full knowledge that there is a long road ahead. This is a problem that is threatening the lives of all of us and will require all of us. Black folks find out everything you need to know I order to make an informed decision. America, give Black folks the access and information to make it possible for all of us to get to the other side of COVID-19.
Let me close with a bit of information about the virus/vaccine, etc.
The vaccine works through a technology called, messenger RNA (mRNA). It uses the “messenger” to train the immune system to attack the spike on the COVID-19 virus. Then, the immune system continues, and learns to attack other parts of the spike, creating full immunity. That is why experts remain convinced the vaccine will work against this variant.
There is also growing concern about the mutation of the virus. This is common in viruses in general, and certainly in other members of the coronavirus family; and it happens quickly. Remember, this is a virus that evolved in animals and made the jump to infecting people around a year ago. In barely a year, it has been picking up around two mutations a month. If you took a sample today and compared it to the first ones from Wuhan in China, there would be around 25 mutations. COVID-19 is still trying out different combinations of mutations to properly succeed at infecting humans. All is not lost; we have seen this happen before with other mutations during viral epidemics. Mass vaccinations put’s pressure on the virus to change in order to infect people who have been immunized. This is why we have to regularly update other vaccines, as we do for flu, to keep up with the mutations.
But the bigger problem we’ll face moving into the New Year will be addressing institutional trustworthiness. The pandemic will be here for a while; others are sure to follow; the toll on the healthcare system will present even greater challenges for equitable allocation of resources; and the exacerbation of the social determinants of health.
2020 has used the COVID-19 pandemic to show us, undeniably as a society, what it will take for us to go from looking for solutions to address issues of mistrust to come from vaccines to looking at issues of institutional trustworthiness.
Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Fellow in Research Bioethics and Writing. He is author of Which Doctor? and Information is the Best Medicine.
For more good health information visit: www.glennellis.com.