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Multiple COVID-19 vaccines are now authorized for emergency use, but uncertainty lies ahead.
Several new studies show that older Americans, especially Latino and Black adults, are skeptical of the safety and efficacy of a COVID-19 vaccine.
This mistrust concerns health care officials, as a vaccine is key to controlling the pandemic.
“Effective vaccines will be crucial to getting this pandemic under control and preventing serious illness and death from COVID-19, especially among people over 50 and those with underlying health issues,” said Dr. Preeti Malani, the poll’s director and a specialist in geriatrics and infectious diseases at Michigan Medicine, according to MarketWatch.
As drugmakers continue to develop and implement vaccines, public health officials must work to restore trust with Latino and Black communities.
UPDATE 1/5/21: As new COVID-19 vaccines are developed and implemented, Latino experts are sharing new ways to address cultural issues to reduce vaccine hesitancy among Latinos.
UPDATE 1/11/21: A study on Mexican adult men’s vaccine hesitancy showed that reasons for avoiding vaccination can be due to lack of money, time, not enough information about a vaccine.
About the COVID-19 Vaccine Hesitancy Studies
Several recent studies have measured Americans’ hesitance to taking an eventual COVID-19 vaccine.
The University of Michigan National Poll on Healthy Aging asked a national sample of adults ages 50–80 about their willingness to take a COVID-19 vaccine.
They found several key findings:
- 34% of adults were unsure about or don’t want to get the vaccine
- 86% of Latinos and 93% of Black people said they would not want to receive a vaccine as soon as possible
- 46% of adults would like to wait to get the vaccine until others receive it
Another study by the COVID Collaborative, a nonprofit coalition made up of Langer Research Associates, Unidos US, and the NAACP, measured hesitancy about the safety of a COVID-19 vaccine in Black and Latino communities.
Their findings showed:
- 86% of Black people and 66% of Latinos do not believe the vaccine will be safe
- 82% of Black people and 60% of Latinos do not trust that the vaccine will be effective
- The majority of Latino (66%) and Black people (72%) are likely to trust their community leaders and health care providers when it comes to a vaccine
In Texas, a recent study by Episcopal Health Foundation that 63% of Texans are likely to take the vaccine as of December 2020, compared to 59% who were likely in September. This indicates that overall hesitancy may be decreasing in this largely Latino state, but hesitancy remain among certain groups.
These results are worrisome to public health officials, especially as Latino and Black communities have been hit the hardest by COVID-19.
In order for Americans to reach a safe level of immunity, the majority of people must take the vaccine.
It will be vital for public health officials to educate the public on the safety and efficacy of a COVID-19 vaccine and allow for distribution through local communities.
COVID-19 Vaccine Developers Make Headway
The results of these surveys become increasingly important in the next month as the development of a COVID-19 vaccine continues.
Several drugmakers have made huge strides in developing a safe and successful vaccine.
Moderna, Pfizer, and AstraZeneca have announced successful vaccine trials and are now in the process of receiving authorization from the Food and Drug Administration to use the vaccine.
The FDA gave Pfizer an “emergency use authorization” on Dec. 11, 2020. Doses began being shipped on Dec. 13.
The FDA also gave Moderna emergency use authorization on Dec. 18, 2020 and began being shipped that weekend.
“[Moderna] concludes the vaccine is 94% effective — and strongly protects against serious illness. Based on these latest findings, the company plans to submit an application for emergency use authorization to the Food and Drug Administration today,” according to NPR.
AstraZeneca also announced encouraging progress with their vaccine trial, but due to some conflicting results on the efficacy and dosage, the drugmaker has not yet sought FDA approval.
Once one or more of these vaccines are approved by the FDA for emergency use, the companies can begin distributing vaccine doses across the country.
The COVID-19 vaccine is expected to go to the most vulnerable groups before being distributed to the general population.
“The first shots of the two vaccines are likely to go to certain groups, including health care workers; essential workers like police officers; people in other critical industries; and employees and residents in nursing homes,” according to The New York Times.
Although much depends on the FDA’s approval of the vaccines, some experts predict the first doses of a COVID-19 vaccine could be distributed to health care workers as early as late December 2020.
Encouraging results from vaccine developers is good news. But a vaccine is only helpful if the majority of Americans will take it.
Skepticism about vaccine safety may prevent people of color from taking a vaccine.
Mistrust of COVID-19 Vaccine Stems from Discrimination
Why are people of color more skeptical of a COVID-19 vaccine than white people?
A study analyzing why Mexican adult men do not get vaccinations showed that it could be due to a variety of reasons.
“Among the reasons given for not getting vaccinated were lack of time or money, feared injections and side effects, insufficient information, interest or motivation. Others did not get vaccines because they perceived themselves to be healthy and did not feel sick,” according to researchers in the Hispanic Journal of Behavioral Sciences.
It may also be due to historical trauma from events, such as the Tuskegee Experiment.
“Black Americans still bear the psychological scars of the Tuskegee Syphilis Study that began in the 1930s and lasted through the 1970s. Researchers on that study withheld treatment from uneducated Black men who had syphilis, and never told them they had the disease. Distrust of health care workers and clinical trials among Black Americans prevails to the present day,” according to MarketWatch.
Unfortunately, these instances of racism are still happening today.
Implicit bias has led to many disparities in how doctors treat people of color, such as:
- Latino men are less likely to receive treatment for high-risk prostate cancer than white men. Uninsured non-Latino white men were 37% less likely to receive definitive treatment than those with insurance, and uninsured Latinos were 66% less likely to undergo definitive treatment compared to their insured counterparts.
- Latinas and other pregnant women of color face discrimination from healthcare providers. This is due not only due to their race, but their socioeconomic background as well.
- White male doctors are less likely to prescribe pain medications to Black patients than white patients.
- Latino and Black patients are less likely than white patients to receive prescriptions for certain medications in an emergency room.
When people of color experience instances of discrimination or bias in the doctor’s office, they become mistrustful and less likely to seek preventative care.
All of this impacts Latino and Black people’s willingness to get a COVID-19 vaccine.
How Can Public Health Officials Rebuild Trust ahead of the COVID-19 Vaccine?
A COVID-19 vaccine can help save lives and may be the only way we can return to normal life.
In order for that to happen, public health officials must work to promote safety and efficacy of an eventual vaccine in a way that is specific to communities of color.
For Latino communities, that means uplifting Latino community leaders.
“Because of the positive correlation between Latinx identity and vaccine intention, and because Latinx elected officials in one’s community are more likely to be trusted than white elected officials, efforts to promote uptake should leverage voices from within the Latinx community and should reinforce the notion that vaccination is a responsibility that helps the Latinx community at large,” according to the COVID Collaborative study.
For Black communities, that means acknowledging harm done in the past.
“The negative correlation between Black identity and vaccine intention suggests that education efforts should work to acknowledge the harm that historical vaccination efforts have caused (notably, the Tuskegee Syphilis Study), while making pointed connections between core values within the Black community and the benefits of vaccination. Specifically, efforts should aim to highlight how vaccination can save Black lives and strengthen Black communities,” according to the COVID Collaborative study.
It will be vital for public health officials to highlight how a vaccine will strengthen all communities, specifically communities of color who have been severely impacted by COVID-19.
Cultural humility can be the key to improving this relationship, says Dr. Eliseo J. Pérez-Stable, director of NIH’s National Institute on Minority Health and Health Disparities.
“Crucially, to gain the trust of many different groups in the U.S., public health messengers must also demonstrate not just cultural awareness, but ‘cultural humility.’ Even well-intended programs sometimes miss the mark,” said Pérez-Stable, according to NPR in January 2021.
This is why public health guidance must come from “messengers who live, work, and worship in the same communities,” according to Pérez-Stable.
“These workers are leading outreach and engagement efforts in ethnic and racial minority communities disproportionately affected by the virus” reports NPR.
Transparency and honest messaging will also be important for increasing trust from those who are skeptical.
“Our findings point to a strong need to communicate effectively and transparently about how well the vaccines work, the safeguards built in to protect the safety of recipients, and the public health importance of widespread vaccination starting with priority groups,” said Dr. Malani, according to MarketWatch.