The COVID-19 vaccines are medical miracles, the fastest developed in history, thanks to a global scientific collaboration and all that modern science has to offer. But as Biden’s new Chief of Staff Ron Klain recently stated, vaccines are not effective until they are placed “into arms—that’s the hard process.” As New York City-based public health and health care professionals of color, we know that modern science historically and currently earns the mistrust of communities of color. Even though it is Black, Indigenous and People of Color (BIPOC) communities that have been most ravaged by COVID-19, reasonable hesitancy about taking the vaccine exists and must be addressed.
Black, Indigenous and People of Color experience a unique set of issues around vaccination hesitancy. We cannot expect them to take up new vaccines without addressing the racist experiences of abuse and mistreatment they have faced in the past—and continue to face today. In acknowledging racism, we can unite to empower people of color to make decisions about vaccination.
Black Americans, in particular, have a complicated history with the medical establishment. Once-lauded leaders of medicine, such as the 19th century gynecologist Dr. J. Marion Sims,
performed barbaric surgical experiments on enslaved Black women without anesthesia. The HELA cell line used in medical research was taken from a Black woman, Ms. Henrietta Lacks, without her permission or compensation. The U.S. Public Health Service Syphilis Experiment at Tuskegee withheld treatment without consent from hundreds of Black men infected with syphilis, leading to unnecessary suffering and death. Today, Black infants and mothers
are much more likely to die after delivery than their white counterparts, an example of hundreds of research studies that document racial disparities in treatment and worse outcomes for Black people in nearly every category of illness and medical care.
But Black people are not the only group with a set of historical and current grievances. Puerto Rican women, along with other minority, poor and disabled women experienced sterilization abuse through much of the 20th century. Latinx, Asian and other immigrant groups often lack linguistically appropriate health information and services, including about COVID-19 and COVID-19 vaccines.
People of color have many reasons to be wary. It is in this context that novel vaccines are being disseminated. So how will New York City address vaccination education and empowerment, especially among communities of color?
First, listen to empower rather than to convince.
Public health officials and health care providers must listen respectfully and empathically to the questions, concerns and sometimes conspiracy-theory fueled perceptions held by individuals in BIPOC communities.
Questions may range from the speed of vaccine creation and approval to baseline distrust of any form of vaccination. Added to these concerns is a tense political climate where public health recommendations such as mask-wearing and stay-at-home orders have been branded as partisan measures.
With accurate information, people will then be empowered to make the best decisions for themselves and their families.
In addition to informative advertisements on television, radio and social media, public health officials must engage in community outreach—for example townhalls and listening sessions—and patiently address each concern raised. This will be of enormous potential benefit both to participants in such discussions and in turn to their social networks, as they spread what they’ve learned.
Second, use trusted messengers.
Information about COVID-19 vaccines must come from trusted health care ambassadors within communities of color. One of the most impactful messengers about a vaccine is a person’s personal physician, and the New York chapters of the National Medical Association, the National Hispanic Medical Association, and other minority physician organizations have partnered with the New York City Department of Health and Mental Hygiene to inform their own members and community groups about COVID-19 vaccines.
Right now, health care workers are receiving the first set of vaccines. The rest of the country is watching their experiences closely, so all health care workers—including maintenance staff, medical assistants and food services employees—must be educated about vaccines to in turn educate their families and friends. Educational materials must be offered in multiple languages and at accessible reading levels.
Vaccine education ambassadors should include college, medical and graduate students, as well as community providers and organizers, and efforts are underway in New York City to train these ambassadors to then inform fellow students, families and communities.
Now that we have a COVID-19 vaccine, we cannot allow medicine’s history of racist blunders prevent Black, Indigenous and People of Color from accessing vaccines that could save millions of lives. While health care staff of color will work hard to get the word out that the COVID-19 vaccine is safe and effective, we will need each New Yorker to help us in these efforts by sharing accurate information about the vaccine and, in some cases, actively debunking disinformation or conspiracy theories.
The fight against COVID-19 will be a long one, and we cannot win this fight if any racial or ethnic group is left behind.
Stella Safo, MD MPH is an assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai and the co-founder of VoteHealth 2020.
Diana Torres-Burgos, MD MPH is the chair of the NYC Chapter of National Hispanic Medical
Association and Hispanic Health Advisor for the National Hispanic Health Foundation.
Glen W. McWilliams, MD is the president of the Manhattan Central Medical Society and the vice chair of the National Medical Association Region.
Susan Morales, MD is an associate professor of clinical medicine and director of the Diversity Center of Excellence of the Cornell Center for Health Equity.