COVID-19 Vaccination Hesitancies

Studies have shown that COVID-19 disproportionately impacts the Black community and other minorities in the United States. These trends have roots in the country’s systematic racism and discrimination towards Black people. Today, as the widespread dissemination of the COVID-19 vaccine begins, many individuals have valid concerns and hesitancies. We cannot address the current issues with vaccine uptake without acknowledging the horrors of the past.

The History of Racism

In a recent survey made by the National Association for the Advancement of Colored People (NAACP), only 18% of Black respondents indicated they would be getting the vaccine. The racial gap in vaccination attitudes is in-part a result of the past historical atrocities of experimentation (Tuskegee, Henrietta Lacks, and James Marion Sims) that instilled distrust amongst the Black community towards the health care systems.

There has never been any period in American history where the health of                                                            Blacks was equal to that of whites. [The] disparity is built into the system 

  Evelynn Hammonds, New York Times

Racism Today

While understanding past traumas help to interpret various attitudes and behaviours, focusing solely on these events ignores the everyday racism Black people still face today. Highlighting only the atrocities in history provide a false narrative that racism is a concept of the past — when in fact, Black Americans experience discrimination to this day.

Research indicates that Black patients will go out of their way to be seen by a Black physician because their resulting health outcomes are often better (Bajaj & Stanford, 2021). Physician-patient racial concordance significantly impacts care delivery, and such concordant messaging was proven to be immensely valuable during the COVID-19 pandemic. Alsan and colleagues (2020) reveal that watching videos delivered by a Black physician increased information-seeking behaviours among Black patients. The NAACP also supports this finding by noting Black Americans are twice as likely to trust messages delivered by someone of their own racial/ethnic group. Hence, the identity of the health professional translates into the trust and attitudes of the recipient, which is a meaningful relationship to keep in mind during vaccine-rollout.

Misinformation

The internet creates a space for misinformation, and it becomes difficult for individuals to differentiate between facts and myths — a phenomenon termed infodemic. Many individuals do not have a clear understanding of how vaccines work (McLernon, 2021) and this lack of knowledge makes them prime targets for conspiracies and myths. To combat the spread of misinformation, public health professionals must shift their strategies and meet people where they are. Social networking sites such as Facebook, Twitter and Instagram are prime locations to engage with the public and tackle misinformation. Many health institutions (e.g. The World Health Organization) have active social media accounts with millions of followers. Social media has proven to be an effective health education tool and is where the future of health promotion lies. Local and national campaigns need to incorporate the use of digital spaces into their strategic plans.

It is important to recognize that while these popular platforms are helpful for education, not everyone is engaging online. As Allison Matthew (Huang, 2021) notes, health promotion efforts need to meet people at a level of communication that is the most convenient for them. For some individuals, this may be through social media, but for others, it could be through television, mail or telephone.

Building Trust

Increasing Black representation in public health is important; however, the reality is only 5% of physicians in the United States are Black (Bajaj & Stanford, 2021). Hence there is a need for efforts to be directed at the community level. Beyond Black doctors, health promotion strategies should seek support from community leaders in churches, sororities, and local organizations. The challenge is not only in education and overcoming vaccine hesitancies, but in building trust for the health care system as a whole.

Strategies of Action

There is a need for Black physicians and healthcare professionals to be at the forefront of current COVID-19 vaccination efforts. Highlighting the involvements of Black health leaders is critical in establishing trust. Dr. Kizzmekia Corbett was part of the Moderna vaccine development team and a lead scientist for COVID-19 vaccine research at the National Institute of Health (Scripps National, 2020). She notes that people have the right to be hesitant and that rebuilding trust in medical institutions will take time (Scripps National, 2020).  

In addition to ensuring Black representation in public health and the scientific community, there also needs to be focus directed towards effective communication strategies. Utilizing different channels and providing information that is accessible and understandable is crucial to increasing vaccination rates.

References

• Alsan, M., Stanford, F. C., Banerjee, A., Breza, E., Chandrasekhar, A. G., Eichmeyer, S.,
• Goldsmith-Pinkham, P., Ogbu-Nwobodo, L., Olken, B. A., Torres, C., Sankar, A.,
• Vautrey, P. L., & Duflo, E. (2020). Comparison of Knowledge and Information-Seeking Behavior After General COVID-19 Public Health Messages and Messages Tailored for Black and Latinx Communities : A Randomized Controlled Trial. Annals of internal medicine, M20-6141. Advance online publication. https://doi.org/10.7326/M20-6141
• Bajaj, S. S., & Stanford, F. C. (2021). Beyond Tuskegee — Vaccine Distrust and Everyday
• Racism. New England Journal of Medicine, 384(5), e12.
• https://doi.org/10.1056/nejmpv2035827
• Huang, P. (2021). Black Doctors Use Social Media To Share Accurate Information About
• COVID-19 Vaccine. Retrieved March 21, 2021, from NPR.org website: https://www.npr.org/2021/01/01/952716747/black-doctors-use-social-media-to-share-accurate-information-about-covid-19-vacc
• McLernon, L. (2021). Experts seek to allay COVID vaccine hesitancy in Black Americans.
• Retrieved March 21, 2021, from CIDRAP website: https://www.cidrap.umn.edu/news-perspective/2021/02/experts-seek-allay-covid-vaccine-hesitancy-black-americans
• Scripps National. (2020, December 11). Vaccine “developed by an African American woman”,
• says Fauci responding to concerns, mistrust. Retrieved March 21, 2021, from KMGH
• website: https://www.thedenverchannel.com/news/national/coronavirus/vaccine-developed-by-an-african-american-woman-says-fauci-responding-to-concerns-mistrust
• Sharpe, S. (2021). Biden spoke about the COVID vaccine at NIH, and Kizzmekia Corbett was
• there to brief him. Retrieved March 21, 2021, from Raleigh News & Observer website:
• https://www.newsobserver.com/news/coronavirus/article249209180.html