Mistrust, lack of access cause COVID-19 vaccine gaps

Dr. Omari Hodge practices family medicine in Gainesville, Ga. These days, he spends a lot of time sharing information and answering patients’ questions about the COVID-19 vaccines. Hodge said many of his older African American patients “don’t necessarily trust the vaccine, because they were alive during some of the times when science wasn’t as kind … to them.”

States and cities are working to get the vaccine to minority communities hardest hit by COVID-19. But a lack of trust and barriers to access are slowing those efforts.

“As a black male, when I first heard about the vaccine … there was some skepticism and doubt,” Hodge said. Wanting to set an example for his patients, he researched the available vaccines and then decided to get the shots. Now he empathizes with nervous patients and tells them, “Even in the face of fear, make the best decision you can for your health and the health of those around you.”

Data from the U.S. Centers for Disease Control and Prevention show that 9.7 percent of the U.S. population was fully vaccinated as of Tuesday, while 18.4 percent had received at least one dose. So far, black and Hispanic people have disproportionately lower rates of vaccination than whites while having more than their share of COVID-19 cases. By late January, 17 states reported vaccine data by race, revealing the disparity: In Mississippi, where an estimated 37.8 percent of the population is African American, black people had 15 percent of vaccinations, 38 percent of COVID-19 cases, and 42 percent of deaths. By March, most states were publicly sharing racial data, and the trend became even clearer.

Several factors may contribute to the disparity. Impoverished, majority-black or Hispanic neighborhoods have fewer pharmacies, hospitals, and other sites for vaccine distribution. Residents must travel further to get immunized, which is difficult for elderly people or those without cars. Inflexible jobs prevent some from taking time off to get a vaccine. Many states have used online scheduling to coordinate appointments, but unreliable internet access can put that out of reach. For the Hispanic community, language barriers can hinder communication about the vaccine’s availability.

In Texas, Austin Public Health aimed to place distribution sites on the east side, where more of the city’s black and Hispanic populations live. In mid-February, Chicago Public Health held a vaccination event at a high school in a Latino neighborhood. They set up signs in Spanish, knocked on doors, and texted and called instead of relying on the internet sign-up form. They vaccinated nearly 2,000 local residents.

Even with readily accessible distribution sites, mistrust of the medical establishment keeps some African Americans from wanting to get vaccinated. A December 2020 Pew Research survey found that only 42 percent of black Americans said they would take a vaccine, compared with 63 percent of Hispanic and 61 percent of white adults.

Among reasons for that lack of trust: Currently, three times more black women die during pregnancy and childbirth than white mothers. Studies have shown white medical students regularly hold misconceptions about black people’s physiology, leading to disparities in pain treatment. Between 1932 and 1972, the U.S. Public Health Service conducted the infamous Tuskegee Study of Untreated Syphilis in the Negro Male, an experiment that tracked the progress of syphilis in more than 400 black men. Researchers withheld information from participants about the disease, the study, and, later, the newly available treatment. During the experiment, men died and went blind, but researchers only provided placebo treatment so they could study the men’s cadavers.

To fight the mistrust, some public health departments are working with clinics, churches, or other community organizations. In January, Ebenezer Baptist Church in Oklahoma City distributed 830 shots, and more than 90 percent of those went to black people, The Hill reported. Pastor Derrick Scobey explained why his church reached more black locals than previous city efforts.

“These are pastors typically that baptized that person, that can counsel that person, that married that person, that eulogized that person’s mother or father,” he said. “The trust is just there.”

Hodge said Christian doctors can show love to patients by empathizing with their concerns, addressing them, and giving hope. “Sometimes through prayer, sometimes through an encouraging word, sometimes through vaccines or other treatment,” he said. Doctors should “learn to see God’s hand in all those ways.”