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Mistrust, lack of access cause COVID-19 vaccine gaps

Groups work to deploy shots to minority groups


Dorrit Crawford receives the first dose of the coronavirus vaccine at a pop-up COVID-19 vaccination site at the God’s Battalion of Prayer Church in New York. Associated Press/Photo by Mary Altaffer (file)

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.”


Charissa Koh

Charissa is a WORLD reporter who often writes about poverty fighting and prison reform, including profiling ministries in the annual Hope Awards for Effective Compassion competition. She is also a part of WORLD's investigative unit, the Caleb Team. Charissa resides with her husband, Josh, in Austin, Texas.

@CharissaKoh

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Laura W

I went and watched the TED talk, and what the speaker is comparing to an "operating system" is the whole structure of DNA to RNA to proteins, not the mRNA itself. He explains the concept pretty quickly in the video, so maybe a more detailed rundown would help? DNA is the double helix we're all familiar with--reams of data contained in our chromosoms that describe who we are, biologically. DNA stays in the cell nucleus, protected and separate from most of the cell. But the only way proteins can be made is if those instructions make it out of the nucleus, so that's where mRNA comes in. Through a complicated process of regulatory controls, the cell determines that more of a given protein is needed, so a small portion of DNA is unwound in the nucleus and is copied as RNA. This RNA is known as messenger RNA (mRNA for short) because it exits the nucleus and takes the recipe for the target protein out to the factories of the cell. These recipes break down rather quickly under normal conditions, so the cell is always producing new mRNA targeted to its needs at the moment. If foreign mRNA is introduced to a cell, either by a vaccine or a wild virus, the cell will produce those proteins too, but the DNA remains unchanged (except in the case of retroviruses such as HIV). And yes, the immune system will likely respond by killing that cell. The body has a lot of cells to spare. It's hard to get good estimates on these things, but we're talking on the order of millions of new cells produced every second, just considering red blood cells: https://www.healthline.com/health/number-of-cells-in-body#daily-production

Now, there are people who want to edit the DNA itself for purposes such as curing genetic diseases. I do think there are some major moral and philosophical questions with this route, and it's not something that should be done lightly. (Especially in the case where this alters the germ line for future generations.) However, mRNA vaccines are doing something much more limited and temporary. There is NO change to the DNA, and the injected RNA goes away within a matter of hours after it has done its job of producing proteins. The whole process does no more genetic engineering than any wild virus does when it gets inside a cell and turns it into a virus factory. The goal of an mRNA vaccine is to give the body a good simulation of that attack so it won't be overwhelmed by the real thing.

Laura W

Hannah, on reread, I see that my earlier comment was unintentionally ambiguous, so I have edited for clarity. In quoting it, you inadvertently edited out a key point of my explanation--the part where I mention that you only get your cells making the real virus if the real virus gets in, not the vaccine. Are you familiar with how viruses work in general? Any real virus will inject its genetic material into your cells, hijack your cell machinery to produce millions of copies of itself (killing the cells), and only stop when your immune system tracks down every last copy and destroys it, or when you die. With the vaccine, the "off switch" is that unlike with the real virus, the vaccine RNA doesn't produce more copies of itself (just a protein that can't replicate itself), so when they're gone, they're gone. (RNA isn't very long-lasting to begin with, and the immune system can also target it as an intruder.)

HANNAH.

Between December 14 2020 and February 19 2021, the Vaccine Adverse Reporting System (VAERS) reported 966 deaths following covid-19 vaccinations by Moderna and Pfizer. (The number is now over 1500 deaths.) The death rate of the COVID-19 mRNA vaccines is much higher than that of the flu vaccine in 2019. “An infectious disease expert in France, Dr. Christian Perrone, filed a complaint against mRNA vaccines in Europe stating that they are ‘not vaccines. They are gene therapy products. They inject nucleic acids that will cause our own cells to produce elements of the virus.’ ”

Laura W

It's not ideal, but there is a lot of moral distance between a cell line used for vaccine testing or development today and the initial decision to take cells for research from the body of a baby killed by abortion. I understand why that might still be too close a connection for some people, but I would hope those people would then instead take every other precaution they can to protect those around them.

So far, it looks like the risks from the vaccines are minimal--I sure didn't have any trouble with mine. https://worldandeverything.org/2021/03/nuisance-side-effects-but-no-serious-risks/ There are always some unknowns with any new technology, but keep in mind that we don't know all the long-term effects of actually getting infected with the virus either. There have been some reports of very old and frail patients reacting poorly to the vaccine, so that might be a reason to wait on vaccinations for the very oldest. But then again, that's the group that also has the biggest risk of dying, or at least ending up in the ICU, if they do get infected, so maybe that's still the greater risk. If they can't be vaccinated (yet), that just means it's all the more important for those of us who can be to get our shots and protect them.

Gregory P

Many Chritians and pro-(human)life people have concerns about the vaccines' development and testing with cells from developed from aborted fetuses.  Also some have concerns about vaccines that have been developed so quickly, and have not had much time to have long term effects evaluated.  And deaths have oocrred to people after they have been vaccinated.  Furhtermore, the numbers of active cases and serious or critical cases of COVID-19 have been dropping for weeks in the United States.  People under age 55 have shown a very low percentage risk of death from COVID-19, and even for the most vulnerable (over 85) only about 13.3% of deaths are attributed to COVID-19.